Abstract
BACKGROUND: Stroke is a common cerebrovascular disease characterized by a high incidence rate, significant disability, frequent recurrence, and elevated mortality. Exercise plays a crucial role in stroke rehabilitation, yet the relationship between traditional Chinese exercise and stroke recovery remains unclear. This study aims to evaluate the effectiveness of various conventional Chinese exercises through a systematic network meta-analysis and identify the most effective interventions for improving the rehabilitation outcomes of stroke patients. METHODS: A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and the China Science and Technology Journal Database (up to July 2024) to identify randomized controlled trials (RCTs) evaluating traditional Chinese exercises for stroke patients. Trials were included if they utilized at least one form of traditional Chinese exercise. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool (ROB 2.0). Data analysis was performed using Stata 17.0 and the Mvmeta package, employing a random-effects model. RESULTS: A total of 43 studies involving 2083 stroke patients were included. These studies assessed outcomes including upper limb motor function, lower limb motor function, overall motor ability, walking ability, balance ability, self-care ability, cognitive function, depression, quality of life, and sleep quality. Baduanjin, originating in the Song Dynasty and consisting of eight movements based on traditional Chinese medicine theories,was the most effective in improving upper limb motor function, overall motor ability, walking ability, self-care ability, cognitive function, quality of life, and sleep quality. Taiji, a practice integrating Chinese philosophy, martial arts, and wellness concepts, was the most effective in enhancing lower limb motor function. Wuqinxi, inspired by the dynamic movements of animals such as the tiger, deer, bear, apes, and birds, showed the best results for balance improvement. Liuzijue, a traditional exercise combining specific sound production, breathing, and movement, was most effective in alleviating depressive symptoms. CONCLUSIONS: These findings suggest that Baduanjin may be the most effective intervention for stroke rehabilitation. However, further high-quality RCTs are required to confirm these results. THE PROSPERO REGISTRATION: CRD42024566780, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024566780.