Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis

Purpose: Exercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and ex-ercise capacity in patients with HF.Methods: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was per-formed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis.Results: Baduanjin exercise showed a favourable improvement of the overall QOL (mean difference =-8.25; 95% confidence interval:-13.62 to-2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% con-fidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients' physical (mean difference =-2.83; 95% confidence interval:-3.76,-1.90; P < 0.00001), emotional (mean difference =-2.52; 95% confidence interval:-3.67 to-1.37; P < 0.0001), and general QOL (mean difference =-2.61; 95% confidence interval:-5.17 to-0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes.Conclusions: Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.