Effects of Traditional Chinese Exercise on Anxiety, Depression, Drug Craving, and Quality of Life in Individuals with Substance Use Disorders: A Meta-Analysis of Randomized Controlled Trials

Objective To evaluate the effects of various Traditional Chinese Exercise modalities on anxiety, depression, drug craving, and quality of life in substance use disorders via meta-analysis, and provide targeted exercise recommendations.Methods We searched PubMed, Web of Science, VIP and CNKI for randomized controlled trials. Study quality was assessed with Cochrane risk-of-bias tool. Analyses were conducted in Review Manager 5.4 and R (RStudio V4.19). Standardized mean difference (SMD) with 95% confidence intervals (CIs) was used for continuous outcomes. Heterogeneity was evaluated using I2 statistic, and subgroup analyses were based on intervention duration. Results: Twenty RCTs (n = 1531) were included. Traditional Chinese Exercise significantly alleviated anxiety (SMD = −0.83, 95%CI [−1.31, −0.35]), depression (SMD = −0.86, 95%CI [−1.22, −0.49]), drug craving (SMD = −0.42, 95%CI [−0.81, −0.04]), and improved overall quality of life (SMD = 0.86, 95%CI [0.48, 1.25]), QOL-DA withdrawal symptoms (SMD = 0.72, 95%CI [0.23, 1.20]), QOL-DA physical function (SMD = 1.09, 95%CI [0.66, 1.53]), and QOL-DA psychological function (SMD = 0.35, 95%CI [0.03, 0.67]) (p < 0.05).Conclusion Traditional Chinese Exercise yields significant benefits for multiple mental and QOL-DA-related outcomes in substance use disorders. Due to limited studies, only duration-based subgroup analysis was conducted, without formal head-to-head comparisons across exercise types. While primary studies suggested rehabilitation potential for all Traditional Chinese Exercise modalities, relative efficacy remains unconfirmed. Mechanistic interpretations should be regarded as research hypotheses requiring empirical validation. Further direct-comparison randomized controlled trials are warranted.