Effects of different traditional Chinese exercise in the treatment of essential hypertension: a systematic review and network meta-analysis.

Background: As a therapy to prevent and treat essential hypertension (EH), traditional Chinese exercises (TCEs) were widely used in clinical practice. However, there is a lack of strictly comparison of the antihypertensive efficacy of different TCEs, which not conducive to the selection of the best and most optimal treatment. This study aimed to perform a network meta-analysis to objectively evaluate which TCE has the best effects in assisting with lowering blood pressure. Methods: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), VIP, SinoMed and Wanfang Data were searched for all randomized controlled trials (RCTs) on TCEs for the treatment of EH published up to July 10, 2023. RoB2.0 tool was utilized to evaluate the quality of the RCTs. The network meta-analysis was performed by R 4.1.2 and Stata 17.0. Weighted mean difference (WMD) was calculated for continuous outcomes. Results: A total of 29 studies, including 2,268 patients were included to analyze 6 different interventions. The network meta-analysis results presented that in comparison with control group, Tai Chi + antihypertensive medication [WMD = -10.18, 95% CI, (-14.94, -5.44)] is the most effective intervention for lowering systolic blood pressure (SBP), and Wuqinxi + antihypertensive medication [WMD = -10.36, 95% CI (-18.98, -1.66)] is the most effective intervention for lowering diastolic blood pressure (DBP). Conclusion: TCEs combined with antihypertensive medication may be able to achieve more prominent antihypertensive effects with Tai Chi and Wuqinxi potentially being the higher-priority options. However, well-designed randomized studies are warranted to further verify currently conclusion.

Bibliometric Analysis of Research on Traditional Chinese Exercise and Osteoarthritis.

Background: Osteoarthritis (OA) is a common disease in geriatric rehabilitation medicine caused by the progressive destruction of articular cartilage. Traditional Chinese exercise (TCE) is an important component of traditional sports in China and aims to stretch the musculoskeletal tract and relieve joint pain. Bibliometrics can help researchers find suitable partners and understand the research hotspots and trends in a certain field. However, there is still a lack of bibliometric analysis in the field of TCE and OA. Methods: All the literature was obtained from the Web of Science Core Collection database. The last search was performed on July 28, 2023. The bibliometric indicators, such as publications, citations, and H-index, were recorded. Bibliometrix and CiteSpace were used for visualization analysis. In addition, randomized controlled trials were included to summarize the exercise prescription of TCE for OA. Results: A total of 170 articles were included. The field of OA with TCE had great development potential and was in the rising period. The countries, institutions, and authors with the most publications were the United States, Tufts Medical Center, and Harvey WF, respectively. The most popular journal was Osteoarthritis and Cartilage. The recent burst keywords in this field were mainly "hip", "pilot", and "risk". Tai Chi was the most studied TCE with the most detailed content of exercise prescription, followed by Baduanjin and Wuqinxi. Conclusion: Our study provides a basis for researchers in this field to choose appropriate partner and academic journals. Moreover, pain, muscle strength, and quality of life management of elderly OA patients are research hotspots in this field. The intervention of hip OA risk through TCE is expected to become a research direction for emerging teams. The TCE prescription we summarized can better provide researchers with more treatment details.

Traditional Chinese Exercises for Cardiovascular Diseases: A Bibliometric Analysis.

Traditional Chinese exercises (TCEs) have great value in the prevention and effective treatment of cardiovascular diseases (CVD). Our purpose in this study was to summarize present research trends and future directions regarding the link between TCEs and CVD by bibliometrics analysis. We searched the Web of Science Core Collection (WoSCC) for all original articles and reviews on TCEs for CVD published in English before August 7, 2022 using CiteSpace 5.8.R3 and Microsoft Excel 2019 software, and we displayed the results in the form of network maps, line graphs, and tables. We initially obtained 725 articles. Our results showed that the United States was the most influential country in this line of research, with Harvard University the most prolific institution in the field, and, Evidence-Based Complementary and Alternative Medicine was the most productive journal for these articles. The highest-frequency keywords in this research area were Tai Chi, exercise, blood pressure, quality of life, and older adult. Additionally, important research topics included heart rate variability, quality of life, meta-analysis, Baduanjin exercise, and breathing exercise. In addition, our results revealed that among all the TCEs, Tai Chi, Baduanjin, and Qigong emerged as the most extensively studied. However, it's important to note our exclusive focus on literature published in English may have led to our missing important results. Future investigators should broaden their search to include other databases and languages to present a still more comprehensive overview of this field.

Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis.

OBJECTIVE: This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS: We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS: The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION: Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.

Kinesitherapy for Knee Osteoarthritis Patients Physical and Psychological Health Based on "Traditional Chinese Exercise" Management Modalities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Traditional Chinese exercise ("TCE" management modalities), including but not limited to Tai Chi, Baduanjin, and Yijinjing, has a good effect on improving the physical function of patients with knee osteoarthritis, but less attention has been paid to the impact on the psychological health of patients, and currently there is insufficient evidence to support it. We conducted this study to provide a systematic synthesis of best evidence regarding the physical and mental health of patients with knee osteoarthritis treated by traditional Chinese exercise. Literature on the effectiveness of traditional Chinese exercise (Tai Chi, Baduanjin, Yijinjing, Qigong, etc.) versus conventional therapy (muscle-strength training of the lower extremity and aerobic training, wellness education, quadriceps strengthening exercises, etc.) on Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), Short Form-36 (SF-36), Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) in knee osteoarthritis (KOA) from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, and SinoMed were collected from their inception to April 2022. Thirty-three studies with 2621 cases were included in this study. The study's results indicated that compared with conventional therapy, traditional Chinese exercise had more advantages on patients' WOMAC score, significantly reducing patients' overall WOMAC score (SMD = -0.99; 95% CI: -1.38, -0.60; p < 0.00001) and relieving pain (SMD = -0.76; 95% CI: -1.11, -0.40; p < 0.0001) in patients with KOA. It also has advantages over conventional therapy in improving mental component score (MCS) (SMD = 0.32; 95% CI: -0.00, 0.65; p = 0.05) and physical component score (PCS) (SMD = 0.34; 95% CI: 0.05, 0.62; p = 0.02). Compared with conventional therapy, traditional Chinese exercise can significantly reduce the effect on timed up and go test (TUG) score (SMD = -0.30; 95% CI: -0.50, -0.11; p = 0.002), beck depression inventory (DBI) score (SMD = -0.62; 95% CI: -1.03, -0.22; p = 0.002), and increase the impact on Berg Balance Scale (BBS) score (SMD = 0.60; 95% CI: 0.37, 0.83; p < 0.00001). The findings of this study indicated that traditional Chinese exercise improved body function and mental health in patients with knee osteoarthritis significantly. More high-quality clinical evidence-based data was needed to confirm the therapeutic effect of traditional Chinese exercise on the physical and mental health in KOA patients.

Effects of pulmonary-based Qigong exercise in stable patients with chronic obstructive pulmonary disease: a randomized controlled trial.

BACKGROUND: Physical exercise training is the central component of pulmonary rehabilitation. This study aimed to further investigate the rehabilitative effects of pulmonary-based Qigong exercise (PQE) in stable patients with chronic obstructive pulmonary disease (COPD). METHODS: In this randomized, assessor-blinded clinical trial, 44 participants with stable COPD were randomly assigned to 2 groups in a 1:1 ratio. Participants in the control group received usual care for 3 months. Participants in the intervention group received usual care combined with PQE (60 min each time, 2 times per day, 7 days per week, for 3 months). The outcome included exercise capacity, lung function test, skeletal muscle strength, dyspnea, and quality of life were measured before and after intervention. RESULTS: A total of 37 participants completed the trial. Compared to the control group, after 3 months of PQE, the mean change in exercise capacity, skeletal muscle strength, and quality of life were statistically significant (P < 0.05, for each), but no significant differences were observed in lung function (except for the forced expiratory volume in one second) and dyspnea (P > 0.05, for each). CONCLUSION: The findings of study suggest that the proposed program of 3 months of PQE intervention has significant improvement in exercise capacity, skeletal muscle strength, and quality of life of COPD-stable patients. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry (Trial ID: ChiCTR-1800017405 on 28 July 2018; available at https://www.chictr.org.cn/showproj.html?proj=28343 ).

Effectiveness of traditional Chinese exercise in patients with fibromyalgia syndrome: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND AND OBJECTIVE: Fibromyalgia syndrome (FMS) is a common disorder characterized by heterogeneous symptoms that leads to decreased functioning, work productivity, and quality of life. Exercise has been recommended for fibromyalgia treatment. Traditional Chinese exercise (TCE), including Taichi, Qigong, Badunjin, Wuqinxi, etc., as a kind of mind-body exercise, plays an important role in alleviating symptoms of FMS. The objective of this study is to summarize the available evidence, through meta-analysis, on the pain relief, quality of life, sleep improvement, and emotion regulation of FMS in TCE. METHODS: Databases of PubMed, EMBASE, Cochrane library, Google scholar, CNKI, WANFANG DATA, VIP, etc. were used to search eligible studies that were published from the time of their inception to February 11, 2022, in English and Chinese. The included studies were divided into two groups: TCE group (experimental group) and control group. The Cochrane collaboration's tool was used to assess the risk of bias, and Revman5.4.1 software was used to synthesize and analyze the data. RESULTS: A total of 12 literatures were included in this study, which contained 781 patients, and 448 of them were included in the treatment group, 333 of others in control group. TCE significantly alleviated pain [SMD = -0.83, 95% CI (-1.15, -0.51), p < .00001], improved quality of life [SMD = -0.53, 95% CI (-0.86, -0.19), p = .002] and improved qualities of sleep [SMD = -0.41, 95% CI (-0.57, -0.24), p < .00001] and relieved depression [SMD = -0.40, 95% CI (-0.69, -0.10), p < .008]. CONCLUSION: TCE may be a way to reduce pain, improve the quality of life and sleep, and relieve depression for FMS, and it could be part of the FMS treatment.

Effects of traditional Chinese exercises on cardiac rehabilitation in patients with myocardial infarction: a meta-analysis of randomized controlled trials.

Objective: Traditional Chinese exercises (TCE) are excellent cardiac rehabilitation (CR) training that can effectively improve cardiorespiratory fitness. However, there is no published meta-analysis of TCE on CR in patients with myocardial infarction (MI). Therefore, this study aimed to provide a comprehensive evaluation from multiple perspectives. Methods: This meta-analysis is based on the Cochrane Handbook of Systematic Reviews. Eight databases were searched from the date of database construction to March 15, 2023. Two investigators independently screened the literature and assessed their quality. The meta-analysis was performed with RevMan5.4 software. Results: A total of 21 articles involving 1,890 patients were included. N-terminal pro-brain natriuretic peptide (NT-proBNP) in the TCE group were lower than the control group (MD = -96.34, 95%CI: -140.69 ∼-51.98, P < 0.00001, I2 = 96%), the left ventricular ejection fraction (LVEF) in the TCE group was higher than the control group (MD = 4.58, 95%CI: 3.28-5.88, P < 0.00001, I2 = 79%), the left ventricular end diastolic dimension (LVDD) in TCE group was lower than the control group (MD = -3.83, 95%CI: -5.27 ∼-2.38, P < 0.00001, I2 = 94%), the left ventricular end systolic diameter (LVESD) in TCE group was lower than the control group (MD = -2.17, 95%CI: -4.10 ∼-0.24, P < 0.00001, I2 = 96%), The 6-minute walk test (6MWT) in the TCE group was higher than the control group (MD = 69.60, 95%CI: 34.59-104.60, P < 0.00001, I2 = 99%), the oxygen uptake (VO2) in the TCE group was higher than the control group (MD = 4.38, 95%CI: 2.25-6.51, P < 0.00001, I2 = 94%), the 36-item short form survey (SF-36) in the TCE group was higher than the control group (MD = 13.34, 95%CI: 9.25-17.42, P = 0.008, I2 = 75%), the Hamilton Anxiety Scale (HAMA) in the TCE group was lower than the control group (MD = -4.34, 95%CI: -5.18 ∼-3.50, P = 1.00, I2 = 0%), the Hamilton Depression Scale (HAMD) in the TCE group was lower than the control group (MD = -3.48, 95%CI: -5.35 ∼-1.61, P = 0.0002, I2 = 88%), the incidence of major adverse cardiac events (MACEs) in the TCE group was lower than the control group (RR = 0.31, 95%CI: 0.20-0.47, P = 0.52, I2 = 0%). Subgroup analysis revealed differences in TCE types could be a potential source of heterogeneity. Conclusion: MI patients who used TCE have not only notable improvements in cardiopulmonary function, physical function, quality of life, and emotions but also reduced the incidence of MACEs. Tai Chi might be more efficient than Ba Duan Jin. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023408675.

Efficacy of traditional Chinese exercise for obesity: A systematic review and meta-analysis.

Background: Obesity is considered one of the biggest public health problems, especially in the background of the coronavirus disease 2019 (COVID-19) lockdown. It is urgent to find interventions to control and improve it. We performed this systematic review and meta-analysis to summarize the effect of traditional Chinese exercise on obesity. Methods: We searched PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (VIP), the Chinese Biomedical Literature Database (CBM), and WanFang database for updated articles published from the inception of each database to June 2022. Randomized controlled trials (RCTs) on traditional Chinese exercise in weight reduction were included, and related data were extracted. The random-effects model was used to adjust for the heterogeneity of the included studies, and funnel plots were used to examine publication bias. Results: A total of 701 participants were included in the 10 studies. Compared with the control group, the outcome of body weight [mean difference (MD) = -6.10; 95% CI = -8.79, -3.42], body mass index (MD = -2.03; 95% CI = -2.66, -1.41), body fat mass (MD = -3.12; 95% CI = -4.49, -1.75), waist circumference (MD = -3.46; 95% CI = -4.67, -2.24), hip circumference (MD = -2.94; 95% CI = -4.75, -1.30), and waist-to-hip ratio (MD = -0.04; 95% CI = -0.06, -0.03) in the intervention group had significant differences. Egger's test and funnel plots showed that the potential publication bias of the included studies was slight (p = 0.249). Conclusion: Traditional Chinese exercise is an effective treatment for obesity; people under the COVID-19 lockdown could do these exercises to control weight. However, a precise and comprehensive conclusion calls for RCTs on a larger scale with more rigorous designs considering the inferior methodological quality and limited retrieved articles. Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier CRD42021270015.

Benefits of Tai Chi Quan on neurodegenerative diseases: A systematic review.

BACKGROUND: Neurodegenerative diseases have become an important concern with the accelerated aging process. Tai Chi Quan (TCQ) has positive benefits for brain health and chronic diseases. The aim of this study was to summarize the protective effects of TCQ for motor function, cognition, quality of life, and mood in patients with neurodegenerative diseases. METHODS: A systematic search was conducted via PubMed database and the Web of Science core collection database until August 20, 2021. The available English systematic reviews, meta-analyses, and clinical trials were included. Two reviewers completed the screening and assessment process independently. RESULTS: A total of 28 studies on Parkinson's disease, 21 on cognitive impairment, and 9 on multiple sclerosis met the included criteria. The study found that TCQ remarkably improved general motor function and balance, and prevented falls for Parkinson's disease. TCQ significantly improved global cognitive function for cognitive impairment. TCQ was likely safe and beneficial for multiple sclerosis as result of heterogeneous outcomes and small samples. CONCLUSION: TCQ exercise can effectively improve the motor function, global cognitive function, and falls in patients with neurodegenerative diseases. However, the positive effects of TCQ on the quality of life and mood of patients with neurodegenerative diseases need further evidence.

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review.

Background: Increasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP. Methods: A systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability. Results: A total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality). Conclusion: The neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.

Effect of traditional Chinese exercise combined with massage on pain and disability in patients with lumbar disc herniation: A multi-center, randomized, controlled, assessor-blinded clinical trial.

Background: Herniation of the nucleus pulposus caused by disc degeneration and other reasons can cause low back pain and disability. In China, traditional Chinese exercises (TCEs) and traditional Chinese massage (TCM) are widely used to improve symptoms of pain and disability in patients with lumbar disc herniation (LDH). The safety and efficacy of combination therapy have not been studied. Objectives: To assess the effect of traditional Chinese exercise combined with massage vs. traditional Chinese massage alone on pain, disability, lumbar mobility and gait performance in patients with LDH. Methods: Multi-center, randomized clinical trial conducted at 4 hospitals in China and enrolling 272 patients with LDH. Participants were randomly assigned to TCEs plus TCM group or TCM alone group. The combined therapy group received 18 Tai Chi training sessions (30-min sessions 3 times a week) and regular TCM treatments over 6 weeks. The control group received TCM therapy alone and was instructed to maintain their usual daily physical activity. Outcome variables measured included Visual Analog Scale (VAS), Short Form of McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI), lumbar spine range of motion (ROM) and gait performance. Results: Among the 272 randomized participants, 259 completed the study. The mean VAS score was 51.77 mm at baseline in the TCEs plus TCM group, and 50.93 mm for the TCM alone group. The reduction in the VAS score at week 6 was greater in the TC group than in the TCM group with a mean difference of 4.05 (95% CI, 2.15-5.95; P < 0.001), and the ODI score with between-group differences of 3.57 points (95% CI, 2.84-4.30 points; P < 0.001). Similar significantly different results were observed in SF-MPQ, walking speed, cadence, and lumbar ROM. No serious adverse events were reported throughout the study period. Conclusion: Compared with TCM alone, TCEs combined with TCM treatment performed better in reducing pain and improving disability. The combination therapy could be considered a valuable treatment option for LDH patients, with potential therapeutic utility for middle-aged and elderly patients with LDH.

Tai Chi Quan Versus Physical Therapy on Pain and Cognitive Performance for Elderly People With Chronic Low Back Pain: Study Protocol for a Randomized Controlled Trial.

Objectives: Chronic low back pain has become a major cause of global disability and caused a huge economic burden to society. Physical therapy is a vital strategy for rehabilitation of chronic low back pain. Although several trials have shown that Tai Chi Quan is a beneficial treatment, the comparative effectiveness of Tai Chi Quan versus physical therapy is unknown. We are conducting a randomized controlled trial to assess the effectiveness of Tai Chi Quan versus that of physical therapy in treating chronic low back pain. Methods: We will perform a single-blind randomized controlled trial on elderly people with chronic low back pain. 138 participants will be randomly assigned to the Tai Chi Quan group (60-min classes, three times per week for 12 weeks) or physical therapy group (10 min of evaluation and warm-up, 40 min of therapist-directed exercise therapy, and 10 min of relaxation, three times per week for 12 weeks) with an allocation of 1:1. The participants will be followed up for 40 weeks for the study of long-term effects. The primary outcomes include pain intensity and back-related function at 12 weeks. Secondary outcomes include lumbar quantitative sensory testing, balance, cognitive function, psychosocial function, cost-effectiveness, compliance and adverse events. We will perform the intention-to-treat analysis for withdrawal and missing data. Discussion: The study will be the first randomized trial with comparative-effectiveness of Tai Chi Quan and physical therapy for chronic low back pain. Standardized protocol, large sample size, and comprehensive outcomes are important features in this trial. This study aims to determine the feasibility and effectiveness of Tai Chi Quan for low back pain. The results of this study will be beneficial for elderly people with low back pain and medical rehabilitation personnel. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR2000029723.

Comparative effectiveness of aerobic exercise versus Yi Jin Jing on ovarian function in young overweight/obese women with polycystic ovary syndrome: study protocol for a randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common heterogeneous endocrine disease among women of childbearing age, characterized by androgen excess and ovarian dysfunction. Aerobic exercise is an important solution used to manage PCOS, due to its multiple benefits. Yi Jin Jing is an important component of traditional Chinese exercise (TCE), based on the root of traditional Chinese medicine theory (TCM), which focuses on keeping the body as a whole in a harmonious state. However, to date there is no literature on the benign effects of Yi Jin Jing on PCOS. The primary purpose of this protocol is to assess the effectiveness of aerobic exercise versus Yi Jin Jing, on the management of ovarian function in young overweight/obese women with PCOS. METHODS: The study will conduct a controlled randomized, superiority trial with three-arm parallel groups, recruiting 90 women diagnosed with PCOS, ages between 18 and 35 years, with a body mass index (BMI) ≥ 23 kg/m2. Women will be randomly assigned to either control group (combined oral contraceptives) or one of the intervention groups (Yi Jin Jing group or aerobic exercise group) with an allocation rate of 1:1:1. After randomization, the intervention will be conducted within a 12-week period. The primary outcome would be anti-Mullerian hormone (AMH) level; the secondary outcomes would be biochemical profiles, ovarian volume, antral follicle count, BMI, menstrual frequency, and homeostasis model assessment of insulin resistance (HOMA-IR). Outcome measures would be collected during baseline and end of treatment. Reporting of the study will follow the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement. DISCUSSION: This proposed study will be the first randomized clinical trial to evaluate the comparative effectiveness of aerobic exercise versus Yi Jin Jing on the management of ovarian function in young overweight/obese women with PCOS. The results may provide a new evidence-based management strategy for young women with PCOS. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900022385 . Registered on 9 April 2019.

Efficacy of traditional Chinese exercise for sarcopenia: A systematic review and meta-analysis of randomized controlled trials.

Objective: To conduct a systematic review and meta-analysis to evaluate the effectiveness of Traditional Chinese Exercise (TCE) for sarcopenia. Methods: A literature search was conducted in eight online databases from inception until September 2022. Based on the Cochrane risk of bias tool, randomized controlled trials (RCTs) with RoB score ≥ 4 were included for further analyses. The primary outcome was muscle strength and physical function, and the secondary outcomes were adverse events. Data collection and analyses were conducted by RevMan 5.4 Software. GRADE system was used to evaluate the certainty of evidence. Results: A total of 13 eligible RCTs with 718 subjects were identified and included in this study. Among them, 10 RCTs involved Yijinjing; 2 involved Tai Chi; and 1 involved Baduanjin. Meta-analyses showed that TCE had better clinical effects than control measures in the chair stand test (P < 0.00001, I2 = 38%; Certainty of evidence: Moderate), squatting-to-standing test (P < 0.00001, I2 = 0%; Certainty of evidence: Moderate), 6-m gait speed (P < 0.00001, I2 = 13%; Certainty of evidence: Moderate), Time Up and Go Test (P = 0.03, I2 = 81%; Certainty of evidence: Low), peak torque of the extensors (P = 0.03, I2 = 0%; Certainty of evidence: Moderate), total work of the extensors (P = 0.03, I2 = 35%; Certainty of evidence: Moderate), peak torque of the flexors (P = 0.03, I2 = 47%; Certainty of evidence: Low), total work of the flexors (P = 0.02, I2 = 42%; Certainty of evidence: Low), the average power of the flexors (P = 0.03, I2 = 30%; Certainty of evidence: Moderate), and balance function (P < 0.00001, I2 = 53%; Certainty of evidence: Low). In additional, no adverse events were reported in participants who receive TCE. Conclusion: The findings of the present systematic review, at least to a certain extent, provided supporting evidence for the routine use of TCE for sarcopenia.

Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis.

BACKGROUND: Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs. OBJECTIVE: This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions. SEARCH STRATEGY: PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020. INCLUSION CRITERIA: Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included. DATA EXTRACTION AND ANALYSIS: Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity. RESULTS: A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I2 = 82%; 15 studies, n = 1063) and GAEs (WMD = -2.88, 95% CI [-5.22, -0.55], P < 0.001; heterogeneity: P < 0.001, I2 = 98%; 5 studies, n = 500) significantly improved total sleep quality, having favorable effects on subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction. Subgroup analysis showed that TCEs demonstrated superiority after 12 weeks (WMD = -2.77, 95% CI [-4.26, -1.28], P < 0.001; heterogeneity: P < 0.001, I2 = 85%; 5 studies, n = 420) and Qigong had a greater intervention effect for improving the sleep quality of older adults than Tai Chi (WMD = -3.37, 95% CI [-4.38, -2.35], P < 0.001; heterogeneity: P = 0.04, I2 = 63%; 4 studies, n = 321). Meta-regression revealed that the year of publication, sample size, mean age of participants, and percentage of females in the primary studies did not account for the overall heterogeneity. CONCLUSION: Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.

Traditional Chinese exercise potential role as prevention and adjuvant therapy in patients with COVID-19.

The epidemic situation of COVID-19 is a great public health emergency worldwide characterized by fastest spreading, widest infection range and the mostly difficult to prevent and control in recent years. According to medical experience, traditional Chinese exercises (TCE) have been applied for COVID-19 prevention, adjuvant treatment or rehabilitation, and achieved some curative effects. They can enhance the body immunity, improve the function of organs, especially cardiopulmonary function, promote physical and mental rehabilitation by adjusting the body, regulating the breath, regulating the mind. This paper aims to investigate the potential value of TCE for health preservation in the prevention and adjuvant treatment for COVID-19 according to an overview of application and analysis of existing evidence. On this basis, this review proposed the TCE plan by visiting clinical and practice experts, so as to provide some references for the prevention and treatment of COVID-19 with TCE in the world.

Effects of traditional Chinese exercise on patients with cognitive impairment: A systematic review and Bayesian network meta-analysis.

OBJECTIVE: To systematically review the effectiveness of four types of traditional Chinese exercise (TCE) on patients with cognitive impairment (CI) and to rank these four TCE types. DESIGN: A Bayesian network meta-analysis. METHODS: Four English databases, including PubMed, EMBASE, Cochrane Library and Web of Science, and three Chinese databases, including CNKI, VIP and Wanfang, were searched from their inception to December 2019. Randomized control trials conducted to verify the effects of TCE on patients with CI were included. We used network meta-analysis to evaluate the relative effects and rank probabilities of the four types of TCE. RESULTS: The results of the network meta-analysis indicated that baduanjin (N = 9), tai chi (N = 11), liuzijue (N = 2) and qigong (N = 1) all had significant benefits compared with control conditions. According to the ranking probabilities, baduanjin was most likely to be associated with substantial improvement in cognition, followed by tai chi, liuzijue and qigong. CONCLUSION: Our study revealed the effectiveness of TCE for improving global cognition in adults with cognitive impairment. Baduanjin may be the most effective exercise type. The evidence summarized in our study still contains bias, and more research should be carried out to verify the validity of TCE.

Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#Sleep disorders are common in older adults and have a negative influence on their physical and mental health. General aerobic exercises (GAEs) have long been used in the treatment of sleep disorders as a non-pharmacological measure. However, there is no consensus on the efficacy of traditional Chinese exercises (TCEs) for treating sleep disorders in older adults and the difference between TCEs and GAEs.@*OBJECTIVE@#This study assessed the effects of TCEs and GAEs on the sleep quality of older adults and the differences between these two interventions.@*SEARCH STRATEGY@#PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, China Science Journal Database and Wanfang Data were searched from their inception to August 2020.@*INCLUSION CRITERIA@#Randomized controlled trials (RCTs) that evaluated the effects of TCEs and GAEs on older adults with sleep disorders were included.@*DATA EXTRACTION AND ANALYSIS@#Data were extracted by two researchers working independently. The risk bias of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the quality of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The Pittsburgh Sleep Quality Index (PSQI) was used to estimate sleep quality. Meta-analyses were performed to assess the total PSQI score of the exercise intervention as the primary outcome, and the scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction were assessed as secondary outcomes. Subgroup, sensitivity, and meta-regression analyses were conducted to assess the contribution of covariables to heterogeneity.@*RESULTS@#A total of 22 RCTs (including 1747 participants) were included in the meta-analysis. The results indicated that TCEs (weighted mean difference [WMD] = -2.14, 95% confidence interval [CI] [-2.82, -1.46], P < 0.001; heterogeneity: P < 0.001, I@*CONCLUSION@#Current evidence shows that both TCEs and GAEs, as complementary and non-pharmacological approaches, help to improve the sleep quality in older adults with potentially clinical implications; however, there was not enough evidence to conclude the difference between them. More rigorous and high-quality RCTs are needed to arrive at reliable conclusions.

Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger's test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = -0.61; 95% CI: -0.86 to -0.37; p < 0.001), stiffness score (SMD = -0.75; 95% CI: -1.09 to -0.41; p < 0.001), and physical function score (SMD = -0.67; 95% CI: -0.82 to -0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.