The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis

ObjectiveTo systematically evaluate the comparative effectiveness of traditional Chinese exercises (TCEs) and other interventions for managing anxiety and depression in adults using a network meta-analysis approach.DesignSystematic review and network meta-analysis.MethodsLiterature search was conduc...

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Main Authors: Huan Feng, YanJing Li, QingChuan Wang, Ye Tao, ZhiHua Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1582923/full
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author Huan Feng
YanJing Li
QingChuan Wang
Ye Tao
ZhiHua Wang
author_facet Huan Feng
YanJing Li
QingChuan Wang
Ye Tao
ZhiHua Wang
author_sort Huan Feng
collection DOAJ
description ObjectiveTo systematically evaluate the comparative effectiveness of traditional Chinese exercises (TCEs) and other interventions for managing anxiety and depression in adults using a network meta-analysis approach.DesignSystematic review and network meta-analysis.MethodsLiterature search was conducted in Embase, PubMed, Web of Science, and Cochrane Library from inception to December 31, 2024. Randomized controlled trials (RCTs) involving TCEs for adults with anxiety or depression were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the ROB2 tool. Bayesian network meta-analyses were performed to compare the effectiveness of interventions. The surface under the cumulative ranking area (SUCRA) was used to rank the interventions.Data sourcesEmbase, PubMed, Web of Science, and Cochrane Library.Eligibility criteria for selecting studiesRCTs involving adults aged 18 years and older, intervention groups engaging in TCEs, comparator groups with no intervention, routine treatment, or distinct interventions, reported outcomes related to anxiety or depression assessed using validated tools, and studies published in English or Chinese.ResultsA total of 82 RCTs were included, with 4,501 participants. For anxiety, Liu Zi Jue (SUCRA = 99.5%), Tai Chi (SUCRA = 87.6%), and CBT (SUCRA = 75.3%) were the most effective interventions. For depression, Tai Chi (SUCRA = 95.5%), Yijinjing (SUCRA = 89.2%), and CBT (SUCRA = 83.6%) ranked as the most effective. TCEs demonstrated comparable or superior efficacy to well-established interventions like CBT. The study also found that TCEs have high adherence rates, low costs, and the potential for large-scale promotion and value.ConclusionThis systematic review and network meta-analysis provides evidence for the efficacy of TCEs, particularly Tai Chi, Liu Zi Jue, and Yijinjing, in managing anxiety and depression in adults. Despite limitations such as heterogeneity in intervention protocols and study populations, the findings suggest that these exercises offer therapeutic benefits and may serve as accessible, cost-effective, and culturally-relevant treatment options. Further research is needed to establish optimal dosages, assess long-term effects, and evaluate generalizability across diverse contexts.Systematic review registrationCRD42025637146.
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spelling doaj-art-8d82f34bed4a4933a598f6c8dcb4ccbb2025-08-20T02:16:44ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15829231582923The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysisHuan Feng0YanJing Li1QingChuan Wang2Ye Tao3ZhiHua Wang4College of Physical Education, Sichuan University, Chengdu, ChinaCollege of Physical Education, Jiangxi Normal University, Nanchang, ChinaCollege of Sports, Chengdu Sport University, Chengdu, ChinaCollege of Sports, Chengdu Sport University, Chengdu, ChinaCollege of Physical Education, Sichuan University, Chengdu, ChinaObjectiveTo systematically evaluate the comparative effectiveness of traditional Chinese exercises (TCEs) and other interventions for managing anxiety and depression in adults using a network meta-analysis approach.DesignSystematic review and network meta-analysis.MethodsLiterature search was conducted in Embase, PubMed, Web of Science, and Cochrane Library from inception to December 31, 2024. Randomized controlled trials (RCTs) involving TCEs for adults with anxiety or depression were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the ROB2 tool. Bayesian network meta-analyses were performed to compare the effectiveness of interventions. The surface under the cumulative ranking area (SUCRA) was used to rank the interventions.Data sourcesEmbase, PubMed, Web of Science, and Cochrane Library.Eligibility criteria for selecting studiesRCTs involving adults aged 18 years and older, intervention groups engaging in TCEs, comparator groups with no intervention, routine treatment, or distinct interventions, reported outcomes related to anxiety or depression assessed using validated tools, and studies published in English or Chinese.ResultsA total of 82 RCTs were included, with 4,501 participants. For anxiety, Liu Zi Jue (SUCRA = 99.5%), Tai Chi (SUCRA = 87.6%), and CBT (SUCRA = 75.3%) were the most effective interventions. For depression, Tai Chi (SUCRA = 95.5%), Yijinjing (SUCRA = 89.2%), and CBT (SUCRA = 83.6%) ranked as the most effective. TCEs demonstrated comparable or superior efficacy to well-established interventions like CBT. The study also found that TCEs have high adherence rates, low costs, and the potential for large-scale promotion and value.ConclusionThis systematic review and network meta-analysis provides evidence for the efficacy of TCEs, particularly Tai Chi, Liu Zi Jue, and Yijinjing, in managing anxiety and depression in adults. Despite limitations such as heterogeneity in intervention protocols and study populations, the findings suggest that these exercises offer therapeutic benefits and may serve as accessible, cost-effective, and culturally-relevant treatment options. Further research is needed to establish optimal dosages, assess long-term effects, and evaluate generalizability across diverse contexts.Systematic review registrationCRD42025637146.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1582923/fullTai Chitraditional Chinese exercisesTCEsanxietydepressionmeta-analysis
spellingShingle Huan Feng
YanJing Li
QingChuan Wang
Ye Tao
ZhiHua Wang
The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
Frontiers in Public Health
Tai Chi
traditional Chinese exercises
TCEs
anxiety
depression
meta-analysis
title The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
title_full The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
title_fullStr The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
title_full_unstemmed The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
title_short The effects of traditional Chinese exercises on anxiety and depression in adults: a systematic review and network meta-analysis
title_sort effects of traditional chinese exercises on anxiety and depression in adults a systematic review and network meta analysis
topic Tai Chi
traditional Chinese exercises
TCEs
anxiety
depression
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1582923/full
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