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Older adults with knee osteoarthritis (KOA) are at a higher risk of falling and tend to experience more severe injuries due to impaired balance. Baduanjin, a mind-body exercise, has been shown to improve lower limb muscle strength and balance in older adults and to reduce fall risk in those with KOA; however, its specific mechanisms remain unclear. Therefore, this study aims to examine the effectiveness of Baduanjin in reducing fall risk among older adults with KOA and to preliminarily elucidate its underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>In this prospective trial, 72 KOA participants will be recruited and randomly assigned (1:1:1) to perform Baduanjin training, brisk walking training and health education. The health education group will conduct health education for the participants in the group once a month, a total of 3 times. Based on the health education group, the Baduanjin group and the brisk walking group were respectively subjected to 12 weeks of Baduanjin exercise intervention (40\u2009min each, 3 times a week) and 12 weeks of brisk walking exercise intervention (60\u2009min each, 3 times a week). The primary outcome will be the fall-risk self-assessment questionnaire and modified falls efficacy scale. The secondary outcome will be balance function test, gait subscale of the Tinetti performance-oriented mobility assessment, lower limb muscle strength and functional MRI (fMRI). In addition to the fMRI scan, the results will be measured before and after the intervention. Other primary and secondary outcomes will be measured at baseline, at week 6 at week 12 (at the end of the trial) and after an additional 12-week follow-up period. The linear mixed model will be used to observe the effect of intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was approved by the Ethics Committee of Bao'an District People\u2019s Hospital, Shenzhen (No. BYL20230811). Our research findings will be published in peer-reviewed journal articles and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2400081342.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114318","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:05:19Z","timestamp":1782270319000},"page":"e114318","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the mechanism of reducing the risk of falls in knee osteoarthritis patients by using Baduanjin based on the functional connection of vestibular network: a study protocol for a randomised controlled 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Traditional Chinese Medicine, Fuzhou, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zesen","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwen","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangjie","family":"Chen","sequence":"additional","affiliation":[{"name":"GuangXi University of Chinese Medicine, Nanning, Guangxi, China"},{"name":"Department of Rehabilitation, 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