Baduanjin mind-body exercise for cancer-related fatigue

Baduanjin mind-body exercise involves a set of gentle aerobic exercises involving mental focus with controlled breathing while performing a sequenced set of coordinated physical movements. According to the American Sports Medicine Association and the American Centres for Disease Control and Prevention, Baduanjin MBE is a low-intensity exercise. Baduanjin mind-body exercise program is in addition to a participant’s standard care. There are no changes to a participant’s usual care practices. Participants commencing the exercise program will have a meeting with a research team member (in week 0), who will organise delivery of the information pack and resources in advance of the participant commencing their Baduanjin mind-body exercise in Week 1. An introductive session (30-minute) is held for participants individually, which is comprised of an introduction to the Baduanjin mind-body exercise program, guidelines for performing the exercise movements, instructions related to the Exercise Logbook to record the completion of the daily exercise routine. The picture-based Instruction Handbook (brochure) displaying the movements and Baduanjin mind-body exercise online demonstration video link will be provided to the patient in Week 1. The picture-based Instruction Handbook (brochure) and Exercise Logbook are sent to the participant by email (only mailing hard copies as required). The picture-based Instruction Handbook is produced by the research team, the demonstration video is accessible via a YouTube link (https://youtu.be/F5OtK935Y8w). This is an information session (in week 0), no instructions on how to perform the exercise is given until one week after (in week 1), that is, the participants are required not to commence their Baduanjin mind-body exercise. After receiving the study information pack and resources, a Baduanjin mind-body exercise instructor (who is a member of the research team) will organise a Zoom meeting to meet with each participant to explain and demonstrate the eight movements and natural breathing methods that comprise the Baduanjin mind-body exercise program. Using the Zoom App, participants will be invited to watch the Baduanjin mind-body exercise demonstration videos which explains how to perform the exercise movements where the instructor will explain and demonstrate the eight movements and natural breathing methods with the participants. This is done before commencing the first exercise session in the program. In addition to self-guided practice, the participants will be asked to join in a coached Zoom exercise program with an instructor, either in the morning or afternoon or both sessions at their own choice throughout the intervention period (8 weeks). Participants will be requested to practice Baduanjin mind-body exercise at least 2 sessions per day, 6 days per week with each session lasting about 17-20 mins for 8 weeks. Missed sessions will not be considered as a protocol deviation. The Baduanjin mind-body exercise sessions via Zoom are instructed by members of the research team who have at least two years' experience in the practice of Baduanjin mind- body exercise. If participants miss out on any Zoom sessions, they can watch the demonstration video as a reference. Participants will be asked to record their daily Baduanjin mind-body exercise schedule in the Exercise Logbook. Recording this in Exercise Logbook will take approximately 2 minutes each session. This will happen twice daily, 6 times per week for 8 weeks. Weekly telephone calls will be performed by a research assistant to see how the participants are progressing and engaging with the Baduanjin mind-body exercise program. The weekly phone calls will also discuss any unexpected side effects or adverse events that might be related to the exercise. Finally, participants are asked to complete two (2) questionnaires at baseline (week 0) as part of the study intake process, and again at the end of week 4 and week 8 of the exercise program. These questionnaires are the brief fatigue inventory (BFI) and the PROMIS-29v2.0. The BFI measures fatigue. The PROMIS-29v2.0 is a patient reported outcome measure used by health services in NSW. Together, these will take 5-10 minutes to complete online and can be accessed using secure links that will be emailed to participants. There is also the Credibility and Expectancy Questionnaire (CEQ) which has four questions and takes one minute to complete. Two questions are completed before entry into the study (week 0), and two at the completion of the Baduanjin mind-body exercise program (week 9). One week after completing the Baduanjin mind-body exercise program (in week 9), a study team member will contact participants by phone for a final time. This is to check on the participant and see if there have any reports or adverse experiences. Participants will also be asked to complete for the final time the BFI and the PROMIS-29v2.0, along with the final two questions from the CEQ. This also includes two open questions for participants to provide feedback.