Effects of traditional Chinese exercise on patients with cognitive impairment: A systematic review and Bayesian network meta-analysis

Objective: To systematically review the effectiveness of four types of traditional Chinese exercise (TCE) on patients with cognitive impairment (CI) and to rank these four TCE types. Design: A Bayesian network meta-analysis. Methods: Four English databases, including PubMed, EMBASE, Cochrane Library and Web of Science, and three Chinese databases, including CNKI, VIP and Wanfang, were searched from their inception to December 2019. Randomized control trials conducted to verify the effects of TCE on patients with CI were included. We used network meta-analysis to evaluate the relative effects and rank probabilities of the four types of TCE. Results: The results of the network meta-analysis indicated that baduanjin (N = 9), tai chi (N = 11), liuzijue (N = 2) and qigong (N = 1) all had significant benefits compared with control conditions. According to the ranking probabilities, baduanjin was most likely to be associated with substantial improvement in cognition, followed by tai chi, liuzijue and qigong. Conclusion: Our study revealed the effectiveness of TCE for improving global cognition in adults with cognitive impairment. Baduanjin may be the most effective exercise type. The evidence summarized in our study still contains bias, and more research should be carried out to verify the validity of TCE.