Title : Reversing functional decline through pulmonary rehabilitation integrating Baduanjin Qigong in an early-onset Asthma–COPD overlap: A case report
Abstract:
Background: Asthma Chronic Obstructive Pulmonary Disease ( COPD) overlap represents a clinical phenotype combining features of both asthma and COPD, often accompanied by airflow limitation, dyspnea, and reduced exercise capacity. Early-onset ACO is uncommon and frequently presents with marked exertional breathlessness and deconditioning, leading to poor quality of life. Pulmonary rehabilitation (PR) has been shown to improve exercise tolerance and ventilatory efficiency in chronic respiratory diseases; however, evidence in early-onset ACO remains limited. In recent years, the integration of traditional breathing and movement therapies such as Baduanjin Qigong, a form of mind–body exercise emphasizing respiratory control and postural coordination, has been explored as an adjunct to conventional PR to enhance respiratory muscle coordination, flexibility, and self-regulation.This case report investigates the clinical benefits of a PR program incorporating Baduanjin training in a young ACO patient.
Case Description: A 44-year-old man with history of asthma and a 13-year smoking history (two packs per day) presented with exertional dyspnea and fatigue. Chest CT revealed diffuse emphysematous changes with air trapping. He was diagnosed with early-onset ACO, classified as COPD GOLD group B (mMRC 2, CAT 15). Pulmonary function showed FEV? at 25% of predicted. Baseline six-minute walk test was 586 meters with oxygen desaturation from 96% to 84%. The patient completed a 12-week outpatient PR program including breathing control, aerobic and resistance training, and integration of Baduanjin Qigong, a traditional qigong exercise emphasizing coordinated breathing and movement. Patient education sessions were incorporated to promote disease self-management and exercise adherence.
Discussion: Following the PR program, exercise-induced oxygen saturation remained above 90%, dyspnea scores decreased, and exercise tolerance markedly improved. The patient was able to perform moderate walking and light uphill activities without significant desaturation. These improvements suggest that PR enhanced peripheral muscle oxidative capacity, respiratory coordination, and autonomic stability, thereby reducing sympathetic overactivity and improving oxygenation. The integration of Baduanjin Qigong further enhanced breathing control, postural awareness, and mind–body coordination, providing additive benefits for functional recovery and self-management.
Conclusion: The combination of pulmonary rehabilitation and Baduanjin Qigong is a feasible and well-tolerated adjunct for early-onset ACO. It may improve exercise capacity, oxygen stability, and overall quality of life, even in individuals with severe airflow limitation. Integrating breathing and movement practices such as Baduanjin Qigong within PR may further enhance patient adherence and functional recovery.
Audience Take Away Notes:
1.PR remains safe and effective even in early-onset ACO with severe airflow limitation (FEV? ≈ 25% predicted).
2.Integrating Baduanjin Qigong enhances respiratory coordination, breathing control, and oxygen maintenance. Combining modern PR with traditional Qigong can reverse functional decline and improve daily activity.
