Abstract
INTRODUCTION: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterised by progressive impairments in motor function, balance, and gait, which significantly compromise activities of daily living and overall quality of life. Traditional Chinese exercises (TCEs), recognised as a mind-body, non-pharmacological therapy, are frequently incorporated into the clinical management of PD. Despite their widespread use, the optimal therapeutic effects and ideal exercise prescriptions for TCEs remain uncertain. Therefore, we aimed to comprehensively evaluate the impact of TCEs on motor function, balance, gait, and quality of life in patients with PD through a systematic review and meta-analysis, with the goal of providing evidence-based guidance for the selection of the most suitable exercise regimen. METHODS: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilising the PICOS framework to systematically search seven databases-CNKI, Wanfang, VIP, PubMed, Embase, Cochrane Library, and Web of Science-for randomised controlled trials (RCTs) published from their inception up to October 2025. Two independent authors screened all eligible studies, and study quality and risk of bias were assessed using the criteria outlined in the Cochrane Handbook version 5.1. Extracted data were statistically analysed using RevMan 5.4 software, calculating the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CIs) and evaluating heterogeneity (I(2)) among the studies. RESULTS: Thirteen RCTs involving 859 patients were ultimately included in the analysis1. The meta-analysis results showed that, compared with the usual control group, TCEs significantly improved patients' motor function (Unified Parkinson's Disease Rating Scale part III, UPDRS-III, MD: -4.30, 95% CI: -5.90 to -2.70, p < 0.00001, I (2) = 71%) and balance function (Berg Balance Scale, MD: 2.63, 95% CI: 1.30-3.96, p = 0.0001, I (2) = 0%; Timed Up and Go Test, TUGT, MD: -1.19, 95% CI: -2.03 to -0.35, p = 0.005, I (2) = 65). However, the improvements observed in gait function (stride length, p = 0.07; cadence, p = 0.85; and gait velocity, p = 0.77) and quality of life (PDQ-39, p = 0.11) were not statistically significant. Necessary subgroup analyses were conducted, with results indicating the following: for motor function (UPDRS-III), the optimal exercise type was Qigong (MD = -4.66), with an optimal exercise duration of ≤12 weeks (MD = -4.25) and frequency of >3 times per week (MD = -4.66). Furthermore, the independent practise of TCEs proved to be the most effective intervention method (MD = -5.66). For balance function (TUGT), the optimal exercise type was Qigong (MD = -2.47), with an optimal exercise duration of ≤12 weeks (MD = -2.2) and frequency of > 3 times per week (MD = -2.47). CONCLUSION: TCEs can serve as an effective adjunct to conventional therapy, significantly improving motor and balance functions in patients with PD. Based on these findings, we recommend Qigong as the preferred modality for early- and moderate-stage PD patients, with an optimal initial prescription involving a duration of ≤12 weeks, a frequency of > 3 times per week, and the independent practise of TCEs. However, studies on the effects of TCEs on gait function and quality of life are limited.