Mind–body exercise and mental health in college students: a systematic review and network meta-analysis

Background College student populations show elevated psychological difficulties. Mind–body exercise, a non-pharmacological intervention, has attracted increasing attention, but direct comparisons of effectiveness across modalities remain limited. This systematic review and network meta-analysis evaluated the comparative efficacy of mindfulness-based exercise, Tai Chi, Baduanjin, yoga, and combined mind–body interventions on core mental health outcomes in college students. Methods Following PRISMA-NMA guidelines, eligible RCTs were searched in PubMed, Embase, Cochrane Library, and Web of Science. Risk of bias was assessed using the RoB 2 tool, and analyses were conducted in R with anxiety, depression, and stress as primary outcomes (SMD, 95% CrI). Results Twenty-four RCTs were included, covering five single interventions and one combined intervention (mindfulness-based exercise + Tai Chi). Network meta-analysis showed that for reducing anxiety, Baduanjin (SMD = −0.53, 95% CrI: −0.96 to −0.10), mindfulness-based exercise (SMD = −0.70, −0.98 to −0.44), Tai Chi (SMD = −0.61, −1.22 to −0.07), yoga (SMD = −0.47, −0.85 to −0.11), and the combined intervention (SMD = −0.99, −2.00 to −0.01) were significantly effective. For depression, Baduanjin (SMD = −0.75, −1.10 to −0.36) and mindfulness-based exercise (SMD = −0.55, −0.82 to −0.29) were superior. For stress, mindfulness-based exercise (SMD = −0.67, −0.91 to −0.47) and yoga (SMD = −0.32, −0.61 to −0.05) were effective, with mindfulness-based exercise outperforming yoga. No intervention significantly improved mental well-being or sleep quality compared with controls. However, this lack of statistically significant benefit does not rule out genuine intervention effects, and these findings remain inconclusive given the limited evidence. Conclusion Mind–body exercises exert differential effects. Baduanjin may relieve anxiety and depression, while mindfulness-based exercise is beneficial for reducing stress.