Effects of traditional Chinese exercise in patients with chronic heart failure: A systematic review and meta-analysis

According to clinical observations, traditional Chinese exercise (TCE) has a potential impact on patients with chronic heart failure (CHF). However, these findings still lack comprehensive assessment, therefore, a systematic review and meta-analysis were conducted to assess the overall efficacy of TCE for CHF. We searched the PubMed, Embase, Cochrane Library, CNKI and SinoMed databases from their inception to March 30, 2020. We included only published English and Chinese full-text articles on randomized controlled trials (RCTs) involving TCE compared with conventional therapy (usual care, conventional treatment or medical treatment) for CHF. Two reviewers independently conducted risk assessments for bias, and the data were analysed using the Cochrane Collaboration's RevMan v.5.3. The study included 22 trials conducted in hospitals with 1646 participants, and only one study was assessed as having a low risk of poor methodological quality. The comprehensive results indicated that compared to the conventional therapy, TCE effectively improved peak VO2 (MD = 0.85 ml/kg/min; 95% CI =0.32-1.38 ml/kg/min; P =0.002), reduced NT-proBNP (MD =-14.08 pg/ml; 95% CI =-17.88 to -10.28 pg/ml; P