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

Abstract

The systematic meta-analysis was conducted to evaluate the clinical efficacy of Traditional Chinese Exercises (TCE) in the rehabilitation of patients with chronic heart failure (CHF). The findings provide evidence-based support for the implementation of non-pharmacological interventions in the management of CHF. A systematic search of PubMed, Web of Science, Cochrane Library, and Embase (up to November 2024) identified RCTs evaluating Traditional Chinese Exercise (TCE) for chronic heart failure rehabilitation. The Cochrane Risk of Bias Tool assessed study quality. RevMan 5.4 calculated mean differences (MD) with 95 % CIs; heterogeneity was evaluated using the I² statistic (P < 0.05). Fifteen RCTs involving 1,132 patients (573 intervention, 559 control) were included. Meta-analysis revealed that TCE significantly improved CHF outcomes: reduced BNP levels (MD=–38.34, 95 %CI:[–54.88, –21.79], P < 0.00001), increased 6-minute walking distance (MD = 49.75, 95 % CI:[33.86,65.65], P < 0.00001), elevated LVEF (MD = 2.91, 95 % CI:[1.32,4.50], P = 0.0003), and lowered MLHFQ scores (MD = –9.58, 95 % CI:[ –12.75, –6.40], P < 0.00001). NT-pro BNP levels also decreased significantly (MD = –547.14, 95 % CI:[ –698.38, –395.90], P = 0.0001). This meta-analysis demonstrates that traditional Chinese exercises (including Tai Chi, Baduanjin, and Liuzijue) as adjunctive rehabilitation for chronic heart failure patients yield significant clinical benefits compared to conventional treatment alone. The interventions showed marked improvements in cardiac function parameters (BNP, NT-proBNP, and LVEF levels), exercise capacity (6MWT assessment), and quality of life (MLHFQ scores). These findings provide robust evidence for integrating traditional Chinese exercises into comprehensive rehabilitation management for chronic heart failure patients.