Frontiers in Public Health · Nov 13, 2026
The effects of different traditional Chinese fitness exercises on physical function in the older adults: a network meta-analysis
By Ma T, Liu W, Ying Y et al.
Objective: To systematically evaluate the effects of four traditional Chinese fitness exercises (TCFE)—Tai Chi, Baduanjin, Yijinjing, and Wuqinxi—on improving physical function in the older adults via a network meta-analysis. Methods: Databases including CNKI, Wanfang Database, PubMed, Web of Science, Cochrane Library, and Embase were systematically searched from inception to 2025. Only randomized controlled trials (RCTs) investigating the effects of the four TCFE on older adults physical function were included. Data analysis was performed using RevMan 5.3 and Stata 17.0 software, with pooled standardized mean differences (SMD) and their 95% confidence intervals (95% CI) calculated to assess intervention effects. For the Timed Up and Go Test (TUG) with closed-loop evidence network, consistency assumption was evaluated. For star-shaped networks (handgrip strength [HGS], Berg Balance Scale [BBS]) without closed loops, inconsistency tests were not applicable; we performed qualitative transitivity assessment instead. Cumulative ranking under the surface (SUCRA) was calculated to obtain probabilistic intervention rankings, which were interpreted only for hypothesis-generation. Results: Twenty RCTs with 1746 older adults were included. Network meta-analysis showed only Tai Chi significantly improved TUG performance versus conventional control (SMD = −0.55, 95% CI: −1.01 to −0.08, p < 0.05). No significant differences in TUG, HGS or BBS were found for Baduanjin, Yijinjing and Wuqinxi (all 95% CIs crossed zero, p > 0.05). SUCRA values yielded probabilistic rank orders for different TCFE modalities across outcomes, yet no intervention demonstrated statistical superiority relative to conventional control. The TUG network showed acceptable global consistency ( p > 0.05). HGS and BBS formed star-shaped networks without closed loops, therefore node-splitting and global inconsistency testing were not performed. Qualitative transitivity assessment indicated moderate risk of transitivity violation for HGS and BBS. GRADE assessment showed low-to-very-low certainty of evidence for HGS and BBS outcomes. Conclusion: For improving older adults physical function (physical capacity, muscle strength, and balance ability), only Tai Chi yielded statistically significant improvements in physical mobility measured by TUG. SUCRA cumulative ranking provided probabilistic rank trends for Baduanjin, Yijinjing, and Wuqinxi across different functional dimensions; these rank-order findings are purely hypothesis-generating and are not supported by statistically significant between-group differences. It is recommended that the older adults engage in TCFE for ≥3 sessions per week, with each session lasting 60 min or more to maximize exercise benefits; however, this exploratory subgroup finding should not be treated as universal clinical prescription. Further high-quality RCTs are required to verify these potential trends and draw definitive conclusions.