Evidence map of traditional Chinese exercises.

Objective: This study aimed to assess and visually depict the clinical evidence landscape of traditional Chinese exercises and identify any research gaps and future research needs. Methods: We comprehensively searched seven Chinese and English databases to identify randomized controlled trials (RCTs) and systematic reviews (SRs) evaluating the effects of traditional Chinese exercises from their inception until May 2023. The quality of evidence was assessed via the GRADE approach, and the research topics, intervention effects, and strength of evidence were graphically displayed. Results: This evidence map includes 2,017 studies, comprising 1,822 RCTs and 195 SRs. These studies were conducted globally in various countries. Among the traditional Chinese exercises, Tai Chi and Baduanjin have received the most research attention, with a growing number of publications. When traditional Chinese exercises were compared with the control groups, 88.2% of the included SRs reported significantly positive effects, 4.1% reported unclear effects, and 7.7% reported no significant differences. The findings suggested that traditional Chinese exercises could benefit patients with osteoarthritis, osteoporosis, hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, stroke, Parkinson's disease, anxiety, and depression. However, the overall quality of the evidence was suboptimal, with 11.3% rated as moderate, 45.6% as low, and 43.1% as critically low. Conclusion: This evidence map visually represents valuable information on traditional Chinese exercises. While most studies have reported significant benefits, the overall quality of evidence is low.

Efficacy and safety of Supine Daoyin in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial.

AIM: This study aimed to develop and evaluate the efficacy and safety of Supine Daoyin, a TCM PR technique, in hospitalized patients with AECOPD. METHODS: This is a multicenter, prospective, randomized, controlled trial involving AECOPD inpatients recruited from April 2021 to December 2023 in five tertiary hospitals in China. Participants were randomly assigned to 14 days of Supine Daoyin group or control group and evaluated at days 3, 7, and 14 (posttreatment). The primary outcomes were LOS and CCQ and secondary outcomes were 6MWD, 30-STS, BI, Borg CR10, time on mechanical ventilation, SGRQ, mCOPD-PRO, and mESQ-COPD. RESULTS: Out of 369 participants screened, 228 were randomly assigned (Supine Daoyin group: n = 114; control group: n = 114). For primary outcomes, there was no significant between-group difference in LOS (p > 0.05), but for CCQ the Supine Daoyin was superior to control at days 7 (p < 0.01) and 14 (p < 0.01). For secondary outcomes, Supine Daoyin groups showed robust and superior improvements in 6MWD, 30-STS, BI, Borg CR10, SGRQ, mCOPD-PRO, and mESQ-COPD (all p < 0.05), but for time on mechanical ventilation there was no significant difference in two groups (p > 0.05). CONCLUSION: Supine Daoyin, a novel TCM PR technique, demonstrates safety and efficacy for AECOPD inpatients, yielding clinically meaningful improvements in health status, exercise capacity, and quality of life. This study offers a viable PR option for AECOPD patients with severe symptoms and limited mobility.

The effect of different traditional Chinese exercises on bone mineral density in menopausal women: a systematic review and network meta-analysis.

Objective: To evaluate the optimal choice of traditional Chinese exercise (TCE) for improving bone mineral density in postmenopausal women through a network meta-analysis. Methods: The Chinese and English databases were searched, including China National Knowledge Infrastructure, Chongqing VIP, PubMed, Web of Science and Cochrane Library. The outcomes included BMD of lumbar L2-L4, femoral neck, ward triangle, and greater trochanter. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to assess the correlation between each group of interventions, and surface under the cumulative ranking (SUCRA) was used to rank the best interventions. Results: A total of 20 randomized controlled trials (RCTs) including 1933 subjects and six interventions: [Tai Chi (TC), Baduanjin (BDJ), Wuqinxi (WQX), Yijinjing (YJJ), TA (Tai chi plus calcium supplementation), BA (Baduanjin plus calcium supplementation)] and three control measures: [Calcium supplementation (CA), Aerobic exercise (AE), Not exercise intervention (NEI)] were analyzed. Regarding BMD of lumbar L2-L4: TC [SMD = 0.99 (0.62, 1.37)], BDJ [SMD = 2.12 (1.39, 2.85)], TA [SMD = 1.12(0.17, 2.07)], BA [SMD = 2.24 (1.16, 3.31)] were superior in increasing BMD of lumbar L2-L4 relative to NEI. Regarding BMD of femoral neck: TC [SMD = 1.24 (0.70, 1.78)], BA [SMD = 3.77 (1.98, 5.56)] were superior in increasing BMD of femoral neck relative to NEI. Regarding BMD of ward's triangle: TC [SMD = 1.63 (1.09, 2.17)] was superior in increasing BMD of ward's triangle relative to NEI. Regarding BMD of greater trochanter: TC [SMD = 0.98 (0.28, 1.68)] were superior in increasing BMD of greater trochanter relative to NEI. TC topped the SUCRA with BMD of lumbar L2-L4: 53.8, femoral neck: 74.9, ward's triangle: 86.9 and greater trochanter: 77.7. Conclusion: Four TCE (TC, BDJ, TA and BA) are all effective in partially improving BMD indicators in postmenopausal women, while TC was effective on all four BMD indicators, which seems to be recommended as the most suitable exercise modality for postmenopausal women. Systematic review registration: This research follows the PRISMA Network statement. The protocol for this study has been registered in the International Prospective Registry of Systematic Reviews (PROSPERO). CRD42023414944.

Bibliometric analysis of traditional Chinese exercises in stroke rehabilitation from 2003 to 2022 using CiteSpace.

Background: A comprehensive analysis was conducted on the relevant literature pertaining to the application of traditional Chinese exercises in stroke rehabilitation over the past 20 years. Additionally, a scientific knowledge map was created to elucidate the current research status, investigate its development process and research trends, and offer novel research perspectives for future studies. Methods: The data is sourced from the WOS Core Collection, and CiteSpace software is used to analyze the relevant literature on traditional Chinese exercises in stroke rehabilitation. The analysis began with the selection of publications, countries, institutions, highly cited authors, and co-cited references to summarize the current research status of traditional exercises in stroke rehabilitation. Second, keywords were employed to identify research hotspots, and keyword clustering time zone diagrams were chosen to track the research development process. Finally, burst keywords were employed to explore the research frontiers and trends in this field. Results: In total, 937 documents were retrieved, and the annual publication volume consistently and sustainably increased. China and the USA emerged as significant contributors. The Chinese University of Hong Kong had the highest publication count, with ADA L from the University of Sydney being a highly cited author. Initially, keywords focused on cardiac output, blood flow, pressure, and performance. Over time, the focus shifted to heart failure, muscle strength, mortality, and exercise capacity. Current trends encompass outcome, impact, virtual reality, and anxiety. Conclusion: Integrating key elements of traditional exercise approaches with the specific attributes of movement disorders during the stroke recovery phase is essential. Therefore, enhancing the stroke rehabilitation training program and exploring novel avenues for traditional exercise-based interventions are critical.

Effects of traditional Chinese exercises in fibromyalgia syndrome: A meta-analysis of randomized controlled trials.

OBJECTIVES: To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS). METHODS: The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model. RESULTS: Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (I2 =86.2, P = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =-0.66,95% CI [-1.08, -0.25], P = 0.002), improving sleep (SMD = -0.35,95% CI [-0.68,0. 01], P = 0.041) and relieving depression (SMD= -0.24,95% CI [-0.47, -0.02], P = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =-0.20,95% CI [-0.48,0.09], P = 0.176). CONCLUSIONS: TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.

Traditional Chinese exercises on pain and disability in middle-aged and elderly patients with lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials.

Background: Traditional Chinese exercises (TCEs) have played a significant role in treating various diseases. However, there is limited research assessing the efficacy of TCEs in treating Lumbar disc herniation (LDH). This study aimed to systematically evaluate the effects of four commonly used TCEs (Baduanjin, Yijinjing, Taichi, and Wuqinxi) on pain and disability in elderly patients with LDH. Objectives: To assess the quality of relevant randomized controlled trials (RCTs) to provide evidence support for the treatment of LDH. Methods: RCTs were identified through eight databases. Meta-analysis and trial sequence analysis (TSA) were conducted using RevMan 5.4, Stata 17.0, and TSA 0.9. Results: A total of 22 RCTs, involving 1931 patients, were included in the analysis. TCEs exhibited a superior effectiveness in treating LDH compared to the control group. However, the TSA analysis suggested the possibility of false positives, indicating the need for more high-quality RCT evidence. Nevertheless, TCEs showed reliable results in significantly improving the VAS score and JOA score of LDH patients. Conclusion: Current evidence indicates that the four TCEs have advantages in treating LDH in middle-aged and elderly individuals. However, considering the limitations of this study, we need to exercise caution in drawing conclusions, and further research is required to validate these findings. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023431633].

Efficacy of traditional Chinese exercise for the treatment of pain and disability on knee osteoarthritis patients: a systematic review and meta-analysis of randomized controlled trials.

Objective: To evaluate the efficacy of Traditional Chinese Exercises (TCEs) in treating knee osteoarthritis (KOA). Methods: Four databases without language or publication status restrictions were searched until April 1, 2022. Based on the principle of Population, Intervention, Comparison, Outcomes and Study design, the researchers searched for randomized controlled trials of TCEs in treating KOA. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain was defined as the primary outcome, whereas stiffness and physical function were the secondary outcomes. Subsequently, two researchers conducted the process independently, and the data were analyzed using the RevManV.5.3 software. Results: Overall, 17 randomized trials involving 1174 participants met the inclusion criteria. The synthesized data of TCEs showed a significant improvement in WOMAC pain score [standardized mean difference (SMD) = -0.31; 95% confidence interval (CI): -0.52 to -0.10; p = 0.004], stiffness score (SMD = -0.63; 95% CI: -1.01 to -0.25; p = 0.001) and physical function score (SMD = -0.38; 95% CI: -0.61 to -0.15; p = 0.001) compared with the control group. Sensitivity analyses were performed to determine the combined results' stability, which was unstable after excluding articles with greater heterogeneity. A further subgroup analysis showed that it might be the reason for the heterogeneity of the different traditional exercise intervention methods. Additionally, it showed that the Taijiquan group improved pain (SMD = 0.74; 95% CI: -1.09 to 0.38; p < 0.0001; I2 = 50%), stiffness (SMD = -0.67; 95% CI -1.14 to 0.20; p = 0.005) and physical function score (SMD = -0.35; 95% CI: -0.54 to 0.16; p = 0.0003; I2 = 0%) better than the control group. The Baduanjin group improved stiffness (SMD = -1.30; 95% CI: -2.32 to 0.28; p = 0.01) and physical function (SMD = -0.52; 95% CI: -0.97 to 0.07; p = 0.02) better than the control group. However, the other interventions showed no difference compared with the control group. Conclusion: This systematic review provides partial evidence of the benefits of TCEs for knee pain and dysfunction. However, due to the heterogeneity of exercise, more high-quality clinical studies should be conducted to verify the efficacy. Systematic review registration: https://inplasy.com/inplasy-2022-4-0154/, identifier: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) [INPLSY202240154].

Effects of traditional Chinese exercises on the rehabilitation of patients with chronic heart failure: A meta-analysis.

Background: With the development of rehabilitation medicine, exercise therapy has gradually become one of the methods to prevent and treat cardiovascular diseases. It is widely used in clinic because it can further reduce the mortality rate, improve clinical symptoms, restore the activity ability of the body, improve the quality of life of patients and reduce the hospitalization rate. Traditional Chinese exercises have developed rapidly in recent years, which mainly include Baduanjin, Tai Ji, etc. However, meta-analyses of all types of exercises are not well characterized. Objectives: To evaluate the effect of traditional Chinese exercises (TCEs) on the rehabilitation of patients with chronic heart failure (CHF) using a meta-analysis. Methods: A systematic search of randomized controlled trials (RCTs) on TCEs for patients with CHF in 13 databases (PubMed, China National Knowledge Infrastructure, etc.). Meta-analysis was performed using Review Manager software (version 5.3) after two investigators independently screened the studies, assessed the quality of the studies, and extracted the data. Results: Meta-analysis of 21 randomized controlled trials which involved 1,665 patients with chronic heart failure showed that practicing TCEs was effective in improving patients' physiological outcomes such as VO2max [MD = 2.14, 95% CI (1.02, 3.26), P < 0.001], AT [MD = 1.61, 95% CI (1.06, 2.16), P < 0.001], and left ventricular ejection fraction [MD = 2.60, 95% CI (1.17, 4.02), P < 0.001]. Non-physiological outcomes benefited from the application of TCEs: 6-min walking distance [MD = 38.55, 95% CI (36.67, 40.42), P < 0.001], quality of life [MD = 5.52, 95% CI (3.17, 7.88), P < 0.001], and single-item TCM symptom scores in CHF patients: tiredness and fatigue [MD = 0.78, 95% CI (0.03, 1.53), P = 0.04], shortness of breath [MD = 0.44,95% CI (0.26, 0.62), P < 0.0001], facial puffiness and limb swelling [MD = 0.44,95% CI (0.12, 0.76), P = 0.007], palpitations [MD = 0.68,95% CI (0.14, 1.21), P = 0.01] were improved. Conclusions: TCEs improved several recovery indicators, heart failure-related clinical symptoms, quality of life, and physiological indicators in patients with CHF. It is worthwhile to expand the participants for practical application in clinical practice, but the existing evidence is insufficient and the heterogeneity of outcome is large. Therefore, more high-quality clinical trials are needed to support these results. Systematic review registration: PROSPERO, identifier [CRD42022383246].

Global trends of traditional Chinese exercises for musculoskeletal disorders treatment research from 2000 to 2022: A bibliometric analysis.

Background: Traditional Chinese exercise has been shown to be effective in relieving long-term chronic pain, physical dysfunction, decreased ability to participate in society and decreased quality of life in musculoskeletal diseases. In recent years, there has been a steady increase in publications on the treatment of musculoskeletal disorders by traditional Chinese exercises. The purpose of this study is to review the characteristics and trends of Chinese traditional exercise studies on musculoskeletal diseases published since 2000 through bibliometric analysis, and identify current research hotspots, so as to guide the direction of future research. Methods: Publications regarding traditional Chinese exercises for musculoskeletal disorders from 2000 to 2022 were downloaded from the Web of Science Core Collection. VOSviewer 1.6.18 and CiteSpace V software were used for bibliometric analyses. Bibliometric visualization and comparative analysis were conducted for authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords. Results: A total of 432 articles were obtained, with an upward trend over time. The most productive countries and institutions in this field are the USA (183) and Harvard University (70). Evidence-based Complementary and Alternative Medicine (20) was the most prolific journal, Cochrane Database System Review (758) was the most commonly cited journal. Wang Chenchen published the largest number of articles (18). According to high frequency keywords, the hot spot musculoskeletal disorder and the type of traditional Chinese exercise are knee osteoarthritis and Tai Chi. Conclusion: This study provides a scientific perspective for the research of traditional Chinese exercises for musculoskeletal disorders and provides valuable information for researchers to discover the current research status, hot spots and new trends of future research.

Traditional Chinese Exercise for Neurodegenerative Diseases: A Bibliometric and Visualized Analysis With Future Directions.

Background: Traditional Chinese Exercise (TCE) has expanded out of China into the world and is frequently used in the prevention and treatment of many diseases. Although many studies have explored the ability of TCE as an intervention for neurodegenerative diseases, there are limited articles summarizing the research. The aim of this study was to investigate current research trends around TCE for neurodegenerative diseases and predict future directions for such research. Materials and Methods: Data was collected from the Web of Science Core Collection (WoSCC). All articles and reviews on TCE in relation to neurodegenerative diseases were retrieved. The data analysis was performed using the CiteSpace (5.8R3) software, and the results were displayed in network maps. Results: The search identified 220 publications between 1999 and 2021. The United States was the most productive country (n = 89), followed by China (n = 68). The United States had the greatest centrality, indicating its tremendous global influence and close collaborations with other countries. Fuzhong Li from the Oregon Research Institute, United States, was not only the most prolific author (n = 5), but also the most co-cited author (n = 120). The Shanghai University of Sport contributed to the most publications (n = 12). PLOS ONE was the most published journal, while Movement Disorders was the most cited journal. Tai Chi, Parkinson's disease, quality of life, balance, and older adult were the most high-frequency keywords, while Alzheimer's disease had the highest centrality. Conclusion: The number of publications on TCE related to neurodegenerative diseases has shown major growth in the past decade. However, there is a need for research institutions to strengthen cooperation between countries and institutions. Tai Chi, Parkinson's disease (PD), Alzheimer's disease, older adults and falls reduction have been the recent research focus. It is anticipated that in the future, PD will continue to be a central focus with the effects of Baduanjin, Wuqinxi, and Yijinjing requiring further research.

Effects of Traditional Chinese Exercise on Oxidative Stress in Middle-Aged and Older Adults: A Network Meta-Analysis.

OBJECTIVE: To evaluate the best option among traditional Chinese exercises for reducing oxidative stress in middle-aged and older adults, using a network meta-analysis. METHODS: PubMed, Web of Science, and CNKI databases were used. We searched randomized controlled trials (RCTs) on middle-aged and older adults to influence oxidative stress by any traditional Chinese exercises from the beginning to 20 January 2022. A network meta-analysis of randomized control trials was performed comparing the changes in the concentration of glutathione peroxidase (GPX), malondialdehyde (MDA), and superoxide dismutase (SOD) as primary outcomes, following different therapeutic interventions with traditional Chinese exercises in middle-aged and older adults over 30 years old. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to assess the correlation between each group of interventions, and surface under the cumulative ranking (SUCRA) was used to rank the best interventions. RESULTS: The meta-analysis comprised 15 trials with a total of 927 participants and six interventions: (Wuqinxi (WQX), Baduanjin (BDJ), Tai Ji Quan (TJQ), Yijinjing (YJJ), Mawangdui Daoyin (MWD), and no exercise intervention (NEI)). Regarding GPX: WQX [SMD = 2.79 (1.75, 3.83)], TJQ [SMD = 0.47 (0.23, 0.70)], YJJ [SMD = 1.78 (1.18, 2.37)], MWD [SMD = 1.89 (1.36, 2.43)] were superior in increasing GPX relative to NEI. Regarding MDA: WQX [SMD = 1.68 (0.94, 2.42)], YJJ [SMD = 0.99 (0.28, 1.69)] were superior in reducing MDA relative to NEI. Regarding SOD: WQX [SMD = 1.05 (0.10, 2.01)] were superior in increasing SOD relative to NEI. WQX topped the SUCRA with GPX: 0.97, MDA: 0.91, and SOD: 0.94. Furthermore, WQX was more effective than TJQ in interfering with GPX [SMD = 2.32 (1.26, 3.39)] and MDA [SMD = 1.47 (0.26, 2.67)], and a significantly better intervention effect on SOD than YJJ [SMD = 1.52 (0.80, 2.24)] and MWD [SMD = 0.89 (0.03, 1.75)]. CONCLUSION: Traditional Chinese exercise can help middle-aged and older adults reduce oxidative stress. WQX may be the best traditional Chinese exercise of the exercises evaluated for reducing oxidative stress in middle-aged and older adults.

Traditional Chinese Exercises on Pain and Disability in Middle-Aged and Elderly Patients With Neck Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: With the change of life and work style, more middle-aged and elderly individuals are suffering from neck pain. In China, traditional Chinese exercises (TCEs) are widely used in the management of neck pain, such as Tai Chi, Qigong, Yijinjing, Baduanjin, Liuzijue, and Five-animal exercises. However, the evidence of TCEs for neck pain maintains controversial. Therefore, the current systematic review was conducted to evaluate the effects of TCEs on pain and disability of middle-aged and elderly patients with neck pain. Methods: A comprehensive literature search was performed in six electronic databases from their inception to January 2022 for randomized controlled trials of TCEs for neck pain. The methodological quality of the included studies was assessed by PEDro scale. The subgroup analysis was conducted based on different TCEs. The I 2 statistic was applied to assess the heterogeneity. Results: Twenty-one studies were included in our review, which were conducted in China, United States, and Germany between 2003 and 2021. Most (86%) of them exceeded the cut off score 6. TCEs included Baduanjin, Yijinjing, Tai Chi, Qigong, and Five-animal exercises. The aggregated results indicated that TCEs showed positive complementary effects in relieving pain (SMD, 1.12; 95% CI, 0.78-1.45; p < 0.00001), especially Baduanjin exercises. Baduanjin exercises also showed beneficial complementary effects in improving flexion (SMD, 0.65; 95% CI, 0.28-1.03; p = 0.0006) and extension (SMD, 0.66; 95% CI, 0.12-1.19; p = 0.02) of the neck. In addition, the aggregated results indicated that TCEs alone showed beneficial effects in improving disability (SMD, 0.74; 95% CI, 0.40-1.08; p < 0.0001) and relieving pain (SMD, 0.81; 95% CI, 0.50-1.13; p < 0.00001) compared with waiting list. The follow-up effects of TCEs were still insufficient. Conclusion: There was the positive evidence to support the clinical use of TCEs, as a complementary therapy, for middle-aged and elderly patients with neck pain, especially Baduanjin exercises. However, the evidence supporting the effects of TCEs alone for the middle-aged and elderly patients with neck pain was limited due to the small sample size. Systematic Review Registration: https://inplasy.com/inplasy-2022-4-0083/, identifier INPLASY202240083.

Effects of Traditional Chinese Exercises on Cognitive Function in Older Adults With Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

Background: Recently, considerable research has been conducted to study the effects of traditional Chinese exercises (TCEs) on cognitive function in older adults with MCI. We completed a comprehensive systematic review and meta-analysis to assess the efficacy of TCEs on cognitive function in this population. Methods: A search strategy based on the PICOS principle was used to find the literatures in the databases of PubMed, Web of Science, MEDLINE, SPORT-Discus, PsycINFO, Cochrane Central Register of Controlled Trials, Ovid. The quality and risk of bias in the studies were independently assessed by two researchers. Results: Nine trials with 1,290 participants were included. The effect size of TCEs on global cognitive function was small (SMD = 0.29, 95% CI 0.15-0.44, p < 0.001) when compared to the active control and was moderate (SMD = 0.58, 95% CI 0.21-0.94, p = 0.002) compared to the inactive control; statistically significant effects were also found for short-term memory (SMD = 0.22, 95% CI 0.05-0.39, p = 0.013), long-term memory (SMD = 0.53, 95% CI 0.20-0.86, p = 0.002), shifting (SMD = -0.39, 95% CI -0.54 to -0.25, p < 0.001), language ability (SMD = 0.32, 95% CI 0.13-0.51, p = 0.001), visuospatial perception (SMD = 0.31, 95% CI 0.15-0.46, p < 0.001). Conclusion: This meta-analysis provides clinicians with moderate evidence to recommend that TCEs hold potential to enhance both global cognitive function and multiple domains of cognitive function, which, however, needs to be confirmed and further examined in futures studies. The results of this work provide critical knowledge for the design of future studies implementing TCEs as well as its clinical practice. Future RCTs with rigorous designs are needed to help obtain more definitive conclusions on the effects of TCEs on cognitive function in older adults with MCI.

Network Meta-Analysis of the Effects of Different Types of Traditional Chinese Exercises on Pulmonary Function, Endurance Capacity and Quality of Life in Patients With COPD.

BACKGROUND: In recent years, Chinese and international studies have reported that traditional Chinese exercises (TCEs) have good therapeutic effects on pulmonary function, endurance capacity, and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, only a few studies have reported the differences in the efficacy of different TCEs in the treatment of COPD. OBJECTIVE: The objective of this study is to compare the effects of five TCEs on patients with COPD, including Taijiquan (TJQ), Baduanjin (BDJ), Liuzijue (LZJ), Wuqinxi (WQX), and Yijinjing (YJJ). METHODS: All randomized controlled trials (RCTs) of TCEs for patients with COPD were searched in PubMed, Web of Science, Cochrane Library, Excerpt Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), China Biology Medicine database (CBM), China Scientific Journal Database (VIP), and Wanfang database. The search period was from the establishment of each database to August 16, 2021. The quality of the included studies was assessed according to the Cochrane handbook of systematic review, and the network meta-analysis was conducted with R 4.0.2 (Ross Ihaka, Auckland, New Zealand) and ADDIS 1.16.8 (Gert vsn Valkenhoef, Groningen, Netherlands). The effect size was evaluated using the mean difference (MD) and 95% confidence interval (CI). RESULTS: A total of 53 RCTs involving 3,924 patients were included. The network meta-analysis results showed that WQX was the most effective in improving FEV1/FVC% score and 6-MWT score. The difference was statistically significant (MD = 8.62, 95% CI 4.46 to 13.04, P < 0.05), (MD = 74.29, 95% CI 47.67 to 102.24, P < 0.05). However, YJJ was the most effective in reducing the CAT score, and the difference was statistically significant (MD = -8.38, 95% CI -13.24 to -3.28, P < 0.05). CONCLUSION: The existing evidence shows that WQX has advantages over other TCEs in improving pulmonary function and endurance capacity in patients with COPD, while YJJ has advantages in improving the quality of life. Although TCEs show no significant adverse effects, more large-scale, double-blind, and high-quality RCTs are needed in the future to verify the findings of this study.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021293640.

Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis.

Our objective in this paper was to systematically review evaluations of the effects of exercises on pain symptoms and activities of daily living (ADL) in middle-aged and elderly patients with low back pain (LBP). We searched Web of Science, PubMed, EBSCO, and China National Knowledge Internet (CNKI) databases for randomized controlled trials (RCTs) on this topic. We evaluated the methodological quality of included articles using the Physiotherapy Evidence Database (PEDro) scale, and we statistically analyzed these studies using RevMan software. We reviewed 18 RCTs (23 comparison groups) with a total of 910 participants, and our meta-analysis confirmed that exercises significantly improved both pain and ADLs measured on visual analog scales (VAS) (SMD = -0.91, 95% CI: [-1.3, -0.52], p < 0.00001) and on the Oswestry Disability Index (ODI) (SMD = -2.07, 95% CI: [-3.19, -0.96], p < 0.00001). We conclude that exercises can reduce pain severity and improve ADL capacity in middle-aged and elderly persons with LBP, confirming that exercise can serve as a medical intervention for these indivdiuals. However, given the high heterogeneity of responses among individual participants, there remains a need for further study.

The Effect of Different Traditional Chinese Exercises on Blood Lipid in Middle-Aged and Elderly Individuals: A Systematic Review and Network Meta-Analysis.

Although the impact of physical exercise on blood lipids is well documented, less information is available regarding the effect of traditional Chinese exercises (TCEs), and it is unclear what the best TCE treatment for dyslipidemia in middle-aged and elderly individuals is. The aim of this study was to systematically assess the effects of TCEs (Taijiquan, TJQ; Wuqinxi, WQX; Baduanjin, BDJ; Liuzijue, LZJ; Yijinjing, YJJ; Dawu, DW) on blood lipids in middle-aged and elderly individuals. Chinese and English databases were searched, including PubMed, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, and Web of Science. A total of 42 randomized controlled trials (RCTs) including 2977 subjects were analyzed. Outcome indicators include total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglyceride (TAG), and high-density lipoprotein cholesterol (HDL-C). Summary mean differences (MD) were calculated using pairwise and network meta-analysis with a random-effects model. The results of this study showed that compared to non-exercise intervention (NEI), all six kinds of TCE treatment had some kind of influence on blood lipid indicators, among which WQX and TJQ could improve all four blood lipid indicators, whereas BDJ was effective on three indicators but not on TC. The results of cumulative probability ranking showed that WQX (84.9%, 73.8%, 63.4%, 63.1% to TC, TAG, HDL-C, LDL-C, respectively) was at the top spot being the best intervention, followed by BDJ (55.6%, 83.7%, 68.4%, 56.1%) and TJQ (73.7%, 47.6%, 63.1%, 54.1%). The network meta-analysis of RCTs demonstrates that WQX may be the best TCE treatment for dyslipidemia in middle-aged and elderly individuals.

Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis.

BACKGROUND: Traditional Chinese exercises (TCEs) have a positive effect on glycemic control and hemoglobin A1c (HbA1c), but there is no consensus on the benefits of TCEs for patients with prediabetes. OBJECTIVE: The objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes. SEARCH STRATEGY: Comprehensive retrieval of randomized controlled trials (RCTs) was carried out using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data Knowledge Service Platform, China Biology Medicine disc, Google Scholar and Baidu academic databases. The retrieval window ranged from the establishment of the database to December 2018, and references related to the included trials were searched without language restrictions. INCLUSION CRITERIA: The study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs. DATA EXTRACTION AND ANALYSIS: Literature screening, data extraction and literature quality assessment were performed independently by two researchers. In the case of disagreement, a third party was invited to negotiate and make a decision. Standardized mean difference (SMD) was used to estimate the therapeutic effect. Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0. Heterogeneity was assessed using Q test and I2, and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis. A Q test resulting in P < 0.1 and I2 > 50% indicated significant difference and random effect model analysis was performed. Otherwise, a fixed effect model was applied. Begg's and Egger's tests were used to assess publication bias. RESULTS: Nine RCTs involving 485 participants were included in this study. The results showed that TCEs could reduce fasting blood glucose (FBG), 2 h blood glucose (2hPBG) and HbA1c in patients with prediabetes. The treatment subgroup showed that an intervention of 6 months had better results, while the Gongfa subgroup showed that the TCE Baduanjin yielded better results. (1) FBG: SMD = -0.73, 95% confidence interval (CI) [-0.97, -0.50], P < 0.00001; Baduanjin: SMD = -0.83, 95% CI [-1.13, -0.53], P < 0.00001; 6 month treatment: SMD = -0.73, 95% CI [-1.20, -0.26], P = 0.002. (2) 2hPBG: SMD = -0.75, 95% CI [-0.94, -0.57], P < 0.00001; Baduanjin: SMD = -0.62, 95% CI [-0.91, -0.32], P < 0.00001; 6 month treatment: SMD = -0.91, 95% CI [-1.39, -0.44], P = 0.0002. (3) HbA1c: SMD = -0.56, 95% CI [-0.89, -0.23], P = 0.00008; Baduanjin: SMD = -0.46, 95% CI [-0.83, -0.08], P = 0.02; 6 month treatment: SMD = -0.77, 95% CI [-1.24, -0.29], P = 0.002. CONCLUSION: TCEs had positive effects in improving blood glucose levels in patients with prediabetes. Hence, TCEs may be of potential therapeutic value for patients with prediabetes, as an adjuvant therapy along with other treatments. Although the evidence suggests that the intervention is effective for 6 months, the mechanism of TCEs on glycemic control, the minimum exercise dose and their safety remain to be further studied.

Current Evidence on Traditional Chinese Exercises for Quality of Life in Patients With Essential Hypertension: A Systematic Review and Meta-Analysis.

Essential hypertension is one of the most common chronic diseases seen in primary human health care that could lead to various health problems and reduce the quality of life (QOL). This study was performed to evaluate the effects of traditional Chinese exercises (TCE) on QOL in patients with essential hypertension. Three English databases and one Chinese database were searched for randomized controlled trials (RCTs) until August 2020. A total of 13 RCTs with 1,361 hypertensive patients met the inclusion criteria, 10 trials employed Tai Chi and 3 trials employed Qigong, including Dongeui Qinggong, Yijinjing, and Wuqinxi. Despite a large heterogeneity within studies, it is demonstrated that TCE may be an effective therapy to improve the QOL of hypertensive patients. More specific, compared with no intervention, the meta-analysis presented that Tai Chi significantly improved both the physical and mental component of the 36-item short-form health survey (SF-36) QOL scale, and it was found that the simplified 24-form Tai Chi with a frequency of 30-50 min per session at five to eight sessions per week was the most commonly used setting. The pooling also revealed that Tai Chi and Qigong had some significantly positive effects on QOL based on other scales. However, more rigorously designed RCTs are warranted for further verification. This systematic review and meta-analysis of RCTs demonstrated that Tai Chi may be an effective therapy to improve the QOL of patients with essential hypertension. All these findings provide helpful information for hypertensive patients and medical personnel.