Effects of traditional Chinese exercise on physiological indicators and quality of life in patients with coronary heart disease: A systematic review and meta-analysis

Abstract

Background: The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of physiological indicators and quality of life in patients with coronary heart disease (CHD) is controversial. Method: Five databases were systematically searched for relevant articles published from inception to February 2023. Controlled trials examining TCE intervention in patients with CHD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges g). The categorical and continuous variables were used to conduct moderator analyses. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence based on the Grading of Recommendations Assessment, Development and Evaluation approach. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023401934). Result: Ten studies involving a total of 718 participants were included in the final analysis. In the physiological indicators outcomes, the meta-analytic findings revealed large and significant improvements in systolic blood pressure (g = 0.78, 95% confidence interval [CI] = 0.51–1.05, P = .00, I 2 = 98%), diastolic blood pressure (g = 0.90, 95% CI = 0.61–1.20, P = .00, I 2 = 98%) and body mass index (g = 1.05, 95% CI = 0.75–1.34, P = .00, I 2 = 99%), small and significant improvements in heart rate (g = 0.28, 95% CI = 0.01–0.54, P = .04, I 2 = 98%) and ventilatory equivalents/carbon dioxide (g = −1.10, 95% CI = −1.47 to −0.74, P = .00, I 2 = 96%). In the quality of life outcomes, the findings revealed small and significant improvements in physical functioning (g = −3.01, 95% CI = −3.45 to −2.57, P = .00, I 2 = 96%), bodily pain (g = −2.16, 95% CI = −2.57 to −1.74, P = .00, I 2 = 98%), vitality (g = −3.67, 95% CI = −4.16 to −3.16, P = .00, I 2 = 97%) and mental health (g = −1.23, 95% CI = −1.771 to −0.692, P = .00, I 2 = 99%). The moderator shows that the effects of TCE on physiological indicators and quality of life were moderated by PEDro score, type of exercise, exercise frequency, exercise duration, and number of sessions. Conclusion: TCE intervention is a beneficial nonpharmacological approach to improving physiological indicators in patients with CHD, especially in systolic blood pressure, diastolic blood pressure, and body mass index. However, there was no significant effect on quality of life. Our findings require broader clinical trials and higher-quality study designs to strengthen the evidence.