Traditional Chinese Exercise for Rehabilitation from Coronary Heart Disease: A Systematic Review and Meta-Analysis

Abstract

Objectives: To assess the effects of Traditional Chinese exercises (TCEs) in patients undergoing rehabilitation from coronary heart disease (CHD). Design: Systematic review and meta-analysis. Data sources: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Science and Technology Periodical Database, and Wan fang Database, were searched from the corresponding inception date to March 2022. Eligibility criteria for selecting studies: Randomized controlled trials involving TCEs alone or in combination with conventional therapy versus conventional therapy on CHD patients undergoing rehabilitation were included. Data synthesis: Data analysis was performed with RevMan software version 5.2.0. Main outcomes and measures: The primary outcomes were the Seattle Angina Questionnaire (SAQ) and self-rating depression scale (SDS), and the secondary outcomes were 36-Item Short Form Health Survey (SF-36), self-rating anxiety scale (SAS), left ventricular ejection fraction (LVEF), N-terminal pro-B type natriuretic peptide (NT-proBNP), six-min walking test (6-MWT), and peak oxygen uptake (peak VO2). Results: 22 studies, including a total of 2100 patients, met the study criteria. When compared with conventional therapy alone: Baduanjin combined with conventional therapy improved the SAQ (physical limitation (n=360, MD=5.72 points, 95% CI (2.02, 9.41), p=0.002, I 2=94) ；angina frequency (n=360, MD=14.49 points, 95% CI (8.43, -20.55), p＜0.00001, I 2=96)), SF-36 (general health (n=425, MD = 9.77 points, 95% CI (8.21, 11.32), p＜0.00001, I 2=0); physical function (n=425, MD = 6.73 points, 95% CI (5.49, 7.97), p＜0.00001, I 2=6)), and 6-MWT (n=336, MD= 40.80 m, 95% CI (8.80, 72.80), p=0.01, I 2=99) of patients after percutaneous coronary intervention (PCI); Baduanjin combined with conventional therapy improved SAQ in patients suffering from stable angina pectoris (SAP) (physical limitation (n=110, MD = 4.13 points, 95% CI (0.38,7.88), p=0.03, I 2=0); angina frequency (n=410, MD=9.88 points, 95% CI (6.08,13.67), p<0.00001, I 2=27)). TaiChi combined with conventional therapy 2improved SF-36 in patients after PCI (general health (n=227, MD = 12.00 points, 95% CI (5.21, 18.80), p=0.0005, I 2=91%) ; physical function (n=227, MD = 12.46 points, 95% CI (7.67, 17.26), p＜0.00001, I 2=83%)). Conclusions: Baduanjin combined with conventional therapy may improve the quality of life of patients with PCI and SAP, and the cardiopulmonary function of patients after PCI; TaiChi combined with conventional therapy may improve the quality of life of patients with PCI. However, due to the low quality of the included studies and high heterogeneity among different studies, we should take a cautious attitude towards this conclusion. PROSPERO registration number: CRD 42022323676