Efficacy of traditional Chinese exercise for stroke patients with hemiplegia: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: A comprehensive assessment of its effectiveness and evidence base is lacking. Therefore, this systematic review and meta-analysis attempts to systematically investigate the therapeutic effect of traditional Chinese exercises (TCEs) on limb motor function, activity of daily living, and balance function in stroke patients with hemiplegia through rigorous meta-analysis methods. Our aim is to verify whether TCEs are effective for the treatment of hemiplegia and provide evidence to support the clinic application of TCEs through synthesizing the existing literature and differences in research methods. METHODS: The randomized controlled trials of treatment for stroke patients with hemiplegia using the TCEs were searched from seven databases up to September 2024, including CNKI, CBM, VIP, WanFang Data, PubMed, Cochrane, and Embase. The clinical effectiveness and Fugl-Meyer Assessment (FMA) score were chosen as the primary outcomes; the Modified Barthel Index (MBI) score and Berg Balance Scale (BBS) score were defined as the secondary outcomes. Two researchers conducted the literature screening and evaluated the risk of bias and quality of the included literature according to the Cochrane Handbook 5.1 independently. The RevMan 5.7 was used for meta-analysis. RESULTS: Twenty-eight randomized trials involving 2826 participants met the inclusion criteria and were used for meta-analysis in this study. The results showed that the TCEs significantly improved all of the measured outcomes in this study compared with the control group, including the clinical efficacy, the upper limb FMA score, lower limb FMA score, MBI score, and BBS score: The clinical efficacy: mean difference (MD) = 4.83, 95% confidence interval (CI) (3.17, 7.37), Z = 7.34, P < .00001; upper extremity FMA score: MD = 7.94, 95% CI (7.50, 8.37), Z = 35.52, P < .00001; lower extremity FMA score: MD = 4.49, 95% CI (4.25, 4.73), Z = 37.36, P < .00001; MBI score: MD = 8.15, 95% CI (7.47, 8.84), Z = 23.36, P < .00001; BBS score: MD = 6.62, 95% CI (6.17, 7.07), Z = 28.69, P < .00001. CONCLUSION: Our results revealed that TCE could improve the motor function, ability to live independently, and balance function of the limbs in patients with hemiplegia after stroke. However, the lack of standards for TCEs may lead to bias and heterogeneity. Well-designed, large-sample, multicenter randomized high-quality clinical studies should be conducted to verify the efficacy.