Effects of Baduanjin exercise on essential hypertension: A meta-analysis of randomized controlled trials

Statistical heterogeneity in meta-analysis of hypertension and exercise training: A meta-review

We aim to evaluate the prevalence of reporting and the extent of statistical heterogeneity of systematic reviews with meta-analyses (SRMAs) of exercise training for hypertension and to provide practical recommendations for dealing with statistical heterogeneity. We systematically searched on four databases (from 2002 to September of 2023) for SRMAs comparing exercise interventions vs. a non-exercise control on blood pressure (BP) control in adults with hypertension. Fifty-nine SRMAs, with a median of 14 studies, were analysed. Cochran's Q (41%), I2 (24%), forest plots (44%), and particularly τ2 (54%) and prediction intervals (96.6%) frequently were not reported for the hypertension subgroup. The recalculated prediction intervals were discrepant (i.e., crossed the null effect) of significant 95% confidence intervals of most meta-analyses (systolic BP: 65%; diastolic BP: 92%). This suggests substantial heterogeneity across studies, which was often not acknowledged by authors' conclusions (78%). Consequently, downgrading the certainty of the available evidence may be justified alone due to heterogeneity across studies. Finally, we illustrate areas for improving I2 interpretation and provide practical recommendations on how to address statistical heterogeneity across all stages of a SRMA.

Analysis of the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on fracture healing, mobility and nutritional status of elderly patients with vertebral or hip fractures

Hip fractures (VOHF) are a type of bone fracture that occurs in the hip bone, typically affecting older adults. Recovery from hip fractures in older adults can be challenging due to factors such as decreased mobility, weakened bones, and other health issues. This paper intends to determine the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on postoperative rehabilitation of elderly patients with vertebral or hip fractures (VOHF). 106 senile VOHF patients were chosen for the study between May 2020 and May 2022. The research group (RG) consisted of 60 patients who received mini-nutrition nursing + Baduanjin rehabilitation exercise, while the control group (CG) had 46 patients who received mini-nutrition nursing + routine rehabilitation training. The study compared the fracture healing effect, MAMC, CC, and MNA-SF scores. The rehabilitation status of patients was evaluated using FMA, BI, BBS, and VAS. Adverse reactions during hospitalization and SF-36 scores were also recorded. Better fracture healing efficacy and higher MAMC, CC, and MNA-SF scores were determined in RG versus CG (P < 0.05). Elevated FMA, BI and BBS scores were observed in both groups after rehabilitation training, with more evident elevations in RG; while the VAS score reduced markedly and was lower in RG compared with CG (P < 0.05). In addition, RG was observed with fewer adverse reactions and higher SF-36 scores (P < 0.05). Mini-nutrition nursing + Baduanjin rehabilitation exercise can effectively accelerate the postoperative rehabilitation of elderly patients with VOHF, improve mobility, and enhance their quality of life.

The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews

Hypertension remains the world's leading cause of premature death. Interventions such as exercise, diet modification, and pharmacological therapy remain the mainstay of hypertension treatment. Numerous systematic reviews and meta-analyses demonstrated the effectiveness of western exercises, such as aerobic exercise and resistance exercise, in reducing blood pressure in hypertensive patients. There is recently emerging evidence of blood pressure reduction with Chinese exercises, such as Tai Chi, Baduanjin, and Qigong. The current overview of systematic reviews aims to evaluate the quality and descriptively summarize the evidence for the effectiveness of western and Chinese exercises for hypertension management. Thirty-nine systematic reviews were included in this overview, with 15 of those being on Chinese exercise. Evidence suggests that exercise training, regardless of Western or Chinese exercise, generally reduced both systolic and diastolic blood pressure. High-intensity intermittent training did not further reduce blood pressure when compared to moderate-intensity continuous training. Conflicting results on the effectiveness of blood pressure reduction when comparing Chinese and Western exercise training were observed. This suggests the comparable effectiveness of Chinese exercise training, in particularly Tai Chi, to general or aerobic exercise training in terms of blood pressure reduction. The Chinese exercise modality and intensity may be more suitable for the middle-aged and elderly population.

Updated Meta-Analysis Assessing Effects of Baduanjin on Cardiopulmonary Functions of Patients with Coronary Heart Disease

Background

Baduanjin is a kind of moderate-intensity aerobic exercise, but its effect on the cardiac rehabilitation (CR) of patients with coronary heart disease (CHD) is controversial. Furthermore, the small sample size of a single study and the inconsistent selection of evaluation indicators among different studies all promote the necessity of conducting a meta-analysis.

Objective

This meta-analysis aims to explore whether Baduanjin can effectively improve the cardiopulmonary function in patients with CHD and to assess the extrapolation of the results.

Methods

Both English and Chinese databases were used for literature retrieval. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included literature. A weighted mean difference and a 95% confidence interval were used to assess the effects of Baduanjin on cardiopulmonary function based on multiple CR indicators. Cochran's Q and I² tests were used for the heterogeneity test. A funnel plot and an Egger test were used to evaluate publication bias.

Results

After literature retrieval, a total of 12 literature papers were included in this meta-analysis, but their methodological quality was unsatisfactory. By comparing differences between CHD patients with and without Baduanjin, we found that levels of 6MWT, LVEF, NT-proBNP, VO₂, peak VO₂, MVV, and VE, AT were significantly improved in the experimental group, but heterogeneity exists among included studies. Results of subgroup analyses were consistent with combined estimates and suggested a significant effect of Baduanjin on LVEF. The Egger test indicated no significant publication bias.

Conclusion

Baduanjin is beneficial to CR in CHD patients, but multiple region-based high-quality studies are necessary to verify the results.

Baduanjin exercise in the treatment of hypertension: A systematic review and meta-analysis

Background

As a therapy to prevent and treat hypertension, exercise is widely used in clinical practice. But due to the lack of documentary evidence, Baduanjin as a relaxed and convenient mode of exercise is not currently recommended by professional health organizations to treat hypertension. The purpose of this article is to examine the efficacy of Baduanjin as an antihypertensive exercise therapy.

Methods

Our systematic retrieved of the entire relevant literatures in 12 databases. Finally, 28 eligible trials involving Baduanjin intervention in hypertension were included. After the quality assessment and bias risk assessment of the included trials, we analyzed the blood pressure values before and after the intervention, and performed meta-analysis on the random effect results. In order to explore the factors influencing the decrease of blood pressure, we also performed a subgroup analysis of the results.

Results

Participants (n = 2121) were adults (61.74 ± 5.85years of age, mean ± SD), with baseline blood pressure (systolic blood pressure (SBP) = 150.7 ± 9.2 mmHg, diastolic blood pressure (DBP) = 93.2 ± 8.8 mmHg). Baduanjin was practiced 7.5 ± 3.8 sessions / week for 28.2 ± 12.8 min /session for 16.7 ± 9.2 weeks. Overall, Baduanjin resulted in SBP (−9.3 mmHg, d = −1.49, 95%CI: −1.73 to −1.13) and DBP (−6.3 mmHg, d = −1.20, 95%CI: −1.51 to −0.88) vs. the control group (p &lt; 0.001). After a subgroup analysis of age, we found that SBP heterogeneity was significantly reduced in the elderly group.

Conclusion

Our results indicate that Baduanjin can effectively reduce blood pressure (i.e., 9.3 mmHg and 6.3 mmHg of SBP and DBP reductions, respectively), and reduce the incidence rate of cardiovascular disease in hypertensive patients. In addition, we will be more likely to recommend that the elderly exercise Baduanjin.

The effects of Baduanjin and yoga exercise programs on physical and mental health in patients with Multiple Sclerosis: A randomized controlled trial

OBJECTIVE

To discuss whether Baduanjin and yoga exercise interventions improve motor function, posture control, and relieving fatigue and depression in MS patients. And to explore whether practicing Baduanjin benefits MS patients more than yoga.

DESIGN

A prospective, randomized, controlled, three-arm trial comparing BDJ (n = 30), yoga (n = 30) and control group (n = 20).

SETTING

Jiangsu Provincial Corps Hospital.

INTERVENTION

Eligible participants were randomized to a 24-week Baduanjin or yoga intervention, or a usual activity control group. Balance, posture control and trunk movement were measured with the Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS). Fatigue was measured using the Fatigue Severity Scale (FSS) and depressive symptoms via the Zung Self-Rating Depression Scale (SDS).

RESULTS

For BBS and TIS, there were significant changes pre- to post- exercise in two exercise groups (P < 0.05), with greater increases in the Baduanjin exercise group (BDJ group). For the FSS, there were significant changes pre- to post- exercise in both the BDJ (P = 0.0292) and yoga groups (P = 0.0150). For the SDS, the pre- and post-exercise difference of the BDJ group was larger than the yoga group (P < 0.0001). On the other hand, we could not find any changes of the BBS, TIS, FSS, and SDS scores in the control group (p > 0.05).

CONCLUSION

The results suggest that practicing Baduanjin was more effective than yoga and that it is suitable for the MS patients.

The Effect of Mind-Body Exercise on Blood Pressure in Middle-Aged and Elderly Patients with Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives. The effects and safety of mind-body exercise in improving blood pressure in middle-aged and elderly patients with hypertension were explored in this meta-analysis. Methods. A meta-analysis of studies from the China National Knowledge Infrastructure, Web of Science, PubMed, and Cochrane was performed to identify related experimental studies by screening out the randomized controlled trials from the time of respective database creation until January 22, 2021. In addition, first, we completed the research registration on the INPLASY platform on March 20, 2021 (registration number: INPLASY202130072) and, second, on the PROSPERO platform on December 28, 2021 (registration number: CRD42021289125). The data were analyzed using a random-effects model with the help of Stata 14.0 software. Results. A total of 2,277 patients from 30 studies were reflected in the present study. The results show that mind-body exercise can effectively improve systolic blood pressure [SMD = −0.994, 95% CI: −1.239∼−0.748, $P<0.01$ ] and diastolic blood pressure [SMD = −0.757, 95% CI: −1.009∼−0.505, $P<0.01$ ] in middle-aged and elderly patients with hypertension. Conclusion. The results of this meta-analysis show that mind-body exercise can effectively improve blood pressure in middle-aged and elderly patients with hypertension without adverse events.

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes.

Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects.

Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia.

Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis

BACKGROUND

Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension.

METHODS

Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed.

RESULTS

It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = -5.94, 95% CI: -8.57, -3.30; diastolic blood pressure (DBP): WMD = -2.66, 95% CI: -3.66, -1.67), yoga (SBP: WMD = -5.09, 95% CI: -9.28, -0.89; DBP: WMD = -3.06, 95% CI: -5.16, -0.96), aquatic sports (SBP WMD = -7.53, 95% CI: -11.40, -3.65; DBP: WMD = -5.35, 95% CI: -9.00, -1.69), and football (SBP: WMD = -6.06, 95% CI: -9.30, -2.82; DBP: WMD = -5.55, 95% CI: -8.98, -2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = -8.31, 95% CI: -20.39, 3.77; DBP: WMD = -3.05, 95% CI: -6.96, 0.87) and Qigong (SBP: WMD = -4.34, 95% CI: -13.5, 4.82; DBP: WMD = -3.44, 95% CI: -7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high.

CONCLUSION

Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.

Effects of Three Traditional Chinese Fitness Exercises Combined with Antihypertensive Drugs on Patients with Essential Hypertension: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Objective

To compare the efficacy of three different traditional Chinese exercises (Tai Chi, Baduanjin, and Wuqinxi) combined with antihypertensive drugs (AHD) on patients with essential hypertension (EH).

Method

Eight electronic databases were searched to identify randomized controlled trials (RCTs) comparing the effects of traditional Chinese fitness exercises combined with AHD and AHD alone. The analysis mainly consists of network meta-analysis (NMA) and pairwise meta-analysis. The Cochrane assessment tool was adopted to assess the risk of bias of included literatures. This study used STATA/SE 15.1 (StataCorp, 2017), R software (version 4.0.1), and Cochrane's Review Manager software (version 5.4) to conduct data analysis and figures generation.

Results

A total of 30 RCTs were included in this study, of which 16 evaluated Tai Chi plus AHD versus AHD, 11 evaluated Baduanjin plus AHD versus AHD, and 3 evaluated Wuqinxi plus AHD versus AHD. No RCT compared directly among the three traditional Chinese fitness exercises. Pairwise meta-analysis showed that Tai Chi plus AHD was significantly superior to AHD alone in reducing systolic blood pressure (SBP) and diastolic blood pressure (DBP). BDJ plus AHD was statistically superior to AHD alone in reducing SBP, DBP, and endothelin (ET) and increasing nitric oxide (NO). NMA results indicated that Tai Chi plus AHD (WMD −12.42 mmHg, 95% CI: −15.29 to −9.55) and Baduanjin plus AHD (WMD −7.03 mmHg, 95% CI: −9.80 to −4.26) were superior to AHD, and Tai Chi was more effective than other traditional exercises in lowering SBP, Tai Chi plus AHD (WMD −7.56 mmHg, 95% CI: −10.15 to −4.96) and Baduanjin plus AHD (WMD −4.51 mmHg, 95% CI: −7.38 to −1.65) were superior to AHD in reducing DBP, Baduanjin plus AHD (WMD 4.26 μmol/L, 95%CI: 2.68 to 5.83) was statistically superior to AHD in increasing NO, and Tai Chi plus AHD (WMD −7.64 pg/ml, 95% CI: −10.46 to −4.83) and Baduanjin plus AHD (WMD −9.23 pg/ml, 95% CI: −10.85 to −7.61) were superior to AHD in lowering ET.

Conclusion

Compared with AHD alone, both Tai Chi plus AHD and Baduanjin plus AHD showed significant benefit in regulating SBP, DBP, and ET. Among the three traditional Chinese fitness exercises, Tai Chi may be the best as an adjunctive therapy for SBP reduction. These findings provided evidence for the therapeutic benefit of either Tai Chi or Baduanjin exercise as an adjunct therapy for patients with EH. Limited by the methodological quality and quantity of included studies, results need to be interpreted with caution, and it is necessary to carry out further high-quality RCTs on traditional Chinese fitness exercise-assisted treatment of EH in the future.

The effect of mind-body exercise on blood pressure in middle-aged and elderly patients with hypertension: A protocol for a systematic review and meta-analysis

BACKGROUND

Depending on the person, cervical spondylosis may have no clinical symptoms, but cervical spondylosis will definitely cause changes in people's blood pressure, which will further affect physical and mental health.

OBJECTIVES

This study aims to explore the effect and safety of mind-body exercise intervention on the blood pressure in middle-aged and elderly patients with hypertension through meta-analysis.

METHODS

This meta-analysis searched studies from 4 research databases: the China National Knowledge Infrastructure (from 1979), Web of Science (from 1950), PubMed (from 1965), and Cochrane (from 1991), Date of retrieval: January 22, 2021, Two authors will independently search literature records, scan titles, abstracts, and full texts, collect data, and assess materials for risk of bias. The data will be analyzed by Stata 14.0 software.

RESULTS

The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed.

DISCUSSION

This meta-analysis may provide clinical practice with more reliable evidence-based medical evidence that mind-body exercise can benefit the blood pressure of middle-aged and elderly hypertensive patients.

INPLASY REGISTRATION NUMBER

INPLASY202130072.