Abstract
Objective:
This study aimed to evaluate the effect of vibroacoustic therapy combined with Baduanjin exercise on cardiac function and psychological states in patients with coronary heart disease (CHD).
Methods:
Clinical data of 200 CHD patients from June 2022 to June 2024 were retrospectively analysed. The patients were divided into a Baduanjin group (n = 110; Baduanjin exercise only) and a combined group (n = 90; vibroacoustic therapy combined with Baduanjin exercise) according to their rehabilitation method. After using propensity score matching (PSM) to balance the baseline data of the two groups, 60 cases were included in each group. After 12 weeks of rehabilitation, the cardiac function indicators (left ventricular ejection fraction [LVEF], stroke volume [SV], left ventricular end-systolic dimension [LVESD], left ventricular end-diastolic diameter [LVEDD]; psychological state (the Profile of Mood States-Short Form [POMS-SF] score); heart rate variability indices (standard deviation of normal-to-normal [SDNN], root mean square of successive differences between normal heartbeats [RMSSD]; quality of life [The 36-Item Short Form Health Survey (SF-36)]; Traditional Chinese Medicine (TCM) symptom scores and complication rate were compared between the two groups.
Results:
After the PSM, no significant differences were observed in the baseline data of the two groups (P > 0.05). After rehabilitation, the combined group showed higher levels of LVEF, SV, SDNN and RMSSD; lower levels of LVESD and LVEDD; lower negative mood scores of POMS-SF; better SF-36 score and positive mood scores of POMS-SF than the Baduanjin group (P < 0.05). The TCM scores and complication rates of the two groups showed no significant differences (P > 0.05).
Conclusion:
The combination of vibroacoustic therapy and Baduanjin exercise can significantly improve the cardiac function and psychological state in patients with CHD. Therefore, this combination is worthy of clinical application.
Keywords: coronary heart disease, music therapy, psychological state, qigong, rehabilitation, vibroacoustic therapy
KEY MESSAGES
-
(1)
Vibroacoustic therapy combined with Baduanjin exercise can improve cardiac function indexes and heart rate variability of patients with coronary heart disease (CHD).
-
(2)
The combination of vibroacoustic therapy and Baduanjin exercise can significantly improve the psychological state and quality of life of CHD patients.
-
(3)
The combined therapy of vibroacoustic therapy and Baduanjin exercise provides new ideas for comprehensive CHD management.
INTRODUCTION
Cardiovascular disease is the leading cause of death for urban and rural residents in China. The prevalence of coronary heart disease (CHD) is 27.8% amongst people aged 60 and above.[1] In addition to impairing cardiac function and activities of daily living,[2,3] CHD frequently coexists with depressive and anxious emotions, creating a vicious cycle of ‘mind–body interaction’.[4,5] Drug therapy, percutaneous coronary intervention (PCI) and exercise rehabilitation are the main treatments for CHD. However, neither drug therapy nor PCI alone can cure CHD. Patients need to adjust their lifestyles, keep exercise and undergo other auxiliary rehabilitation measures to increase cardiovascular function and thus reduce the incidence of adverse events.
Baduanjin exercise is a traditional Chinese qigong exercise that emphasises the oneness of body and mind through gentle, well-coordinated motions. Long-term practice can enhance cardiopulmonary function and improve the body’s immunity. It also helps regulate emotions and achieve a state of physical and mental harmony.[6,7,8]
Music therapy can effectively improve the recovery status of patients with CHD by regulating the neuroendocrine system through the frequency of sound waves.[9] Music of specific frequencies can reportedly activate the limbic and autonomic nervous systems, thereby reducing heart-rate variability.[10] Meanwhile, music therapy can regulate the hypothalamic pituitary adrenal axis, reduce cortisol secretion and alleviate negative emotions such as postoperative anxiety and depression. However, the efficacy of traditional music therapy is limited by stimulation through a single auditory channel, which is ineffective for people with auditory perception disorders. In recent years, vibroacoustic therapy has demonstrated unique advantages in the treatment of chronic diseases by integrating 20–150 Hz mechanical vibrations with sound wave conduction to form a dual-channel stimulation of ‘auditory–tactile’ stimulation. As an emerging non-drug therapy, vibroacoustic therapy can regulate the function of the autonomic nervous system, promote blood circulation and relieve muscle tension. Thus, this therapy can improve heart function and reduce the patient’s psychological stress through the resonance of specific music frequencies with the human body.[11]
The present study is the first to integrate vibroacoustic therapy and Baduanjin exercise for CHD rehabilitation, with the aim of promoting patients’ physical and psychological recovery.
MATERIALS AND METHODS
Study design and sample screening
This study retrospectively analysed clinical data of 200 CHD patients who received PCI at Xingtai Central Hospital from June 2022 to June 2024. The patients were divided into a Baduanjin group (n = 110) and a combined group (n = 90) according to the rehabilitation method used.
The study was approved by our Hospital’s Medical Ethics Committee (2022-KY-32), with informed consent obtained from all participants.
Inclusion and exclusion standards
Inclusion criteria: (1) CHD patients who received PCI treatment and met the diagnostic standards as outlined in the 2011 American College of Cardiology Foundation/American Heart Association Guidelines for Interventional Therapy of CHD[12]; (2) patients whose clinical symptoms were stable and can tolerate moderate intensity exercise and (3) patients and families who were informed and signed the informed consent form.
Exclusion criteria: (1) Patients who simultaneously participated in other clinical researchers; (2) patients with liver, kidney and lung dysfunction; (3) patients with intellectual disabilities or poor compliance and inability to cooperate with treatment and (4) patients with severe blood diseases.
Treatment method
Baduanjin exercise
The Baduanjin group adopted Baduanjin qigong exercise 1 month after PCI. The exercise includes the following eight movements:
1. Two hands hold up the heavens (Liang Shou Tuo Tian Li San Jiao): From a natural standing position, with the hands crossed in front of the chest. The palms are then turned upward as the heels simultaneously lift off the ground. The gaze follows the upward motion of the hands. As the heels return to the ground, the hands are gradually lowered, concluding with a return to the initial posture. This movement helps regulate the triple energiser (San Jiao, a concept in traditional Chinese medicine) and improve the circulation of qi and blood.
2. Drawing the bow to shoot the eagle (Zuo You Kai Gong Si She Diao): From a horse stance, the fists are clenched. The left hand extends forward to the left front, whereas the right hand retracts to the waist. The torso rotates to the left, accompanied by a gaze directed at the left hand. Subsequently, the right hand is extended outward, the left hand is drawn back and the torso turns to the right. This movement enhances upper-limb strength and lung function.
3. Separating heaven and earth to regulate the spleen and stomach (Tiao Li Pi Wei Xu Dan Ju): From a natural standing position, with hands crossed in front of the chest. The left palm is rotated upward and elevated, whereas the right palm is rotated downward and pressed in a descending motion, accompanied by a slight backward lean of the torso. The hands are then restored to their original position. Subsequently, the right hand is raised as the left hand presses downward. This exercise regulates the spleen and stomach, as well as promotes digestion and absorption.
4. Looking backward to relieve five fatigue and seven injuries (Wu Lao Qi Shang Wang Hou Qiao): From a natural standing posture, both hands are placed on the waist. The head is rotated backward, directing the gaze behind the body. The action concludes with the head returning to its initial forward-facing position. This movement relieves neck fatigue and improves blood circulation.
5. Swaying the head and tail to dissipate heart fire (Yao Tou Bai Wei Qu Xin Huo): From a horse stance, both hands are placed on the waist. The head and upper body are directed towards the left front, whilst the hips simultaneously shift towards the right back. Then, the head and upper body are swung to the right front, and the hips shift towards the left back. This action removes heart fire and improves sleep quality.
6. Hands clasping feet to strengthen kidney and back (Liang Shou Pan Zu Gu Shen Yao): From a naturally standing position with the hands hung down, hands are raised along both sides of the body to the top of the head. The torso is bent forward to attempt touching the ground or toes. This exercise strengthens the waist, kidneys and back.
7. Punching with angry gaze to enhance qi and strength (Zuan Quan Nu Mu Zeng Qi Li): From a horse stance, the fists are clenched and positioned at the waist. The right fist (palm up) is then extended forward, accompanied by a focused gaze. The right fist is then retracted to the waist, and the left fist is similarly extended forward. This movement strengthens upper-limb strength and lower-limb stability.
8. Seven bounces on the heels to cure all ailments (Bei Hou Qi Dian Bai Bing Xiao): From a natural upright stance, with the arms relaxed and hanging at the sides. The heels are elevated from the ground, raising the body upward whilst the hands are simultaneously lifted. The movement concludes as the heels return to the ground and the hands are lowered to their original position. This action invigorates the spirit and eliminates fatigue.
All patients were added to a WeChat group for the rehabilitation exercise before discharge. One month after discharge, medical staff shared the Baduanjin exercise videos with the WeChat group and guided patients to exercise online. An exercise lasted for 30 minutes each time, five times a week. Patients were asked to record their exercise process and send the video to the WeChat group after each session. Medical staff were responsible for reminding and supervising patients to complete their weekly exercise.
Vibroacoustic therapy
The combined group received vibroacoustic therapy combined with Baduanjin exercise. A Vibroacoustic Therapy System DK-YY-03 (Dukang Medical Equipment Co., Ltd., Shijiazhuang, China) was used with an input power of 300 VA and rated frequencies from 16 to 150 Hz. Patients were placed in a separate room that is well-ventilated and has low lighting. They lie on the vibroacoustic therapy chair in a semi-recumbent position and wear headphones, with a heart-rate sensor fixed on their right index fingers. The vibroacoustic therapy was started after adjusting the time (30 minute), volume (45–60 dB) and vibration frequency (usually 50–80 Hz). During hospitalisation, the treatment frequency was once a day and after discharge, patients were asked to visit the hospital for vibroacoustic therapy twice a week. The total treatment course lasted 12 weeks.
Observation indicators
General information
General information of 200 CHD patients was obtained from the hospital’s electronic medical records. Chi-square test showed significant differences in age and disease type between the two groups. A propensity score matching (PSM) was conducted to balance the baseline data. Gender, age, disease duration and disease type were selected as covariates, and a logistic regression model was constructed to calculate the propensity score. A 1:1 near-neighbour matching was performed to match samples, with the caliper width set at 0.2 times the standard deviation of the propensity score.
Cardiac function
Before and after 12 weeks of rehabilitation, the cardiac function indicators of patients were measured using a GE-ViVid E9 echocardiography (General Electric, USA). The cardiac function indicators included stroke volume (SV), left ventricular ejection fraction (LVEF), left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic diameter (LVEDD).
Psychological status
Before and after 12 weeks of rehabilitation, the Profile of Mood States-Short Form (POMS-SF)[13,14] was used to assess the psychological status of patients. This scale contains 30 items, with scores ranging from 0 to 4 for each item. POMS-SF comprises six subscales: Tension-Anxiety (TA), Anger-Hostility (AH), Fatigue-Inertia (FI), Depression-Dejection (DD), Vigor-Activity (VA) and Confusion-Bewilderment (CB). Each subscale has five items, with scores ranging from 0 to 4 for each item. A higher total score of negative mood (TA+AH+FI+DD+CB) indicates more severe psychological distress, with a score range of 0–100 points. A higher total score of positive mood (VA) indicates more abundant psychological energy, with a score range of 0–20 points. The Cronbach’s alpha coefficient for the POMS-SF scale was 0.85, indicating good internal consistency.
Heart-rate variability (HRV) indicators
Before and after 12 weeks of rehabilitation, a BeneHeart R12 dynamic electrocardiograph (Mindray Bio Medical Electronics Co., Ltd., Shenzhen, China) was used to record the temporal indicators of HRV through a 24-hour dynamic electrocardiogram. The indicators include the overall standard deviation (SDNN) of normal sinus R-R intervals (the time intervals between adjacent R waves) and the root mean square of successive differences between normal heartbeats (RMSSD) of normal continuous sinus R-R intervals.
Quality of life
The 36-Item Short Form Survey (SF-36) was used to assess patients’ quality of life before and after 12 weeks of rehabilitation.[15] The SF-36 comprises eight dimensions, namely, vitality, physical functioning, bodily pain, general health perception, physical role functioning, emotional role functioning, social role functioning and mental health. The dimensions were scored 0–100, with higher scores indicating a better quality of life. The Cronbach’s alpha coefficient for the SF-36 scale was 0.846, indicating good internal consistency.
Traditional Chinese Medicine (TCM) symptom score
The ‘Guidelines for Clinical Research of New Chinese Medicines’[16] was used to rate the four TCM symptoms, including tongue coating, paleness, palpitations and chest pain. Higher ratings indicate severe symptoms. The scoring range for each symptom is 0–4. The Cronbach’s alpha coefficient of the scale is 0.842.
Complications
The incidence of complications within 12 weeks after PCI was collected, including chest pain, thromboembolism and arrhythmia.
Statistical methods
SPSS 23.0 software (IBM, USA) was used for statistical analysis. Normality tests were performed using the Shapiro–Wilk test. Measurement data in line with normal distribution were described as mean and standard deviation. The independent sample t-test was used for inter-group comparison, and the paired sample t-test was used for intra-group comparison. Categorical data were expressed as cases and tested with the chi-square test. P < 0.05 was considered statistically significant.
RESULTS
General information
Before PSM, the two groups showed a significant difference in age and disease type (P < 0.05) [Table 1]. After PSM, 60 patients in the combined group were effectively matched with 60 patients in the Baduanjin group, and no significant difference existed in general information between the two groups (P > 0.05) [Table 2].
Table 1.
Comparison of general information between the two groups before PSM
| Group | Gender |
Age (years) | Disease duration (years) | Disease type |
|||
|---|---|---|---|---|---|---|---|
| Male | Female | Myocardial ischemia | Stable angina | Unstable angina | |||
| Baduanjin group (n = 110) | 75 (70.00) | 35 (30.00) | 57.49 ± 7.23 | 4.20 ± 1.30 | 53 (48.18) | 32 (29.10) | 25 (22.72) |
| Combined group (n=90) | 53 (58.89) | 37 (41.11) | 60.92 ± 6.36 | 4.24 ± 1.61 | 38 (42.22) | 42 (46.67) | 10 (11.11) |
| t /χ2 value | 1.855 | 3.454 | 0.210 | 8.336 | |||
| P-value | 0.173 | 0.001 | 0.834 | 0.015 | |||
Table 2.
Comparison of general information between the two groups after PSM
| Group | Gender |
Age (years) | Disease duration (years) | Disease type |
|||
|---|---|---|---|---|---|---|---|
| Male | Female | Myocardial ischemia | Stable angina | Unstable angina | |||
| Baduanjin group (n = 60) | 37 (61.67) | 23 (38.33) | 58.10 ± 4.21 | 4.03 ± 1.05 | 30 (50.00) | 20 (33.33) | 10 (16.67) |
| Combined group (n = 60) | 38 (63.33) | 22 (36.67) | 59.23 ± 3.78 | 4.06 ± 1.04 | 28 (46.67) | 23 (38.33) | 9 (15.00) |
| t /χ2 value | 0.036 | 1.552 | 0.082 | 2.310 | |||
| P-value | 0.850 | 0.123 | 0.935 | 0.315 | |||
Cardiac function indicators
After rehabilitation, the LVEF and SV levels of the combined group were significantly higher than those of the Baduanjin group. Conversely, the LVESD and LVEDD levels were significantly lower than those of the Baduanjin group (P < 0.05) [Table 3].
Table 3.
Comparison of cardiac function indicators of the two groups before and after rehabilitation (x̄±s)
| Group | LVEF (%) |
LVESD (mm) |
LVEDD (mm) |
SV (mL) |
||||
|---|---|---|---|---|---|---|---|---|
| Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | |
| Baduanjin group (n = 60) | 44.70 ± 4.19 | 47.52 ± 5.05* | 47.40 ± 4.12 | 44.91 ± 3.37* | 65.22 ± 3.05 | 62.08 ± 2.35* | 49.68 ± 4.91 | 52.25 ± 5.16* |
| Combined group (n = 60) | 44.67 ± 4.21 | 49.74 ± 5.69* | 47.38 ± 4.22 | 43.43 ± 3.07* | 65.16 ± 2.93 | 60.42 ± 2.22* | 49.27 ± 4.75 | 54.56 ± 5.22* |
| t-value | 0.038 | 2.254 | 0.018 | 2.501 | 0.119 | 3.966 | 0.465 | 2.440 |
| P-value | 0.969 | 0.026 | 0.986 | 0.014 | 0.906 | <0.001 | 0.643 | 0.016 |
LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic dimension; SV, stroke volume.; **Correspondence to P < 0.05 compared with the same group before rehabilitation.
Psychological status
After rehabilitation, the combined group’s positive mood score was greater than that of the Baduanjin group, and the negative mood score was lower than that of the Baduanjin group. The difference was statistically significant (P < 0.05) [Table 4].
Table 4.
Comparison of psychological status between the two groups before and after rehabilitation (x̄±s)
| Group | Positive mood |
Negative mood |
||
|---|---|---|---|---|
| Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | |
| Baduanjin group (n = 60) | 11.46 ± 2.38 | 14.23 ± 2.49* | 74.40 ± 4.12 | 70.30 ± 5.28* |
| Combined group (n = 60) | 11.18 ± 2.16 | 15.80 ± 2.34* | 74.23 ± 4.01 | 55.26 ± 4.86* |
| t-value | 0.618 | 3.548 | 0.224 | 16.227 |
| P-value | 0.497 | 0.001 | 0.823 | <0.001 |
Note: The psychological status was assessed by the POMS-SF.; *P < 0.05 compared with the same group before rehabilitation.
HRV indicators
After rehabilitation, the SDNN and RMSSD levels were higher in the combined group than in the Baduanjin group (P < 0.05) [Table 5].
Table 5.
Comparison of HRV indicators between the two groups before and after rehabilitation (ms, x̄±s)
| Group | SDNN |
RMSSD |
||
|---|---|---|---|---|
| Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | |
| Baduanjin group(n = 60) | 103.19 ± 9.15 | 140.69 ± 10.10* | 29.66 ± 5.11 | 34.60 ± 6.48* |
| Combined group (n = 60) | 104.41 ± 9.64 | 150.38 ± 10.68* | 28.41 ± 5.04 | 39.48 ± 6.35* |
| t-value | 0.711 | 5.107 | 1.350 | 4.168 |
| P-value | 0.478 | <0.001 | 0.180 | <0.001 |
HRV, heart-rate variability; RMSSD, the root mean square of successive differences between normal heartbeats; SDNN, the overall standard deviation of normal sinus R-R intervals; *P < 0.05 compared with the same group before rehabilitation.
Quality of life
After rehabilitation, the SF-36 scores on all dimensions in the combined group were higher than those in the Baduanjin group. These differences were statistically significant (P < 0.05) [Table 6].
Table 6.
Comparison of the two groups’ SF-36 scores before and after rehabilitation (points, x̄±s)
| SF-36 dimension | Time | Baduanjin group (n = 60) | Combined group (n = 60) | t-value | P-value |
|---|---|---|---|---|---|
| Vitality | Before rehabilitation | 62.40 ± 10.41 | 61.50 ± 10.66 | 0.468 | 0.641 |
| After rehabilitation | 70.55 ± 9.84* | 79.05 ± 8.50* | 5.059 | <0.001 | |
| Physical functioning | Before rehabilitation | 58.65 ± 10.68 | 57.06 ± 11.12 | 0.793 | 0.429 |
| After rehabilitation | 66.86 ± 10.93* | 75.63 ± 11.48* | 4.282 | <0.001 | |
| Bodily pain | Before rehabilitation | 58.96 ± 10.38 | 57.85 ± 11.76 | 0.551 | 0.582 |
| After rehabilitation | 66.01 ± 11.72* | 75.68 ± 10.84* | 4.689 | <0.001 | |
| General health perception | Before rehabilitation | 59.90 ± 10.64 | 61.18 ± 11.43 | 0.141 | 0.888 |
| After rehabilitation | 68.52 ± 10.34* | 79.98 ± 9.95* | 6.186 | <0.001 | |
| Role physical | Before rehabilitation | 68.60 ± 8.69 | 67.46 ± 9.66 | 0.675 | 0.501 |
| After rehabilitation | 76.42 ± 9.07* | 80.13 ± 8.52* | 2.312 | 0.023 | |
| Role emotional | Before rehabilitation | 63.55 ± 10.48 | 63.16 ± 10.80 | 0.197 | 0.844 |
| After rehabilitation | 74.66 ± 10.46* | 79.73 ± 9.85* | 2.730 | 0.007 | |
| Social role functioning | Before rehabilitation | 64.13 ± 10.41 | 63.86 ± 10.79 | 0.138 | 0.891 |
| After rehabilitation | 73.26 ± 9.76* | 79.62 ± 9.70* | 3.572 | <0.001 | |
| Mental health | Before rehabilitation | 62.30 ± 9.43 | 61.58 ± 9.87 | 0.406 | 0.685 |
| After rehabilitation | 75.03 ± 9.86* | 79.45 ± 8.94* | 2.570 | 0.011 |
SF-36, 36-Item Short Form Health Survey; *P < 0.05, compared with the same group before rehabilitation.
TCM symptom ratings
The TCM symptom scores decreased in both groups after rehabilitation, but the difference was not statistically significant [Table 7].
Table 7.
TCM symptom scores between the two groups before and after rehabilitation (x̄±s, points)
| Group | Palpitations |
Chest pain |
Paleness |
Tongue coating |
||||
|---|---|---|---|---|---|---|---|---|
| Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | Before rehabilitation | After rehabilitation | |
| Baduanjin group (n = 60) | 1.35 ± 0.30 | 0.82 ± 0.15* | 3.04 ± 0.24 | 2.89 ± 0.32* | 1.33 ± 0.15 | 0.66 ± 0.16* | 2.26 ± 0.51 | 1.26 ± 0.23* |
| Combined group (n = 60) | 1.32 ± 0.28 | 0.67 ± 0.13* | 3.02 ± 0.21 | 2.79 ± 0.30* | 1.34 ± 0.17 | 0.63 ± 0.14* | 2.24 ± 0.49 | 1.21 ± 0.20* |
| t-value | 0.621 | 0.581 | 0.000 | 0.942 | 0.877 | 0.468 | 0.454 | 1.134 |
| P-value | 0.536 | 0.563 | 1.000 | 0.348 | 0.382 | 0.640 | 0.650 | 0.259 |
TCM, Traditional Chinese Medicine; *P < 0.05 compared with the same group before rehabilitation.
Complication incidence
No significant difference was found between the Baduanjin group’s complication incidence of 26.67% and the combined group’s incidence of 21.67% (P > 0.05) [Table 8].
Table 8.
Comparison of the two groups’ complication incidence (n [%])
| Group | Chest pain | Thromboembolism | Arrhythmias | Overall incidence |
|---|---|---|---|---|
| Baduanjin group (n = 60) | 8 (13.33) | 4 (6.67) | 4 (6.67) | 16 (26.67) |
| Combined group (n = 60) | 7 (11.67) | 3 (5.00) | 3 (5.00) | 13 (21.67) |
| χ2-value | 0.409 | |||
| P-value | 0.522 |
DISCUSSION
CHD, a common cardiovascular disease in middle-aged and older people, is recently trending towards younger people.[17] Even after PCI treatment, patients’ cardiac function may still decline owing to myocardial damage, limiting their ability to perform daily life. Additionally, the psychological stress brought by long-term illness may easily lead to mood disorders such as anxiety and depression. Clinical data show that appropriate rehabilitation techniques can improve the cardiac function and mental health of patients with CHD and reduce the risk of recurrence of cardiovascular events.[18]
Baduanjin is a traditional qigong exercise which may positively affect cardiopulmonary function by enhancing myocardial contractility, improving vascular endothelial function and regulating cardiovascular neurohumoral factors.[19,20] The exercise intensity of Baduanjin is moderate, which helps control patients’ body weight and reduce the burden on the heart. Additionally, Baduanjin exercise emphasises the coordination of breathing and movement, which may reduce hypoxia in the heart by regulating the respiratory centre, increasing alveolar ventilation and improving gas exchange.[21,22]
Previous studies have found that vibroacoustic therapy may decrease heart rate and improve cardiac function by regulating the autonomic nervous system and increasing vagal tone.[23] The frequency and rhythm of music may likewise resonate with the body’s physiological rhythms, thereby promoting blood circulation and reducing the burden on the heart.[24] Music has also been shown to affect vascular endothelial function, which is strongly associated with cardiac risk events.[25] Unlike traditional music therapy, vibroacoustic therapy can directly stimulate the body’s mechanoreceptors through mechanical vibrations, forming a dual-channel regulation of ‘auditory–tactile’ sensations, which may have a more comprehensive regulatory effect on the cardiovascular system.
Vibroacoustic therapy combined with Baduanjin exercise can improve LVEF and SV, which are important indicators for evaluating cardiac pumping function.[26] Research indicates that vibroacoustic therapy in conjunction with Baduanjin exercise has a substantial impact on increasing heart-pumping function.[27] After 12 weeks of rehabilitation, patients with CHD showed significant improvements in LVEF and SV. LVESD and LVEDD are important indicators reflecting the geometric shape of the heart. Vibroacoustic therapy can promote the relaxation and contraction of the myocardium through music’s rhythm and vibration stimulation, whereas with whole-body training, Baduanjin exercise can increase the myocardium’s strength and flexibility. By combining the two rehabilitation methods, the myocardium’s systolic and diastolic functions can be enhanced, so LVESD and LVEDD can be lowered.[28,29]
Psychological issues including anxiety and depression are common in patients with CHD. These issues may worsen the heart’s workload and impact the healing process in addition to lowering quality of life.[30] Studies have shown that music therapy can induce emotional resonance in patients, reduce psychological stress and enhance positive mood through the rhythm and melody of music.[31,32] The practice of Baduanjin exercise requires concentration and breathing adjustment, which can promote the balance and regulation of the nervous system and improve the mental state.[33] When the two rehabilitation methods are applied together, individuals with CHD can experience a considerable enhancement in their positive mood and a reduction in anxiety and depression. The outcome is an overall improvement in their quality of life.[34,35]HRV refers to the heart-rate fluctuation of the heart within a certain period of time. SDNN and RMSSD are important indicators for evaluating HRV. The combined application of vibroacoustic therapy and Baduanjin exercise positively affects the heart’s self-regulation and adaptive ability. The reason is that the frequency resonance of vibroacoustic therapy can optimise endothelial function, whereas low-intensity exercise of Baduanjin promotes blood circulation. The combination of the two further reduces peripheral vascular resistance and cardiac load, thereby improving HRV indicators.
SF-36 is a commonly used scale to assess quality of life, including assessment of multiple dimensions (such as physical function, social function, mental health, etc.). Patients with CHD may have higher quality-of-life scores when vibroacoustic therapy and Baduanjin exercise are used together, especially in physiological functions, mental health and social functions, showing significant improvement effects. Continuous Baduanjin exercise can strengthen the heart’s pumping function, improve blood circulation and help restore heart function. Vibroacoustic therapy can also help patients better manage disease-related stress, enhance their psychological resilience and alleviate unpleasant feelings like anxiety and sadness. Exercise rehabilitation is a long-term process and maintaining exercise and vibroacoustic therapy after discharge is crucial to a patient’s continued recovery. Enhancing adherence entails promoting family support and peer interaction, as well as educating patients and their families through lectures, brochures and videos. In-hospital rehabilitation should also be provided for home-limited patients to ensure sustained compliance.
After rehabilitation, the TCM score of the tongue coating, paleness, palpitations and chest pain was reduced, with no significant difference between the two groups. The reason may be the insufficient sensitivity of the TCM score, with macro-symptoms lagging behind improvements in physical and mental function. Although the improvement in TCM scores is not significant, this does not negate the synergistic potential of Baduanjin exercise combined with vibroacoustic therapy.
Limitation
This retrospective study may have potential selection/information bias, the small sample size reduced generalisability and the 12-week observation limited long-term assessment. Future studies should validate findings in larger populations, develop user-friendly rehabilitation tools (e.g., home impedance trainer), enhance clinician training and strengthen patient self-management platforms to maximise clinical outcomes and sustainability.
CONCLUSIONS
Patients with CHD benefit from vibroacoustic therapy and Baduanjin exercise in terms of their psychological well-being and cardiac function. Baduanjin exercise can enhance cardiopulmonary function and promote blood circulation. Vibroacoustic therapy has the advantages of high grassroots applicability, easy operation and outstanding results in relieving anxiety and stress. When combined, they can significantly improve patients’ cardiac function and psychological status.
Conflicts of Interest
All authors declare no conflicts of interest.
Availability of Data and Materials
The data used and/or analysed in this study are available from the corresponding author on reasonable request.
Author contributions
Xuehong Du: Conception and design; Bo Miao: Administrative support; Liang Jia, Bo Miao: Provided research materials or patients; Xuehong Du, Bo Miao: Data collection and summary; Xuehong Du, Liang Jia: Data analysis and interpretation; All authors: Manuscript writing; All authors: Final approval of manuscripts.
Ethics Approval and Consent to Participate
This study strictly followed the Declaration of Helsinki and was approved by the Hospital Ethics Committee (approval number: 2022-KY-32).
Patients who were aware of the purpose and significance of the study all signed informed consent forms.
Acknowledgement
Not applicable.
Funding Statement
None.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data used and/or analysed in this study are available from the corresponding author on reasonable request.
