Comparative effectiveness of traditional Chinese exercises as complementary cardiac rehabilitation strategies after percutaneous coronary intervention: a systematic review and network meta-analysis
4 affiliations
- 1Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- 2Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University
- 3School of Nursing, Beijing University of Chinese Medicine
- 4School of Acupuncture and Tuina, Beijing University of Chinese Medicine
Abstract
Background: Percutaneous coronary intervention (PCI) is one of the most important therapies in patients with coronary heart disease (CHD). However, there are still many problems, such as in-stent restenosis, recurrent angina pectoris, postoperative anxiety and depression. Traditional Chinese exercise (TCE) therapies belong to the aerobic exercise of low and medium intensity, which may have a certain efficacy on cardiac rehabilitation of patients after PCI. The objective of this network meta-analysis is to compare the impacts of different traditional Chinese exercise on cardiac function and exercise capacity in patients after PCI.
Methods: Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, Chinese Science and Technique Journals Database (VIP), Chinese Biomedical Literature Database (Sinomed), Yiigle databases, PubMed, EMBASE, and the Cochrane Library were searched from inception to May 2025, to collect randomized controlled trials (RCTs) about TCE interventions for patients after PCI. We screened the literatures and extracted the data. The Cochrane Collaboration “Risk of bias 2.0” assessment tool will be used to assess the bias of RCTs. Network meta-analysis was conducted using Stata17.0 software.
Results: A total of 38 studies were included in this network meta-analysis that tested 6 TCE interventions and included 3,343 patients. The quality assessment of included studies revealed that 1 was high risk and 37 studies had some concerns. TCE interventions included Baduanjin (BDJ), Tai Chi (TC), Wu Qinxi (WQX), Tai Chi Yunshou (TCYS), Tai Chi Ball + Baduanjin (TCB + BDJ), and Baduanjin + Yi Jinjing (BDJ + YJJ). The results of network meta-analysis and surface under the cumulative ranking curve(SUCRA) showed that with conventional treatment(CT) as a common control, BDJ + CT achieved the highest SUCRA values for LVEF, NT-proBNP, and 6MWD within the available network (81.1%, 86.5%, and 75.5%, respectively). The network meta-analysis results revealed that BDJ + CT were significantly different compared with CT alone for LVEF [WMD=6.28, 95% CI (4.90, 7.67)], NT-proBNP level [SMD=-2.35, 95% CI (-3.64, −1.06)], and 6MWD [WMD=65.19, 95% CI (38.91,91.48)]. In addition, compared with the control group, the incidence of adverse events in the treatment group was lower [RR = 0.39, 95% CI (0.30, 0.52), P<0.00001].
Conclusions: In conclusion, the combination of TCE and CT approaches may enhance the efficacy of CT on cardiac rehabilitation in patients after PCI. BDJ + CT ranked highly within the available network, but its comparative superiority remains uncertain. Indirect comparisons, substantial heterogeneity, and low or very low certainty of evidence limit interpretation. High-quality head-to-head RCTs are needed before recommending one TCE modality over another.
Systematic Review Registration: PROSPERO CRD420251053210.
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BibTeX
@article{jiale2026comparative,
title = {{Comparative effectiveness of traditional Chinese exercises as complementary cardiac rehabilitation strategies after percutaneous coronary intervention: a systematic review and network meta-analysis}},
author = {Wang Jiale and Liu Longcheng and Yang Shuo and Yu Qiushuang and Ren Zeyang and Tian Jiayi and Ma Lihong},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = nov,
doi = {10.3389/fcvm.2026.1963283},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1963283/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparative effectiveness of traditional Chinese exercises as complementary cardiac rehabilitation strategies after percutaneous coronary intervention: a systematic review and network meta-analysis
AU - Wang Jiale
AU - Liu Longcheng
AU - Yang Shuo
AU - Yu Qiushuang
AU - Ren Zeyang
AU - Tian Jiayi
AU - Ma Lihong
PY - 2026
DA - 2026/11/13
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1963283
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1963283/full
AB - Background: Percutaneous coronary intervention (PCI) is one of the most important therapies in patients with coronary heart disease (CHD). However, there are still many problems, such as in-stent restenosis, recurrent angina pectoris, postoperative anxiety and depression. Traditional Chinese exercise (TCE) therapies belong to the aerobic exercise of low and medium intensity, which may have a certain efficacy on cardiac rehabilitation of patients after PCI. The objective of this network meta-analysis is to compare the impacts of different traditional Chinese exercise on cardiac function and exercise capacity in patients after PCI. Methods: Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, Chinese Science and Technique Journals Database (VIP), Chinese Biomedical Literature Database (Sinomed), Yiigle databases, PubMed, EMBASE, and the Cochrane Library were searched from inception to May 2025, to collect randomized controlled trials (RCTs) about TCE interventions for patients after PCI. We screened the literatures and extracted the data. The Cochrane Collaboration “Risk of bias 2.0” assessment tool will be used to assess the bias of RCTs. Network meta-analysis was conducted using Stata17.0 software. Results: A total of 38 studies were included in this network meta-analysis that tested 6 TCE interventions and included 3,343 patients. The quality assessment of included studies revealed that 1 was high risk and 37 studies had some concerns. TCE interventions included Baduanjin (BDJ), Tai Chi (TC), Wu Qinxi (WQX), Tai Chi Yunshou (TCYS), Tai Chi Ball + Baduanjin (TCB + BDJ), and Baduanjin + Yi Jinjing (BDJ + YJJ). The results of network meta-analysis and surface under the cumulative ranking curve(SUCRA) showed that with conventional treatment(CT) as a common control, BDJ + CT achieved the highest SUCRA values for LVEF, NT-proBNP, and 6MWD within the available network (81.1%, 86.5%, and 75.5%, respectively). The network meta-analysis results revealed that BDJ + CT were significantly different compared with CT alone for LVEF [WMD=6.28, 95% CI (4.90, 7.67)], NT-proBNP level [SMD=-2.35, 95% CI (-3.64, −1.06)], and 6MWD [WMD=65.19, 95% CI (38.91,91.48)]. In addition, compared with the control group, the incidence of adverse events in the treatment group was lower [RR = 0.39, 95% CI (0.30, 0.52), P<0.00001]. Conclusions: In conclusion, the combination of TCE and CT approaches may enhance the efficacy of CT on cardiac rehabilitation in patients after PCI. BDJ + CT ranked highly within the available network, but its comparative superiority remains uncertain. Indirect comparisons, substantial heterogeneity, and low or very low certainty of evidence limit interpretation. High-quality head-to-head RCTs are needed before recommending one TCE modality over another. Systematic Review Registration: PROSPERO CRD420251053210.
SN - 2297-055X
ER -