Journal of the American Medical Directors Association · Nov 2, 2026

Effectiveness of Traditional Chinese Medicine Exercise Therapy for Frailty in Older Adults and Descriptive Summary of Exercise Prescription Characteristics: A Systematic Review and Meta-Analysis

By Huang X, Xin B, Wang R et al.

Objectives To evaluate outcome-specific effects of Traditional Chinese Medicine (TCM) exercise therapy on frailty-related outcomes in older adults and descriptively summarize exercise prescription characteristics. Design Systematic review and meta-analysis. Setting and Participants Randomized controlled trials involving adults aged 60 years or older with frailty, prefrailty, or eligible cognitive frailty in community, institutional, or clinical settings. Methods Eight databases were searched from inception to March 31, 2026. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Separate random-effects meta-analyses were conducted for key outcomes using standardized mean differences (SMDs) with Hedges’ g correction. Heterogeneity was assessed using τ² and I² statistics, with prediction intervals calculated where appropriate. Exercise prescription characteristics were summarized descriptively. Results Twenty-one studies were included, with 15 contributing to the main meta-analysis. TCM exercise therapy showed favorable effects on Edmonton Frail Scale scores (SMD, 0.55; 95% CI, 0.04-1.06), Fried frailty phenotype scores (SMD, 2.70; 95% CI, 1.15-4.25), Timed Up and Go performance (SMD, 0.75; 95% CI, 0.17-1.33), Berg Balance Scale scores (SMD, 1.32; 95% CI, 1.00-1.64), and Montreal Cognitive Assessment scores (SMD, 1.02; 95% CI, 0.63-1.41). Gait speed was not significantly improved, and grip strength showed a small, imprecise effect. Heterogeneity was substantial for several outcomes. Tai Chi and Baduanjin were the most frequently represented modalities, whereas reported exercise prescription characteristics varied across studies. Conclusions and Implications TCM exercise therapy may benefit selected frailty, mobility, balance, and cognitive outcomes, but heterogeneity and limited evidence for several outcomes warrant caution. Exercise prescription characteristics are descriptive and hypothesis generating, not evidence for an optimized frequency, intensity, time, type, volume, and progression prescription.

doi.org/10.1016/j.jamda.2026.106521PubMed 42971076Interventions