Traditional Chinese exercises significantly improved exercise capacity, increasing the 6-minute walk test distance by a mean of 52.75 meters compared to conventional treatment in heart failure patients.
Meta-Analysis
Do traditional Chinese exercises improve exercise capacity, quality of life, and cardiovascular function in adult patients with chronic heart failure?
Traditional Chinese exercises may serve as a beneficial, low-intensity adjunct to standard care for improving exercise capacity, quality of life, and cardiac function in patients with chronic heart failure.
Effect estimate: MD 52.75 (95% CI 28.96-76.56)
Background: Chronic heart failure (CHF) is a common clinical syndrome characterized by reduced exercise capacity, diminished quality of life (QoL), and unfavorable cardiovascular outcomes. Conventional cardiac rehabilitation often requires moderate-to-high-intensity exercise, which may be tolerated poorly by many CHF patients. Low-intensity mind–body interventions, such as traditional Chinese exercises (TCEs), are potentially more suitable; however, the evidence from existing studies is fragmented and sometimes inconsistent. Thus, this study aimed to conduct an umbrella review of systematic reviews (SRs) and meta-analyses (MAs) to evaluate the effectiveness of TCEs in improving exercise capacity, QoL, and cardiovascular function in patients with CHF. Methods: An umbrella review of SRs/MAs was conducted by searching English and Chinese databases without language limits and focusing on randomized controlled trials (RCTs) that assessed the additional benefit of TCEs in individuals with CHF. Methodological quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist and the Risk of Bias in Systematic Reviews (ROBIS) instrument. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to quantify the certainty of evidence. Individual trial data were retrieved, and re-meta-analyses were performed using standard statistical procedures, with publication bias assessed via Egger's test. Results: A total of 15 SRs/MAs were included, encompassing 65 original trials. Our re-meta-analysis indicated that TCEs were associated with substantially longer 6-minute walk test (6-MWT) values, improved QoL measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), higher left ventricular ejection fraction (LVEF), reduced B-type natriuretic peptide (BNP) levels, and enhanced maximal oxygen consumption (VO2max). Baduanjin exhibited a particularly robust effect on lowering N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations, while Yijinjing yielded comparatively greater improvements in VO2max. Nonetheless, limitations such as suboptimal methodological quality and overlapping study samples require cautious interpretation. Conclusions: TCEs may serve as a beneficial adjunct to standard care for CHF, improving exercise capacity, QoL, and key cardiac markers. Large, rigorous RCTs with extended follow-up are needed to confirm the durability of TCEs and further define the role of these exercises in comprehensive CHF rehabilitation. The PROSPERO Registration: CRD420251003129 (https://www.crd.york.ac.uk/PROSPERO/view/CRD420251003129).
Zhao et al. (2026) conducted a meta-analysis in Chronic Heart Failure. Traditional Chinese Exercises (TCEs) vs. Conventional treatment was evaluated on 6-minute walk test (6-MWT) distance (MD 52.75, 95% CI 28.96-76.56). Traditional Chinese exercises significantly improved exercise capacity, increasing the 6-minute walk test distance by a mean of 52.75 meters compared to conventional treatment in heart failure patients.