Baduanjin Combined with Computerized Cognitive Remediation Therapy for the Treatment of Schizophrenia : A 8-week randomized controlled trial

Baduanjin Combined with Computerized Cognitive Remediation Therapy for the Treatment of Schizophrenia : A 8-week randomized controlled trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Baduanjin Combined with Computerized Cognitive Remediation Therapy for the Treatment of Schizophrenia : A 8-week randomized controlled trial Qingjin Xue, Wei Liang, Ling Xiao, Qing Hao, Wenjing Ma, Ziwen Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8641027/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract BACKGROUND Schizophrenia is a severe mental disorder characterized by complex clinical presentations and marked impairments in social and occupational functioning. While antipsychotic medications are effective in managing positive symptoms, their efficacy in addressing negative symptoms, cognitive deficits, and overall improvements in social functioning and quality of life remains substantially limited.This study aims to evaluate the effects of Baduanjin combined with Computerized Cognitive Remediation Therapy (CCRT) on patients with schizophrenia, thereby contributing to the evidence base for its clinical management. METHODS A total of 120 hospitalized patients with schizophrenia (aged 29–64 years; 66.67% male) were recruited and randomly allocated to either an intervention group (n = 60) or a control group (n = 60). Participants in the intervention group received a combined 85-minute session (45 minutes of CCRT plus 40 minutes of Baduanjin training) five times per week, whereas the control group received CCRT alone for the same duration. Assessments of psychiatric symptoms, cognitive function, social functioning, and quality of life were conducted at baseline and post-intervention. RESULTS Baseline characteristics were comparable between the two groups for all outcome measures (P > 0.05). Following the 8-week intervention, within-group analyses showed significant improvements from baseline in NCSE, SSPI, and SQLS scores for both groups (all P < 0.05). In contrast, a statistically significant reduction in PANSS total scores was only observed in the intervention group (P < 0.05). Moreover, intergroup analysis revealed that the intervention group demonstrated significantly greater improvements across all outcome measures (NCSE, SSPI, SQLS, and PANSS) compared to the control group post-intervention (all P < 0.05). CONCLUSION Patients with schizophrenia showed significantly better overall efficacy with an 8-week combined treatment of Baduanjin and CCRT compared to CCRT alone, particularly in improving psychiatric symptoms (especially negative symptoms), enhancing cognitive function, restoring social functioning, and improving quality of life. schizophrenia Baduanjin Computerized Cognitive Remediation Therapy Figures Figure 1 1. Background Schizophrenia, a severe mental disorder, is characterized by core symptoms, which often include significant cognitive impairment and social withdrawal [ 1 ] . Although antipsychotic medications have achieved breakthroughs in controlling positive symptoms, interventions focused on negative symptoms (e.g., emotional blunting, lack of motivation) and cognitive deficits remain challenging [ 2 ] . In recent years, non - pharmacological treatment modalities have increasingly served as crucial adjuncts for improving patient outcomes [ 3 ] .The Eight Brocades exercise regimen, originating from traditional Chinese medicine and characterized by its relaxed, tranquil, natural, gentle, and slow movement patterns, has demonstrated unique advantages in improving physical function, sleep quality, and emotional state among schizophrenia patients [ 4 ] . However, exercise intervention alone has limited effects on deep cognitive restructuring. Meanwhile, CCRT—an evidence-based neuropsychological rehabilitation technique—precisely targets core cognitive domains such as attention, working memory, and executive function via human-computer interaction, and has been proven effective in enhancing patients' social adaptation abilities [ 5 – 7 ] . The combination of Bajianjin and CCRT aims to establish a comprehensive rehabilitation system addressing both mind and body. This model employs CCRT for intensive cognitive neuroplasticity while incorporating Bajianjin's mind-body regulation, potentially advancing from“cognitive improvement”to “enhanced quality of life.”This paper examines the potential effectiveness of this combined therapy in improving psychotic symptoms, self-functioning, and overall quality of life in schizophrenia patients. 2. Methods 2.1 Subjects recruitment and sample size calculation All subjects were recruited from Chuzhou Second People's Hospital and provided informed consent before intervention initiation. Subjects were consecutively numbered by their initials and randomly assigned to one of two groups: the Baduanjin plus CCRT group or the CCRT-only group, using a random number table. Sample size was calculated using G*Power [ 8 ] , resulting in an initial sample size of 108 subjects per group; after accounting for a 10% dropout rate, the final sample size was set at 120 subjects. 2.2 Inclusion and exclusion criteria Inclusion criteria: 1) Diagnosed with schizophrenia by a clinician according to the diagnostic criteria for schizophrenia in the WHO International Classification of Diseases, 10th Revision (ICD-10) [ 9 ] ; 2) Hospitalized for ≥ 1 year; 3) Maintained stable medication dosage for ≥ 3 months. Exclusion criteria: 1) Individuals with severe physical conditions, such as serious cardiovascular, pulmonary, or musculoskeletal disorders, that prevent participation in exercise; 2) visual and/or hearing impairments that prevent completion of neurocognitive testing; 3) coexisting mental or neurological disorders. 2.3 Intervention Control Group : During an 8-week CCRT treatment cycle, patients received 5 sessions per week, each lasting 45 minutes, and underwent cognitive training via a local area network (LAN). The intervention included five core modules: attention, working memory, problem-solving, cognitive flexibility, and social cognition. Each module contained 4–6 training tasks, totaling 30 exercises. All training tasks were structured with progressive difficulty and gradually increasing speed, comprising 4–96 corrective trials per exercise. Prior to the main intervention, research team members provided subjects with basic computer operation training. Following the guidance of rehabilitation therapists, subjects engaged in the assigned module exercises. The software adaptively selected appropriate game modules and training difficulty levels based on the subjects’performance, gradually increasing task complexity to guide progressive therapeutic task completion. Intervention Group : The research group combined CCRT intervention with Baduanjin exercises. Training was conducted according to the National Sports Administration's guidelines on Baduanjin movement essentials [ 10 ] . The regimen included a 5-minute warm-up, 30 minutes of Baduanjin practice, and a 5-minute cool-down. Professionally trained and certified nursing staff led patients through the Baduanjin exercises. The intervention cycle lasted 8 weeks, with 5 sessions per week, each lasting 40 minutes. 2.4 Evaluation tools 2.4.1Psychiatric Symptoms: The Positive and Negative Syndrome Scale (PANSS) [ 11 ] was used to assess patients' psychiatric symptoms. This scale stands as one of the most fundamental tools in psychiatric clinical evaluations of schizophrenia, demonstrating robust reliability and validity. Through semi-structured interviews, it quantifies symptom severity and is widely employed for drug efficacy assessment, condition monitoring, and clinical trials. 2.4.2Cognitive Function: Cognitive Function: The Neurobehavioral Cognitive Status Examination (NCSE) [ 12 ] categorizes cognitive function into five primary domains and independently assesses level of consciousness. This structure enables rapid identification of intact domains while providing detailed evaluation of impaired areas. 2.4.3Social Function: The Scale of Social Function in Psychosis Inpatients (SSPI) [ 13 ] was used to evaluate patients' practical abilities in daily living, interpersonal interactions, and social adaptation. It is one of the most widely used social function assessment tools in current domestic psychiatric research. 2.4.4Quality of Life: The Schizophrenia Quality of Life Scale (SQLS) [ 14 ] is a self-report instrument specifically designed for individuals with schizophrenia. Developed by Wilkinson et al. at the University of Liverpool in the UK, it has been translated and revised by Chinese scholars. It has strong psychometric properties, with a test-retest reliability coefficient of 0.87 and internal consistency alpha coefficients ranging from 0.70 to 0.92. The scale is widely used in clinical research in China. Group Allocation and Intervention: Patients were randomly allocated to the groups, with the allocation maintained as a triple-blind process involving participants, assessors, and therapists. To prevent potential cross-contamination, all interventions were conducted at the rehabilitation physical therapy center, with the intervention and control groups undergoing their respective treatments in separate batches. 2.4.5Statistical analyses Statistical analyses were performed using SPSS version 26.0. Quantitative variables following a normal distribution are reported as mean ± standard deviation (‾ X ± s), while categorical data are presented as n (%). For baseline characteristics, independent samples t-tests or chi-square tests were used for quantitative or categorical data, respectively (with Fisher's exact test applied when n < 5). Outcome measures were analyzed using two-way repeated measures ANOVA, with specific comparisons between subscales within PANSS and SSPI performed using t-test. P < 0.05 was considered statistically significant. 3. Results 3.1Study Population and Baseline Characteristics Between June 2024 and October 2025, 120 patients with schizophrenia were recruited from Chuzhou Second People's Hospital. All subjects completed both assessments and interventions. The participant flow is presented in Fig. 1 and baseline characteristics are summarized in Table 1 . As shown in Table 1 , no statistically significant differences were observed between the two groups in terms of age, educational attainment, disease duration, or other demographic and clinical variables (P > 0.05). Table 1 Demographic Characteristics and Medication Use of Participants group Intervention Group (n = 60) Control Group (n = 60) T/χ 2 DF P value Age (year) 51.53 ± 8.41 49.48 ± 8.45 1.332 118 0.186 Education (year) 0.592 4 0.964 Primary School Dropout 7(11.67) 9(15.00) Elementary school 23(38.30) 23(38.30) junior high school 21(35.00) 18(30.00) high school 4(6.67) 5(8.33) college 5(8.33) 5(8.33) Duration of illness (year) 24.05 ± 10.80 20.82 ± 9.58 1.735 118 0.085 Gender 0.150 1 0.699 male 41(68.33) 39(65.00) female 19(31.67) 21(35.00) Marital status 3.013 3 0.390 Unmarried 35(58.33) 27(45.00) Married 10(16.67) 11(18.33) Widowed 3(5.00) 7(11.67) Medication 0.000 1 1.000 AP typical 1(1.67) 59(98.33) Atypical 1(1.67) 59(98.33) Total CPZ equivalent dosages (g) 311.25 ± 181.41 290.08 ± 161.11 0.676 118 0.501 Note: CPZ, chlorpromazine; AP, Antipsychotic; PANSS, Positive and Negative Syndrome Scale. 3.2Two-Way Repeated Measures ANOVA Test Results Two-way repeated measures ANOVA demonstrated significant effects of the intervention on mental state, social functioning, cognitive function, and quality of life. The "group × time" interaction was significant for all outcome measures: PANSS (F = 4.958, P = 0.028), SSPI (F = 108.45, P < 0.001), NCSE (F = 9.360, P = 0.003), and SQLS (F = 24.147, P < 0.001). Post-hoc analyses revealed that the intervention group showed significant improvements in all outcome measures compared to baseline (all P < 0.05) and demonstrated superior results compared to the concurrent control group (all P < 0.05) (Table 2 ). Table 2 Two-Way Repeated-Measures ANOVA for psychiatric symptoms, social function,cognitive function and quality of life (` ± s) χ Group PANSS SSPI NCSE SQLS Control Group (n = 60) Baseline 63.23 ± 10.03 14.45 ± 6.33 55.05 ± 9.90 18.23 ± 2.89 After intervention 63.48 ± 9.53 16.27 ± 6.02 a 56.75 ± 10.68 a 19.87 ± 2.67 a Change (Δ) 0.25 ± 0.96 1.82 ± 6.31 1.17 ± 0.72 1.64 ± 1.45 Intervention Group (n = 60) Baseline 63.37 ± 9.49 14.50 ± 7.53 56.59 ± 5.56 17.95 ± 3.12 After intervention 60.58 ± 8.75 ab 25.62 ± 7.00 ab 61.41 ± 4.67 ab 21.56 ± 2.89 ab Change (Δ) 2.78 ± 0.96 11.12 ± 0.63 4.82 ± 0.72 + 3.61 ± 1.78 Group × Time Interaction F-value 4.958 108.45 9.360 24.147 ɳ2 0.04 0.479 0.073 0.170 P -value 0.028 < 0.001 0.003 < 0.001 a P < 0.05, compared with baseline within the same group (based on the simple effects analysis of the repeated−measures ANOVA). b P < 0.05, compared with the control group at the same time point (based on the simple effects analysis of the repeated−measures ANOVA). The P−values in the "Group × Time Interaction" row are derived from the two−way repeated−measures ANOVA and indicate that the improvement trajectory was significantly different between the two groups over time . 3.3Results of the T-test Results indicated significant improvements in negative symptoms and the total PANSS score in the intervention group post-intervention. Additionally, although both groups showed enhanced performance in self-care, initiative/engagement, and social activity skills on the SSPI from baseline to post-intervention, the intervention group demonstrated greater improvement than the control group (all P < 0.001). These findings are detailed in Table 3 and Table 4 . Table 3 T-test for psychiatric symptoms Group Positive symptom Negative symptom General pathology Totals Control group (n = 60) Baseline 11.87 ± 4.49 23.22 ± 7.82 28.15 ± 5.94 63.23 ± 10.03 After intervention 11.43 ± 4.38 23.68 ± 7.70 28.3 ± 5.76 63.48 ± 9.53 Intervention group (n = 60) Baseline 11.42 ± 4.40 23.58 ± 7.61 28.37 ± 5.76 63.37 ± 9.49 After intervention 10.78 ± 3.97 20.87 ± 5.80 ab 28.93 ± 5.62 60.58 ± 8.75 ab P value 0.699 < 0.001 0.677 0.029 aThe comparison between the two groups after treatment and before treatment, P < 0.05 b Compare the degree of improvement between two groups of control and intervention groups, P < 0.05; The P−value is calculated by comparing the degree of improvement between the intervention group and the control group after treatment . Table 4 T-test for social function Group The daily living skills Motivation and socialization Sociamobility skills Totals Control group (n = 60) Baseline 5.42 ± 1.89 6.03 ± 3.23 3.00 ± 2.07 18.23 ± 2.89 After intervention 5.95 ± 1.84 a 6.78 ± 3.00 a 3.53 ± 2.08 a 19.87 ± 2.67 a Intervention group (n = 60) Baseline 5.58 ± 2.12 5.85 ± 3.59 3.067 ± 2.59 14.50 ± 7.53 After intervention 8.32 ± 1.60 ab 10.68 ± 3.48 ab 6.62 ± 2.97 ab 25.62 ± 7.00 ab P value < 0.001 < 0.001 < 0.001 < 0.001 aThe comparison between the two groups after treatment and before treatment, P < 0.05 b Compare the degree of improvement between two groups of control and intervention groups, P < 0.05; The P−value is calculated by comparing the degree of improvement between the intervention group and the control group after treatment . 4. Discussion Schizophrenia is a severe mental disorder predominantly affecting young adults and working-age populations, with its etiology remaining largely unknown. Characterized by a chronic and relapsing condition [ 15 , 16 ] , it imposes a significant burden on patients and their families. With increased health awareness and improved medical care, treatment for chronic schizophrenia now extends beyond symptom management. It has generated new demands for rehabilitation outcomes, aiming to maximize quality of life, restore social functioning, and alleviate the stress associated with the illness. The current study demonstrated significantly superior efficacy of the combined intervention in improving overall symptoms of schizophrenia, particularly negative symptoms, compared to the control group, consistent with prior findings by Gao et al. [ 17 ] . The underlying mechanisms may involve multi-pathway synergistic effects of Baduanjin as an integrated mind-body exercise. First, its unique characteristics as a slow, continuous, and attention-demanding aerobic exercise may directly improve motivation deficits and emotional blunting—key components of negative symptoms—by regulating central neurotransmitter systems (e.g., enhancing serotonergic activity). Second, the structured movement practice itself serves as a form of behavioral activation, helping counteract psychomotor retardation and difficulties initiating daily activities. Third, the guided group practice format provides a structured, low-pressure social interaction environment, potentially mitigating social withdrawal tendencies [ 18 ] . Thus, Baduanjin exerts a comprehensive intervention effect on core negative symptom dimensions not through a single mechanism, but simultaneously across neurobiological, behavioral activation, and psychosocial pathways. This study demonstrates that CCRT effectively enhances cognitive function in schizophrenia patients, consistent with the findings of Ma et al [ 19 , 21 ] . The mechanism centers on neuroplasticity and cognitive remodeling, wherein CCRT systematically induces functional remodeling of neural circuits through repetitive cognitive task training. This may enhance the brain's processing efficiency for complex cognitive tasks by altering low-frequency amplitude (ALFF) in key regions such as the prefrontal cortex and anterior cingulate cortex [ 22 ] . Notably, the combined intervention group showed better cognitive improvement than CCRT alone. This synergistic effect may be attributed to Baduanjin—a mind-body exercise integrating specific breathing regulation and dynamic stretching—which promotes peripheral and cerebral blood circulation. By enhancing cerebral oxygen supply and optimizing physiological activation in the cerebral cortex, Baduanjin potentially provides a more responsive neural foundation for cognitive task execution [ 23 ] .Second, studies show that Baduanjin practice modulates functional connectivity in brain networks supporting higher-order cognitive control. Specifically, it enhances regulatory functions in the dorsolateral prefrontal cortex (DLPFC) and alters resting-state activity in the default mode network (DMN), thereby supporting executive function and other core cognitive domains. Additionally, Baduanjin reduces psychological stress by balancing autonomic nervous system activity and mitigating stress responses [ 24 ] .This reduction in stress frees up cognitive resources, thereby enhancing cognitive performance. In summary, the combined intervention achieves synergistic effects through multiple mechanisms. Baduanjin improves the overall mind-body state and optimizes the brain's "hardware" environment, while CCRT targets "software"-level neurocognitive remodeling. Long-term Baduanjin practice not only creates more favorable conditions for immediate CCRT training effects but may also help sustain cognitive gains by consolidating neuroplasticity changes, preventing their decline over time. This study found that both the combined intervention group and the single CCRT control group demonstrated significant improvements in social functioning. However, the combined intervention group showed greater improvement compared to the control group. This synergistic effect likely arises from the complementary roles of both interventions across different dimensions of social functioning. CCRT employs targeted training to enhance patients' social cognitive abilities—including emotion recognition and interpretation of social cues—thereby enabling the construction of more accurate cognitive representations for social interactions [ 25 ] ; While Baduanjin, starting from mind-body regulation, utilizes its unique breathing-movement coordination pattern to help regulate neuroendocrine homeostasis (e.g., reducing stress-related cortisol levels) and improve foundational behavioral dimensions related to social motivation, such as personal neatness, mental alertness, and emotional expression [ 26 , 27 ] .This combination represents more than a simple summation but a deep integration at the mechanistic level between "social cognitive reconstruction" and "social behavioral activation." This synergy effectively promotes the overall restoration of patients' social functioning. Individuals with schizophrenia often experience deficits in attention, memory, and executive functions (e.g., planning). CCRT employs high-intensity cognitive training (e.g., working memory exercises) to enhance neural efficiency and promote brain plasticity, thereby alleviating negative symptoms and improving overall quality of life [ 28 ] . Additionally, CCRT enhances cognitive potential through targeted brain training [ 29 ] . Baduanjin, a gentle traditional Chinese exercise, improves physiological functions like balance, logical memory, and social interaction interest, fostering long-term adherence and high self-efficacy [ 30 ] . This combination synergistically enhances patients' overall quality of life by addressing both cognitive and physiological aspects, achieving "internal and external cultivation." Limitations and Future Directions: This study has several limitations. First, the 8-week follow-up period is insufficient to assess long-term effects in a chronic condition like schizophrenia. Longer observation periods are needed to determine whether improvements in clinical symptoms, cognitive function, social functioning, and quality of life persist beyond the immediate post-intervention phase. Some early improvements may diminish over time, while extended interventions could consolidate or even enhance therapeutic effects. Therefore, future studies with extended follow-up periods of 6 to 12 months are needed to provide stronger evidence regarding the long-term clinical value of combined therapy.Second, all participants were recruited from a single center (Chuzhou Second People's Hospital). The lack of a multicenter design may limit the generalizability of our findings and reduce statistical power for detecting more subtle treatment effects. Although significant differences were observed in the primary outcome measures, the external validity of these results requires further validation. Future studies should therefore prioritize multicenter trials with expanded sample sizes. Additionally, employing longer follow-up periods and predefined thresholds for clinically meaningful change is crucial for determining the true clinical impact of observed alterations. 5. Conclusion The findings indicate that an 8-week combined intervention combining Baduanjin and CCRT significantly improved psychotic symptoms, cognitive function, social functioning, and quality of life in schizophrenia patients more effectively than CCRT alone. This synergy may stem from complementary effects across physiological, molecular, and behavioral domains. Physiologically, Baduanjin enhances cerebral blood flow and hippocampal plasticity, supporting cognitive training. Molecularly, CCRT elevates BDNF levels, while Baduanjin may sustain this elevation through neuroendocrine modulation. Behaviorally, Baduanjin alleviates negative emotions, improving patient motivation and adherence to CCRT. Collectively, this multi-level synergy provides a novel holistic non-pharmacological approach for schizophrenia rehabilitation. Abbreviations CCRT Computerized Cognitive Remediation Therapy RCT Randomized Controlled Trial ICD 10-International Statistical Classification of Diseases and Related Health Problems 10th Revision PANSS The Positive and Negative Syndrome Scale NCSE The Neurobehavioral Cognitive Status Examination SSPI The Scale of Social Function in Psychosis Inpatients SQLS The Schizophrenia Quality of Life Scale Declarations Clinical Trial Registration Information This Randomized Controlled Trial (RCT) is registered with the National Universal Health Security Information Platform, a national medical research registration system in China，(Registration Number: MR-34-25-010431 https://www.medicalresearch.org.cn/cas/sso/login?clientId=9001&redirectUri=https%3A%2F%2Fwww.medicalresearch.org.cn%2Findex） Ethics approval and consent to participate This study adheres to the Declaration of Helsinki and received ethical approval from the Medical Ethics Committee of Chuzhou Second People's Hospital (Approval No. 2024-Yuan-Lun-Shen-Yi-Zi-No. (06)). Written informed consent was obtained from all participants. The study adhered to the principles of the Declaration of Helsinki. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Acknowledgments The authors have no acknowledgments. Conflict of interest The authors have no conflict of interest to report. Funding This work was supported by the Scientific research projects in natural sciences of Anhui Higher Education Institutions of China(2024AH051393) Authors’contributions QX was an investigator in the study, participated in conceptualization and methodology design, performed randomization of the participants, supervised the study WL participated in processing of the data and edited the main manuscript participated in recruitment and clinical assessments LX\QH\WM participated in recruitment and data collection ZZ participated in data collection All authors reviewed the manuscript. Acknowledgements We gratefully acknowledge the support of the Second People's Hospital of Chuzhou. The hospital provided essential conditions for patient recruitment and financial support, which were fundamental to this study. We extend our sincere thanks to all the rehabilitation therapists and physicians involved. Their professional expertise, diligent efforts, and collaboration were invaluable to the implementation of the research protocol and data collection. Our deepest appreciation goes to all the patients who participated in this study. Their willingness to contribute their time and experiences made this research possible. Finally, we thank everyone who contributed to this work. References Sumiyoshi T, De Peri L, Barlati S. Editorial: Unveiling the neurobiological underpinnings of cognitive dysfunction in patients with schizophrenia. Front Psychiatry. 2024. https://doi.org/10.3389/fpsyt.2024.1511643 . Meyer JM. How antipsychotics work in schizophrenia: A primer on mechanisms. CNS Spectr. 2025;30(1):e6. https://doi.org/10.1017/S1092852924002244 . Schizophrenia Collaborative Group of the Psychiatric Branch of the Chinese Medical Association. Schizophrenia Clinical Research Alliance of the Basic and Clinical Branch of Psychiatry of the Chinese Neuroscience Society, … Chinese Expert Consensus on Maintenance Treatment of Schizophrenia. Chin J Psychiatry, 57(7), 397–406. Zhang J, Gao W, Gao M, Ma Y, Li D. Effects of Baduanjin on Psychopathological Symptoms, Sleep, and Quality of Life in Elderly Patients with Schizophrenia. Int J Nurs. 2025;7(8):45–55. Hu JJ, Sun XR, Ni SM, Kong Y. Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia. World J Psychiatry. 2024;14(6):884–93. Liao L-W, Ding Y, Wu X, Zhou Y-P, Pan G-H. A randomized controlled trial of the computerized cognitive remediation therapy to adult schizophrenia. Chin J Clin Psychol. 2016;24(5):954–7. Fan F, Zou Y, Tan Y, Hong LE, Tan S. Computerized cognitive remediation therapy effects on resting state brain activity and cognition in schizophrenia. Sci Rep. 2017;7(1):4758. 10.1038/s41598-017-04829-9 . Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. https://doi.org/10.3758/BF03193146 . Health Statistics Information Center, Ministry of Health. International Classification of Diseases (ICD-10) application guidebook. Beijing: Union Medical College; 2001. Fitness Qigong Management Center of the General Administration of Sports of the People's Republic of China. Fitness qigong: Yi Jin Jing, Wuqin Xi, Liuzi Jue, Baduan Jin. People's Sports Publishing House; 2005. Nielsen CM, Kølbæk P, Dines D, Opler M, Correll CU, Østergaard SD. Are informants required to obtain valid ratings on the Positive and Negative Syndrome Scale (PANSS)? Schizophrenia. 2023;9(1):54. https://doi.org/10.1038/s41537-023-00378-5 . Kiernan RJ, Mueller J, Langston JW, Van Dyke C. The Neurobehavioral Cognitive Status Examination: A brief but quantitative approach to cognitive assessment. Ann Intern Med. 1987;107(4):481–5. https://doi.org/10.7326/0003-4819-107-4-481 . Yu W, Tong J, Sun X, Chen F, Zhang J, Pei Y, Zhang T, Zhang J, Zhu B. Analysis of medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Int J Environ Res Public Health. 2021;18(9):4746. https://doi.org/10.3390/ijerph18094746 . Luo H. Shenjing fenlie zheng huanzhe shenghuo zhiliang liangbiao (SQLS) zhongwenban: Xiugai ji linchuang yingyong yanjiu. Hangzhou: Zhejiang University; 2002. Jauhar S, Johnstone M, McKenna PJ. Schizophrenia Lancet. 2022;399(10323):473–86. https://doi.org/10.1016/S0140-6736(21)01730-X . Cahaya N, Kristina SA, Widayanti AW, Green J. Interventions to improve medication adherence in people with schizophrenia: A systematic review. Patient Prefer Adherence. 2022;16:2431–49. Gao D, Liu Y, Zhang Z. Effect of Baduanjin exercise on mental rehabilitation of patients with chronic schizophrenia. J Armed Police Med. 2011;22(12):1061–3. https://doi.org/10.3969/j.issn.1004-3594.2011.12.017 . Yang W, Wang Y, Zhu Q, et al. The effect of Baduanjin combined with mindfulness stress reduction therapy on the mood of patients with schizophrenia in convalescence. Psychol Monthly. 2024;19(14):119–21. Nishuangmin Y, Zhendong Y, Wei Y, Liu H, Kong Y. The current research status of computerized cognitive therapy in improving cognitive function of hospitalized schizophrenia patients. Int J Psychiatry. 2024;51(2):341–4. Yang Y, Li S, Wang L, Liu J. The effect of computerized cognitive remediation therapy on social function and quality of life in chronic schizophrenia patients. Clin Psychiatry J. 2017;27(1):59. Wu X, Ding L, Mao X, et al. Effect of computerized cognitive remediation therapy on cognitive function, symptoms, and daily living ability in patients with schizophrenia. Zhongwai Yiyao Yanjiu (Chinese J Foreign Med Research). 2025;4(20):10–2. Zeng Y, Feng X. The Effects of Olanzapine Combined with Computer-Assisted Cognitive Rehabilitation on Cognitive Function in Schizophrenia Patients. J Clin Ration Drug Use. 2022;15(3):25–8. Fengmei F, et al. Computerized cognitive remediation therapy effects on resting state brain activity and cognition in schizophrenia. Sci Rep. 2017;7(4758). https://doi.org/10.1038/s41598-017-04829-9 . Feng J. Clinical study of Baduanjin combined with transcranial direct current stimulation in the treatment of mild cognitive dysfunction after stroke. New Chin Med. 2022;54(18):4. https://doi.org/10.13457/j.cnki.jncm.2022.18.032 . Gupta A, Kumari S. Effect of cognitive retraining treatment in mild to moderate depressive disorders. Psicologia: Reflexão e Crítica. 2023;36(10):1–14. https://doi.org/10.5772/36783 . Du M, Lang H, Zhang Z, et al. Application effects of Baduanjin in patients with schizophrenia and its impact on quality of life. Chin J Foreign Med Res. 2020;18(6):167–9. Liu W, Zhou Q, Sun Y, He Y. Application of traditional Chinese medicine physical exercises in the rehabilitation of residual symptoms of schizophrenia. Shanghai J Traditional Chin Med. 2023;57(9):91–5. https://doi.org/10.16305/j.1007-1334.2023.2302060 . Subramaniam K, Laird AR, Liddle EB, Seidman LJ, Goldstein JM. Intensive cognitive training in schizophrenia enhances working memory and associated prefrontal cortical efficiency in a manner that drives long-term functional gains. NeuroImage. 2014;99:281–92. https://doi.org/10.1016/j.neuroimage.2014.05.057 . Li S. (2016). The effect of Baduanjin exercise on overall cognitive function and memory in elderly individuals with mild cognitive impairment (Master’s thesis, Fujian University of Traditional Chinese Medicine). Zhu J-Y, Li Y-H. The application effect of exercise therapy on insomnia in patients with chronic schizophrenia. Practical Clin Med Pharm. 2020;24(24):57–60. https://doi.org/10.7619/jcmp.202024017 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 04 Mar, 2026 Reviews received at journal 23 Feb, 2026 Reviews received at journal 18 Feb, 2026 Reviewers agreed at journal 25 Jan, 2026 Reviewers agreed at journal 25 Jan, 2026 Reviewers invited by journal 23 Jan, 2026 Editor assigned by journal 21 Jan, 2026 Submission checks completed at journal 21 Jan, 2026 First submitted to journal 19 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8641027","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":580242253,"identity":"a743bc65-0250-4e96-849e-64a42f1c0d80","order_by":0,"name":"Qingjin Xue","email":"","orcid":"","institution":"The Second People's Hospital of Chuzhou","correspondingAuthor":false,"prefix":"","firstName":"Qingjin","middleName":"","lastName":"Xue","suffix":""},{"id":580242255,"identity":"13d81f53-d095-4405-b1d8-5e34489e76e6","order_by":1,"name":"Wei Liang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtUlEQVRIiWNgGAWjYBACPmYIzcPA3kCkFja4Fp4DxGqBsyQSiNXCzvzs4dc2GxmDm4833mCosYkmwmFs5saybWk8BrfTii0YjqXlNhDWwmAmLbntMI/Z7RwzCcaGw8RoYf8G1PKfx+zmGaK18JhJftx2gMfsBg/xWsqkGf8l89ifAfolgRi/8PMf3yb544ydvWT74Y03PtTYENYCAsw8ENqA6KhhYPwB00KsjlEwCkbBKBhZAACy5DXJ5MgSSQAAAABJRU5ErkJggg==","orcid":"","institution":"The Second People's Hospital of Chuzhou","correspondingAuthor":true,"prefix":"","firstName":"Wei","middleName":"","lastName":"Liang","suffix":""},{"id":580242258,"identity":"87131a8b-9370-41a0-8d5f-03d140613496","order_by":2,"name":"Ling Xiao","email":"","orcid":"","institution":"The Second People's Hospital of Chuzhou","correspondingAuthor":false,"prefix":"","firstName":"Ling","middleName":"","lastName":"Xiao","suffix":""},{"id":580242259,"identity":"8c4776f7-be61-4e80-8c9d-fc215c6fbe40","order_by":3,"name":"Qing Hao","email":"","orcid":"","institution":"The Second People's Hospital of Chuzhou","correspondingAuthor":false,"prefix":"","firstName":"Qing","middleName":"","lastName":"Hao","suffix":""},{"id":580242260,"identity":"b00c6399-590f-4c02-aac8-6efa9c731f47","order_by":4,"name":"Wenjing Ma","email":"","orcid":"","institution":"The Second People's Hospital of Chuzhou","correspondingAuthor":false,"prefix":"","firstName":"Wenjing","middleName":"","lastName":"Ma","suffix":""},{"id":580242262,"identity":"65ad7071-7e9e-4247-b4ce-4cb3007a74d6","order_by":5,"name":"Ziwen Zhou","email":"","orcid":"","institution":"Bengbu Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ziwen","middleName":"","lastName":"Zhou","suffix":""}],"badges":[],"createdAt":"2026-01-19 15:40:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8641027/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8641027/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101363983,"identity":"ed32d5be-911f-4c2d-9c47-5550ea4eeef7","added_by":"auto","created_at":"2026-01-29 00:44:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":34274,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe flow of participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage150.png","url":"https://assets-eu.researchsquare.com/files/rs-8641027/v1/449642b018ae9ed2ca8b16a2.png"},{"id":101364070,"identity":"38799811-2abf-4345-b914-04fb237eb009","added_by":"auto","created_at":"2026-01-29 00:44:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":927735,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8641027/v1/3b10ccb2-a043-4139-b29b-469ea52e5392.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Baduanjin Combined with Computerized Cognitive Remediation Therapy for the Treatment of Schizophrenia : A 8-week randomized controlled trial","fulltext":[{"header":"1. Background","content":"\u003cp\u003eSchizophrenia, a severe mental disorder, is characterized by core symptoms, which often include significant cognitive impairment and social withdrawal \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Although antipsychotic medications have achieved breakthroughs in controlling positive symptoms, interventions focused on negative symptoms (e.g., emotional blunting, lack of motivation) and cognitive deficits remain challenging \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. In recent years, non - pharmacological treatment modalities have increasingly served as crucial adjuncts for improving patient outcomes \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.The Eight Brocades exercise regimen, originating from traditional Chinese medicine and characterized by its relaxed, tranquil, natural, gentle, and slow movement patterns, has demonstrated unique advantages in improving physical function, sleep quality, and emotional state among schizophrenia patients \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. However, exercise intervention alone has limited effects on deep cognitive restructuring. Meanwhile, CCRT\u0026mdash;an evidence-based neuropsychological rehabilitation technique\u0026mdash;precisely targets core cognitive domains such as attention, working memory, and executive function via human-computer interaction, and has been proven effective in enhancing patients' social adaptation abilities \u003csup\u003e[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. The combination of Bajianjin and CCRT aims to establish a comprehensive rehabilitation system addressing both mind and body. This model employs CCRT for intensive cognitive neuroplasticity while incorporating Bajianjin's mind-body regulation, potentially advancing from\u0026ldquo;cognitive improvement\u0026rdquo;to \u0026ldquo;enhanced quality of life.\u0026rdquo;This paper examines the potential effectiveness of this combined therapy in improving psychotic symptoms, self-functioning, and overall quality of life in schizophrenia patients.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Subjects recruitment and sample size calculation\u003c/h2\u003e \u003cp\u003eAll subjects were recruited from Chuzhou Second People's Hospital and provided informed consent before intervention initiation. Subjects were consecutively numbered by their initials and randomly assigned to one of two groups: the Baduanjin plus CCRT group or the CCRT-only group, using a random number table. Sample size was calculated using G*Power \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e, resulting in an initial sample size of 108 subjects per group; after accounting for a 10% dropout rate, the final sample size was set at 120 subjects.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Inclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eInclusion criteria: 1) Diagnosed with schizophrenia by a clinician according to the diagnostic criteria for schizophrenia in the WHO International Classification of Diseases, 10th Revision (ICD-10) \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e; 2) Hospitalized for \u0026ge;\u0026thinsp;1 year; 3) Maintained stable medication dosage for \u0026ge;\u0026thinsp;3 months.\u003c/p\u003e \u003cp\u003eExclusion criteria: 1) Individuals with severe physical conditions, such as serious cardiovascular, pulmonary, or musculoskeletal disorders, that prevent participation in exercise; 2) visual and/or hearing impairments that prevent completion of neurocognitive testing; 3) coexisting mental or neurological disorders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Intervention\u003c/h2\u003e \u003cp\u003e\u003cb\u003eControl Group\u003c/b\u003e: During an 8-week CCRT treatment cycle, patients received 5 sessions per week, each lasting 45 minutes, and underwent cognitive training via a local area network (LAN). The intervention included five core modules: attention, working memory, problem-solving, cognitive flexibility, and social cognition. Each module contained 4\u0026ndash;6 training tasks, totaling 30 exercises. All training tasks were structured with progressive difficulty and gradually increasing speed, comprising 4\u0026ndash;96 corrective trials per exercise. Prior to the main intervention, research team members provided subjects with basic computer operation training. Following the guidance of rehabilitation therapists, subjects engaged in the assigned module exercises. The software adaptively selected appropriate game modules and training difficulty levels based on the subjects\u0026rsquo;performance, gradually increasing task complexity to guide progressive therapeutic task completion.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntervention Group\u003c/b\u003e: The research group combined CCRT intervention with Baduanjin exercises. Training was conducted according to the National Sports Administration's guidelines on Baduanjin movement essentials \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. The regimen included a 5-minute warm-up, 30 minutes of Baduanjin practice, and a 5-minute cool-down. Professionally trained and certified nursing staff led patients through the Baduanjin exercises. The intervention cycle lasted 8 weeks, with 5 sessions per week, each lasting 40 minutes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Evaluation tools\u003c/h2\u003e \u003cp\u003e2.4.1Psychiatric Symptoms: The Positive and Negative Syndrome Scale (PANSS) \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e was used to assess patients' psychiatric symptoms. This scale stands as one of the most fundamental tools in psychiatric clinical evaluations of schizophrenia, demonstrating robust reliability and validity. Through semi-structured interviews, it quantifies symptom severity and is widely employed for drug efficacy assessment, condition monitoring, and clinical trials.\u003c/p\u003e \u003cp\u003e2.4.2Cognitive Function: Cognitive Function: The Neurobehavioral Cognitive Status Examination (NCSE)\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e categorizes cognitive function into five primary domains and independently assesses level of consciousness. This structure enables rapid identification of intact domains while providing detailed evaluation of impaired areas.\u003c/p\u003e \u003cp\u003e2.4.3Social Function: The Scale of Social Function in Psychosis Inpatients (SSPI) \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e was used to evaluate patients' practical abilities in daily living, interpersonal interactions, and social adaptation. It is one of the most widely used social function assessment tools in current domestic psychiatric research.\u003c/p\u003e \u003cp\u003e2.4.4Quality of Life: The Schizophrenia Quality of Life Scale (SQLS)\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e is a self-report instrument specifically designed for individuals with schizophrenia. Developed by Wilkinson et al. at the University of Liverpool in the UK, it has been translated and revised by Chinese scholars. It has strong psychometric properties, with a test-retest reliability coefficient of 0.87 and internal consistency alpha coefficients ranging from 0.70 to 0.92. The scale is widely used in clinical research in China.\u003c/p\u003e \u003cp\u003eGroup Allocation and Intervention: Patients were randomly allocated to the groups, with the allocation maintained as a triple-blind process involving participants, assessors, and therapists. To prevent potential cross-contamination, all interventions were conducted at the rehabilitation physical therapy center, with the intervention and control groups undergoing their respective treatments in separate batches.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.4.5Statistical analyses\u003c/h2\u003e \u003cp\u003eStatistical analyses were performed using SPSS version 26.0. Quantitative variables following a normal distribution are reported as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u0026oline;\u003cb\u003eX\u003c/b\u003e\u0026thinsp;\u0026plusmn;\u0026thinsp;s), while categorical data are presented as n (%). For baseline characteristics, independent samples t-tests or chi-square tests were used for quantitative or categorical data, respectively (with Fisher's exact test applied when n\u0026thinsp;\u0026lt;\u0026thinsp;5). Outcome measures were analyzed using two-way repeated measures ANOVA, with specific comparisons between subscales within PANSS and SSPI performed using t-test. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1Study Population and Baseline Characteristics\u003c/h2\u003e \u003cp\u003eBetween June 2024 and October 2025, 120 patients with schizophrenia were recruited from Chuzhou Second People's Hospital. All subjects completed both assessments and interventions. The participant flow is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and baseline characteristics are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, no statistically significant differences were observed between the two groups in terms of age, educational attainment, disease duration, or other demographic and clinical variables (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic Characteristics and Medication Use of Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention Group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eControl Group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eT/χ\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.53\u0026thinsp;\u0026plusmn;\u0026thinsp;8.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.48\u0026thinsp;\u0026plusmn;\u0026thinsp;8.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.186\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary School Dropout\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(15.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElementary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(38.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23(38.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ejunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18(30.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecollege\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5(8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of illness (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.05\u0026thinsp;\u0026plusmn;\u0026thinsp;10.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.82\u0026thinsp;\u0026plusmn;\u0026thinsp;9.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.735\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(68.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39(65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(31.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21(35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.390\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(58.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27(45.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11(18.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7(11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAP typical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59(98.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtypical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59(98.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal CPZ equivalent dosages (g)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e311.25\u0026thinsp;\u0026plusmn;\u0026thinsp;181.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e290.08\u0026thinsp;\u0026plusmn;\u0026thinsp;161.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"11\"\u003eNote: CPZ, chlorpromazine; AP, Antipsychotic; PANSS, Positive and Negative Syndrome Scale.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.2Two-Way Repeated Measures ANOVA Test Results\u003c/h2\u003e \u003cp\u003eTwo-way repeated measures ANOVA demonstrated significant effects of the intervention on mental state, social functioning, cognitive function, and quality of life. The \"group \u0026times; time\" interaction was significant for all outcome measures: PANSS (F\u0026thinsp;=\u0026thinsp;4.958, P\u0026thinsp;=\u0026thinsp;0.028), SSPI (F\u0026thinsp;=\u0026thinsp;108.45, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), NCSE (F\u0026thinsp;=\u0026thinsp;9.360, P\u0026thinsp;=\u0026thinsp;0.003), and SQLS (F\u0026thinsp;=\u0026thinsp;24.147, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Post-hoc analyses revealed that the intervention group showed significant improvements in all outcome measures compared to baseline (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and demonstrated superior results compared to the concurrent control group (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTwo-Way Repeated-Measures ANOVA for psychiatric symptoms, social function,cognitive function and quality of life (`\u0026thinsp;\u0026plusmn;\u0026thinsp;s)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eχ\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePANSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSSPI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNCSE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSQLS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl Group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.23\u0026thinsp;\u0026plusmn;\u0026thinsp;10.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.45\u0026thinsp;\u0026plusmn;\u0026thinsp;6.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.05\u0026thinsp;\u0026plusmn;\u0026thinsp;9.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.48\u0026thinsp;\u0026plusmn;\u0026thinsp;9.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.27\u0026thinsp;\u0026plusmn;\u0026thinsp;6.02\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.75\u0026thinsp;\u0026plusmn;\u0026thinsp;10.68\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange (Δ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;6.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention Group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.37\u0026thinsp;\u0026plusmn;\u0026thinsp;9.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.50\u0026thinsp;\u0026plusmn;\u0026thinsp;7.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.59\u0026thinsp;\u0026plusmn;\u0026thinsp;5.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17.95\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.75\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.62\u0026thinsp;\u0026plusmn;\u0026thinsp;7.00\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.41\u0026thinsp;\u0026plusmn;\u0026thinsp;4.67\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89 \u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange (Δ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e+\u0026thinsp;3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup \u0026times; Time Interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.958\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eɳ2\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ea P \u0026lt; 0.05, compared with baseline within the same group (based on the simple effects analysis of the repeated\u0026minus;measures ANOVA).\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb P \u0026lt; 0.05, compared with the control group at the same time point (based on the simple effects analysis of the repeated\u0026minus;measures ANOVA).\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eThe P\u0026minus;values in the \"Group \u0026times; Time Interaction\" row are derived from the two\u0026minus;way repeated\u0026minus;measures ANOVA and indicate that the improvement trajectory was significantly different between the two groups over time\u003c/sup\u003e.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.3Results of the T-test\u003c/h2\u003e \u003cp\u003eResults indicated significant improvements in negative symptoms and the total PANSS score in the intervention group post-intervention. Additionally, although both groups showed enhanced performance in self-care, initiative/engagement, and social activity skills on the SSPI from baseline to post-intervention, the intervention group demonstrated greater improvement than the control group (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). These findings are detailed in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eT-test for psychiatric symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive symptom\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative symptom\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGeneral pathology\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotals\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.87\u0026thinsp;\u0026plusmn;\u0026thinsp;4.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.22\u0026thinsp;\u0026plusmn;\u0026thinsp;7.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.15\u0026thinsp;\u0026plusmn;\u0026thinsp;5.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.23\u0026thinsp;\u0026plusmn;\u0026thinsp;10.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.43\u0026thinsp;\u0026plusmn;\u0026thinsp;4.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.68\u0026thinsp;\u0026plusmn;\u0026thinsp;7.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.48\u0026thinsp;\u0026plusmn;\u0026thinsp;9.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.42\u0026thinsp;\u0026plusmn;\u0026thinsp;4.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.58\u0026thinsp;\u0026plusmn;\u0026thinsp;7.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.37\u0026thinsp;\u0026plusmn;\u0026thinsp;5.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.37\u0026thinsp;\u0026plusmn;\u0026thinsp;9.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.87\u0026thinsp;\u0026plusmn;\u0026thinsp;5.80\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.93\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.75\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eaThe comparison between the two groups after treatment and before treatment, P \u0026lt; 0.05\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb Compare the degree of improvement between two groups of control and intervention groups, P \u0026lt; 0.05; \u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eThe P\u0026minus;value is calculated by comparing the degree of improvement between the intervention group and the control group after treatment\u003c/sup\u003e.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eT-test for social function\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe daily living skills\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMotivation and socialization\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSociamobility skills\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotals\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.42\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.95\u0026thinsp;\u0026plusmn;\u0026thinsp;1.84\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.08\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention group (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.58\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.85\u0026thinsp;\u0026plusmn;\u0026thinsp;3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.067\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.50\u0026thinsp;\u0026plusmn;\u0026thinsp;7.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.60\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.68\u0026thinsp;\u0026plusmn;\u0026thinsp;3.48\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.62\u0026thinsp;\u0026plusmn;\u0026thinsp;7.00\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eaThe comparison between the two groups after treatment and before treatment, P \u0026lt; 0.05\u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb Compare the degree of improvement between two groups of control and intervention groups, P \u0026lt; 0.05; \u003c/sup\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eThe P\u0026minus;value is calculated by comparing the degree of improvement between the intervention group and the control group after treatment\u003c/sup\u003e.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":" \u003cp\u003eSchizophrenia is a severe mental disorder predominantly affecting young adults and working-age populations, with its etiology remaining largely unknown. Characterized by a chronic and relapsing condition \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, it imposes a significant burden on patients and their families. With increased health awareness and improved medical care, treatment for chronic schizophrenia now extends beyond symptom management. It has generated new demands for rehabilitation outcomes, aiming to maximize quality of life, restore social functioning, and alleviate the stress associated with the illness.\u003c/p\u003e \u003cp\u003eThe current study demonstrated significantly superior efficacy of the combined intervention in improving overall symptoms of schizophrenia, particularly negative symptoms, compared to the control group, consistent with prior findings by Gao et al. \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. The underlying mechanisms may involve multi-pathway synergistic effects of Baduanjin as an integrated mind-body exercise. First, its unique characteristics as a slow, continuous, and attention-demanding aerobic exercise may directly improve motivation deficits and emotional blunting\u0026mdash;key components of negative symptoms\u0026mdash;by regulating central neurotransmitter systems (e.g., enhancing serotonergic activity). Second, the structured movement practice itself serves as a form of behavioral activation, helping counteract psychomotor retardation and difficulties initiating daily activities. Third, the guided group practice format provides a structured, low-pressure social interaction environment, potentially mitigating social withdrawal tendencies \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Thus, Baduanjin exerts a comprehensive intervention effect on core negative symptom dimensions not through a single mechanism, but simultaneously across neurobiological, behavioral activation, and psychosocial pathways.\u003c/p\u003e \u003cp\u003eThis study demonstrates that CCRT effectively enhances cognitive function in schizophrenia patients, consistent with the findings of Ma et al \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. The mechanism centers on neuroplasticity and cognitive remodeling, wherein CCRT systematically induces functional remodeling of neural circuits through repetitive cognitive task training. This may enhance the brain's processing efficiency for complex cognitive tasks by altering low-frequency amplitude (ALFF) in key regions such as the prefrontal cortex and anterior cingulate cortex \u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. Notably, the combined intervention group showed better cognitive improvement than CCRT alone. This synergistic effect may be attributed to Baduanjin\u0026mdash;a mind-body exercise integrating specific breathing regulation and dynamic stretching\u0026mdash;which promotes peripheral and cerebral blood circulation. By enhancing cerebral oxygen supply and optimizing physiological activation in the cerebral cortex, Baduanjin potentially provides a more responsive neural foundation for cognitive task execution \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e.Second, studies show that Baduanjin practice modulates functional connectivity in brain networks supporting higher-order cognitive control. Specifically, it enhances regulatory functions in the dorsolateral prefrontal cortex (DLPFC) and alters resting-state activity in the default mode network (DMN), thereby supporting executive function and other core cognitive domains. Additionally, Baduanjin reduces psychological stress by balancing autonomic nervous system activity and mitigating stress responses \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e.This reduction in stress frees up cognitive resources, thereby enhancing cognitive performance. In summary, the combined intervention achieves synergistic effects through multiple mechanisms. Baduanjin improves the overall mind-body state and optimizes the brain's \"hardware\" environment, while CCRT targets \"software\"-level neurocognitive remodeling. Long-term Baduanjin practice not only creates more favorable conditions for immediate CCRT training effects but may also help sustain cognitive gains by consolidating neuroplasticity changes, preventing their decline over time.\u003c/p\u003e \u003cp\u003eThis study found that both the combined intervention group and the single CCRT control group demonstrated significant improvements in social functioning. However, the combined intervention group showed greater improvement compared to the control group. This synergistic effect likely arises from the complementary roles of both interventions across different dimensions of social functioning. CCRT employs targeted training to enhance patients' social cognitive abilities\u0026mdash;including emotion recognition and interpretation of social cues\u0026mdash;thereby enabling the construction of more accurate cognitive representations for social interactions \u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e; While Baduanjin, starting from mind-body regulation, utilizes its unique breathing-movement coordination pattern to help regulate neuroendocrine homeostasis (e.g., reducing stress-related cortisol levels) and improve foundational behavioral dimensions related to social motivation, such as personal neatness, mental alertness, and emotional expression \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e.This combination represents more than a simple summation but a deep integration at the mechanistic level between \"social cognitive reconstruction\" and \"social behavioral activation.\" This synergy effectively promotes the overall restoration of patients' social functioning.\u003c/p\u003e \u003cp\u003eIndividuals with schizophrenia often experience deficits in attention, memory, and executive functions (e.g., planning). CCRT employs high-intensity cognitive training (e.g., working memory exercises) to enhance neural efficiency and promote brain plasticity, thereby alleviating negative symptoms and improving overall quality of life \u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. Additionally, CCRT enhances cognitive potential through targeted brain training \u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e. Baduanjin, a gentle traditional Chinese exercise, improves physiological functions like balance, logical memory, and social interaction interest, fostering long-term adherence and high self-efficacy \u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. This combination synergistically enhances patients' overall quality of life by addressing both cognitive and physiological aspects, achieving \"internal and external cultivation.\"\u003c/p\u003e \u003cp\u003eLimitations and Future Directions: This study has several limitations. First, the 8-week follow-up period is insufficient to assess long-term effects in a chronic condition like schizophrenia. Longer observation periods are needed to determine whether improvements in clinical symptoms, cognitive function, social functioning, and quality of life persist beyond the immediate post-intervention phase. Some early improvements may diminish over time, while extended interventions could consolidate or even enhance therapeutic effects. Therefore, future studies with extended follow-up periods of 6 to 12 months are needed to provide stronger evidence regarding the long-term clinical value of combined therapy.Second, all participants were recruited from a single center (Chuzhou Second People's Hospital). The lack of a multicenter design may limit the generalizability of our findings and reduce statistical power for detecting more subtle treatment effects. Although significant differences were observed in the primary outcome measures, the external validity of these results requires further validation. Future studies should therefore prioritize multicenter trials with expanded sample sizes. Additionally, employing longer follow-up periods and predefined thresholds for clinically meaningful change is crucial for determining the true clinical impact of observed alterations.\u003c/p\u003e "},{"header":"5. Conclusion","content":"\u003cp\u003eThe findings indicate that an 8-week combined intervention combining Baduanjin and CCRT significantly improved psychotic symptoms, cognitive function, social functioning, and quality of life in schizophrenia patients more effectively than CCRT alone. This synergy may stem from complementary effects across physiological, molecular, and behavioral domains. Physiologically, Baduanjin enhances cerebral blood flow and hippocampal plasticity, supporting cognitive training. Molecularly, CCRT elevates BDNF levels, while Baduanjin may sustain this elevation through neuroendocrine modulation. Behaviorally, Baduanjin alleviates negative emotions, improving patient motivation and adherence to CCRT. Collectively, this multi-level synergy provides a novel holistic non-pharmacological approach for schizophrenia rehabilitation.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCCRT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eComputerized Cognitive Remediation Therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRandomized Controlled Trial\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003e10-International Statistical Classification of Diseases and Related Health Problems 10th Revision\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePANSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Positive and Negative Syndrome Scale\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNCSE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Neurobehavioral Cognitive Status Examination\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSSPI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Scale of Social Function in Psychosis Inpatients\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSQLS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Schizophrenia Quality of Life Scale\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch3\u003eClinical Trial Registration Information\u003c/h3\u003e\n\u003cp\u003eThis Randomized Controlled Trial (RCT) is registered with the National Universal Health Security Information Platform, a national medical research registration system in China，(Registration Number: MR-34-25-010431 https://www.medicalresearch.org.cn/cas/sso/login?clientId=9001\u0026amp;redirectUri=https%3A%2F%2Fwww.medicalresearch.org.cn%2Findex）\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adheres to the Declaration of Helsinki and received ethical approval from the Medical Ethics Committee of Chuzhou Second People\u0026apos;s Hospital (Approval No. 2024-Yuan-Lun-Shen-Yi-Zi-No. (06)). Written informed consent was obtained from all participants. The study adhered to the principles of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no acknowledgments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflict of interest to report.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Scientific research projects in natural sciences of \u0026nbsp;Anhui Higher Education Institutions of China(2024AH051393)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo;contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQX was an investigator in the study, participated in conceptualization and \u0026nbsp;methodology design, performed randomization of the participants, supervised the study\u003c/p\u003e\n\u003cp\u003eWL participated in processing of the data and \u0026nbsp; edited the main manuscript\u003c/p\u003e\n\u003cp\u003eparticipated in recruitment and clinical assessments\u003c/p\u003e\n\u003cp\u003eLX\\QH\\WM participated in recruitment and data collection\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eZZ participated in data collection\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the support of the Second People\u0026apos;s Hospital of Chuzhou. The hospital provided essential conditions for patient recruitment and financial support, which were fundamental to this study.\u003c/p\u003e\n\u003cp\u003eWe extend our sincere thanks to all the rehabilitation therapists and physicians involved. Their professional expertise, diligent efforts, and collaboration were invaluable to the implementation of the research protocol and data collection.\u003c/p\u003e\n\u003cp\u003eOur deepest appreciation goes to all the patients who participated in this study. Their willingness to contribute their time and experiences made this research possible.\u003c/p\u003e\n\u003cp\u003eFinally, we thank everyone who contributed to this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSumiyoshi T, De Peri L, Barlati S. Editorial: Unveiling the neurobiological underpinnings of cognitive dysfunction in patients with schizophrenia. Front Psychiatry. 2024. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fpsyt.2024.1511643\u003c/span\u003e\u003cspan address=\"10.3389/fpsyt.2024.1511643\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMeyer JM. How antipsychotics work in schizophrenia: A primer on mechanisms. CNS Spectr. 2025;30(1):e6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1017/S1092852924002244\u003c/span\u003e\u003cspan address=\"10.1017/S1092852924002244\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchizophrenia Collaborative Group of the Psychiatric Branch of the Chinese Medical Association. Schizophrenia Clinical Research Alliance of the Basic and Clinical Branch of Psychiatry of the Chinese Neuroscience Society, \u0026hellip; Chinese Expert Consensus on Maintenance Treatment of Schizophrenia. Chin J Psychiatry, 57(7), 397\u0026ndash;406.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang J, Gao W, Gao M, Ma Y, Li D. Effects of Baduanjin on Psychopathological Symptoms, Sleep, and Quality of Life in Elderly Patients with Schizophrenia. Int J Nurs. 2025;7(8):45\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHu JJ, Sun XR, Ni SM, Kong Y. Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia. World J Psychiatry. 2024;14(6):884\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiao L-W, Ding Y, Wu X, Zhou Y-P, Pan G-H. A randomized controlled trial of the computerized cognitive remediation therapy to adult schizophrenia. Chin J Clin Psychol. 2016;24(5):954\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFan F, Zou Y, Tan Y, Hong LE, Tan S. Computerized cognitive remediation therapy effects on resting state brain activity and cognition in schizophrenia. Sci Rep. 2017;7(1):4758. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41598-017-04829-9\u003c/span\u003e\u003cspan address=\"10.1038/s41598-017-04829-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFaul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175\u0026ndash;91. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3758/BF03193146\u003c/span\u003e\u003cspan address=\"10.3758/BF03193146\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHealth Statistics Information Center, Ministry of Health. International Classification of Diseases (ICD-10) application guidebook. Beijing: Union Medical College; 2001.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFitness Qigong Management Center of the General Administration of Sports of the People's Republic of China. Fitness qigong: Yi Jin Jing, Wuqin Xi, Liuzi Jue, Baduan Jin. People's Sports Publishing House; 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNielsen CM, K\u0026oslash;lb\u0026aelig;k P, Dines D, Opler M, Correll CU, \u0026Oslash;stergaard SD. Are informants required to obtain valid ratings on the Positive and Negative Syndrome Scale (PANSS)? Schizophrenia. 2023;9(1):54. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41537-023-00378-5\u003c/span\u003e\u003cspan address=\"10.1038/s41537-023-00378-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKiernan RJ, Mueller J, Langston JW, Van Dyke C. The Neurobehavioral Cognitive Status Examination: A brief but quantitative approach to cognitive assessment. Ann Intern Med. 1987;107(4):481\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.7326/0003-4819-107-4-481\u003c/span\u003e\u003cspan address=\"10.7326/0003-4819-107-4-481\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu W, Tong J, Sun X, Chen F, Zhang J, Pei Y, Zhang T, Zhang J, Zhu B. Analysis of medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Int J Environ Res Public Health. 2021;18(9):4746. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijerph18094746\u003c/span\u003e\u003cspan address=\"10.3390/ijerph18094746\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo H. Shenjing fenlie zheng huanzhe shenghuo zhiliang liangbiao (SQLS) zhongwenban: Xiugai ji linchuang yingyong yanjiu. Hangzhou: Zhejiang University; 2002.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJauhar S, Johnstone M, McKenna PJ. Schizophrenia Lancet. 2022;399(10323):473\u0026ndash;86. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/S0140-6736(21)01730-X\u003c/span\u003e\u003cspan address=\"10.1016/S0140-6736(21)01730-X\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCahaya N, Kristina SA, Widayanti AW, Green J. Interventions to improve medication adherence in people with schizophrenia: A systematic review. Patient Prefer Adherence. 2022;16:2431\u0026ndash;49.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao D, Liu Y, Zhang Z. Effect of Baduanjin exercise on mental rehabilitation of patients with chronic schizophrenia. J Armed Police Med. 2011;22(12):1061\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3969/j.issn.1004-3594.2011.12.017\u003c/span\u003e\u003cspan address=\"10.3969/j.issn.1004-3594.2011.12.017\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang W, Wang Y, Zhu Q, et al. The effect of Baduanjin combined with mindfulness stress reduction therapy on the mood of patients with schizophrenia in convalescence. Psychol Monthly. 2024;19(14):119\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNishuangmin Y, Zhendong Y, Wei Y, Liu H, Kong Y. The current research status of computerized cognitive therapy in improving cognitive function of hospitalized schizophrenia patients. Int J Psychiatry. 2024;51(2):341\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang Y, Li S, Wang L, Liu J. The effect of computerized cognitive remediation therapy on social function and quality of life in chronic schizophrenia patients. Clin Psychiatry J. 2017;27(1):59.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu X, Ding L, Mao X, et al. Effect of computerized cognitive remediation therapy on cognitive function, symptoms, and daily living ability in patients with schizophrenia. Zhongwai Yiyao Yanjiu (Chinese J Foreign Med Research). 2025;4(20):10\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeng Y, Feng X. The Effects of Olanzapine Combined with Computer-Assisted Cognitive Rehabilitation on Cognitive Function in Schizophrenia Patients. J Clin Ration Drug Use. 2022;15(3):25\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFengmei F, et al. Computerized cognitive remediation therapy effects on resting state brain activity and cognition in schizophrenia. Sci Rep. 2017;7(4758). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41598-017-04829-9\u003c/span\u003e\u003cspan address=\"10.1038/s41598-017-04829-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeng J. Clinical study of Baduanjin combined with transcranial direct current stimulation in the treatment of mild cognitive dysfunction after stroke. New Chin Med. 2022;54(18):4. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.13457/j.cnki.jncm.2022.18.032\u003c/span\u003e\u003cspan address=\"10.13457/j.cnki.jncm.2022.18.032\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta A, Kumari S. Effect of cognitive retraining treatment in mild to moderate depressive disorders. Psicologia: Reflex\u0026atilde;o e Cr\u0026iacute;tica. 2023;36(10):1\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5772/36783\u003c/span\u003e\u003cspan address=\"10.5772/36783\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDu M, Lang H, Zhang Z, et al. Application effects of Baduanjin in patients with schizophrenia and its impact on quality of life. Chin J Foreign Med Res. 2020;18(6):167\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu W, Zhou Q, Sun Y, He Y. Application of traditional Chinese medicine physical exercises in the rehabilitation of residual symptoms of schizophrenia. Shanghai J Traditional Chin Med. 2023;57(9):91\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.16305/j.1007-1334.2023.2302060\u003c/span\u003e\u003cspan address=\"10.16305/j.1007-1334.2023.2302060\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSubramaniam K, Laird AR, Liddle EB, Seidman LJ, Goldstein JM. Intensive cognitive training in schizophrenia enhances working memory and associated prefrontal cortical efficiency in a manner that drives long-term functional gains. NeuroImage. 2014;99:281\u0026ndash;92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.neuroimage.2014.05.057\u003c/span\u003e\u003cspan address=\"10.1016/j.neuroimage.2014.05.057\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi S. (2016). The effect of Baduanjin exercise on overall cognitive function and memory in elderly individuals with mild cognitive impairment (Master\u0026rsquo;s thesis, Fujian University of Traditional Chinese Medicine).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu J-Y, Li Y-H. The application effect of exercise therapy on insomnia in patients with chronic schizophrenia. Practical Clin Med Pharm. 2020;24(24):57\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.7619/jcmp.202024017\u003c/span\u003e\u003cspan address=\"10.7619/jcmp.202024017\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"schizophrenia, Baduanjin, Computerized Cognitive Remediation Therapy","lastPublishedDoi":"10.21203/rs.3.rs-8641027/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8641027/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBACKGROUND\u003c/h2\u003e \u003cp\u003eSchizophrenia is a severe mental disorder characterized by complex clinical presentations and marked impairments in social and occupational functioning. While antipsychotic medications are effective in managing positive symptoms, their efficacy in addressing negative symptoms, cognitive deficits, and overall improvements in social functioning and quality of life remains substantially limited.This study aims to evaluate the effects of Baduanjin combined with Computerized Cognitive Remediation Therapy (CCRT) on patients with schizophrenia, thereby contributing to the evidence base for its clinical management.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eA total of 120 hospitalized patients with schizophrenia (aged 29\u0026ndash;64 years; 66.67% male) were recruited and randomly allocated to either an intervention group (n\u0026thinsp;=\u0026thinsp;60) or a control group (n\u0026thinsp;=\u0026thinsp;60). Participants in the intervention group received a combined 85-minute session (45 minutes of CCRT plus 40 minutes of Baduanjin training) five times per week, whereas the control group received CCRT alone for the same duration. Assessments of psychiatric symptoms, cognitive function, social functioning, and quality of life were conducted at baseline and post-intervention.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eBaseline characteristics were comparable between the two groups for all outcome measures (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Following the 8-week intervention, within-group analyses showed significant improvements from baseline in NCSE, SSPI, and SQLS scores for both groups (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In contrast, a statistically significant reduction in PANSS total scores was only observed in the intervention group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Moreover, intergroup analysis revealed that the intervention group demonstrated significantly greater improvements across all outcome measures (NCSE, SSPI, SQLS, and PANSS) compared to the control group post-intervention (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e \u003cp\u003ePatients with schizophrenia showed significantly better overall efficacy with an 8-week combined treatment of Baduanjin and CCRT compared to CCRT alone, particularly in improving psychiatric symptoms (especially negative symptoms), enhancing cognitive function, restoring social functioning, and improving quality of life.\u003c/p\u003e","manuscriptTitle":"Baduanjin Combined with Computerized Cognitive Remediation Therapy for the Treatment of Schizophrenia : A 8-week randomized controlled trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-29 00:43:52","doi":"10.21203/rs.3.rs-8641027/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-04T09:00:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-23T05:01:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-18T15:00:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"161775310125078171226557651772759203736","date":"2026-01-26T02:51:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"171528201628287094545860599932796439923","date":"2026-01-26T02:48:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-23T13:17:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-21T09:46:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-21T09:41:19+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2026-01-19T14:48:21+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f26dea67-a304-4764-aa08-9bfb1a08e9fb","owner":[],"postedDate":"January 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T14:08:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-29 00:43:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8641027","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8641027","identity":"rs-8641027","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}