Abstract
BACKGROUND: Previous research on traditional exercise interventions for chronic heart failure (CHF) has primarily concentrated on single exercise modalities in isolation, providing scant insight into the ideal exercise regimen for this patient population. This study aims to assess the effects of 6 traditional exercise therapies - specifically Liuzijue, Tai Chi, Baduanjin, yoga, Wuqinxi, and meditation - on CHF outcomes using the Minnesota living with heart failure questionnaire (MLHFQ), six-minute walk test (6MWT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF). METHODS: A comprehensive search was conducted across databases including CNKI, Wanfang, VIP, PubMed, Embase, Web of Science, and the Cochrane Library. After applying the inclusion and exclusion criteria, relevant studies were screened, and data were extracted. A network-meta-analysis (NMA) was then performed to compare and rank the effectiveness of different outcome measures. RESULTS: This NMA included 34 studies with a total sample size of 2521 participants (intervention group: 1268; control group: 1253). For MLHFQ, Liuzijue combined with usual care showed the greatest improvement (MD = -18.14, 95% CI [-24.61, -11.67]; P < .05), with the highest surface under the cumulative ranking (SUCRA) ranking (0.5%). For 6MWT, Liuzijue was most effective (MD = 69.89, 95% CI [21.32, 118.45]; P < .05). In reducing NT-proBNP levels, Baduanjin had the strongest effect (MD = -309.81, 95% CI [-550.86 to -68.76]; P < .05). For LVEF, Tai Chi ranked highest (MD = 4.15, 95% CI [2.40 to 5.90]; P < .05). Overall, Liuzijue and Baduanjin emerged as the most beneficial exercise therapies across multiple outcomes. CONCLUSIONS: When used as adjunctive therapies, traditional exercise modalities demonstrate clinically meaningful benefits for patients with CHF, particularly in improving 4 different clinical outcomes. In clinical practice, personalized exercise prescriptions can be tailored to the individual needs of patients.