Baduanjin exercise intervention trial: research protocol of a randomised controlled trial for frail kidney transplant recipients Author: Keke Lin#1, Jiaxin Fang#1, Shuping Zhang1, Zhenshan Ding2, Yanbin Hu1, Bei Zhang1, Xuejie Guo2, Hongxia Liu3, Peiyu Zhao4 Affiliation: <sup>1</sup> Beijing University of Chinese Medicine, Beijing, China. <sup>2</sup> China-Japan Friendship Hospital, Beijing, China. <sup>3</sup> Beijing University of Chinese Medicine, Beijing, China hongxia_t@163.com cjzhaopeiyu@sina.com. <sup>4</sup> China-Japan Friendship Hospital, Beijing, China hongxia_t@163.com cjzhaopeiyu@sina.com. Conference/Journal: BMJ Open Date published: 2024 Jan 9 Other: Volume ID: 14 , Issue ID: 1 , Pages: e074717 , Special Notes: doi: 10.1136/bmjopen-2023-074717. , Word Count: 320 Introduction: Frailty is one of the most common comorbidities in kidney transplant recipients (KTRs). Physical, psychological and social frailty could be improved by exercise intervention. Baduanjin, also known as Eight-section Brocades, is a type of traditional Chinese medicine exercise characterised by the interplay between physical postures and movements, breathing and mind. It can help frail patients strengthen their upper and lower body muscles, improve their mood, quality of life and frailty. However, the effectiveness of Baduanjin on frail KTRs remains unknown. Therefore, we will conduct a randomised controlled trial (RCT) to evaluate the effectiveness of Baduanjin on frail KTRs. Methods and analysis: This protocol describes an assessor and analyst blinded, parallel RCT for frail KTRs comparing Baduanjin group (n=72) with care-as-usual group (n=72). The primary outcomes are frailty assessed by Frailty Phenotype scale and Tilburg Frailty Indicator scale, and muscle strength assessed by a grip strength metre. The secondary outcomes are quality of life assessed by Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) and depression assessed by the Hospital Anxiety and Depression Scale. All these data will be collected at the baseline, after 3, 6, 9 and 12 months, respectively. Two-way mixed analysis of variance (ANOVA) will be used to test the effectiveness of Baduanjin exercise. Qualitative interviews with participants in the intervention group will also be performed after 6 months. Themes will be extracted from interview transcripts using NVivo software. Ethics and dissemination: The Ethics Committees of Beijing University of Chinese Medicine (2022BZYLL1018) and China-Japan Friendship Hospital (2022-KY-250) had approved the study. The organ donors were all from China-Japan Friendship Hospital. They provided informed consent and they were not executed prisoners. We have provided BMJ Open with documentation from the hospital that indicates that the organs will be harvested ethically. The findings of this study will be disseminated through peer-reviewed journals, international conferences, media reports and briefings. Trial registration number: ChiCTR2100041730. Keywords: Clinical Trial; Protocols & guidelines; Renal transplantation. PMID: 38199632 DOI: 10.1136/bmjopen-2023-074717