# Effects of standing Baduanjin exercise on cardiac function and quality of life in patients with chronic heart failure: a systematic review and meta-analysis

## TL;DR

Standing Baduanjin exercise improves heart function and quality of life in chronic heart failure patients, according to a review of 50 studies.

## Contribution

A systematic review and meta-analysis of 50 RCTs provides high-quality evidence on the efficacy of standing Baduanjin exercise in chronic heart failure.

## Key findings

- SBE significantly improved left ventricular ejection fraction and 6-minute walking distance in CHF patients.
- SBE reduced biomarkers like BNP and NT-proBNP, indicating better heart function.
- Quality of life scores improved significantly across multiple domains with SBE.

## Abstract

Chronic heart failure (CHF) is characterized by progressive cardiac dysfunction and impaired quality of life (QoL), which contribute to poor prognosis and frequent hospital readmissions. Standing Baduanjin exercise (SBE), a standing-form traditional Chinese mind–body exercise that integrates gentle movements, breathing control, and mental focus, has been increasingly applied in cardiac rehabilitation in China. However, although a growing number of randomized controlled trials (RCTs) have investigated SBE, a comprehensive synthesis of high-quality evidence regarding its effects on cardiac function and QoL in patients with CHF remains limited.

To evaluate the effects of SBE on cardiac function and QoL in patients with CHF.

Following PRISMA and Cochrane guidelines, eight databases were searched for RCTs published up to October 2025. Study quality was assessed using the Cochrane Risk of Bias tool and modified Jadad scale. Meta-analysis was performed using Stata version 18.0, with subgroup analyses conducted based on intervention duration. Sensitivity analysis was performed by sequentially excluding individual studies, and publication bias was evaluated using Egger's test.

Fifty RCTs involving 3,964 participants were included. Compared with conventional pharmacotherapy (CPT) alone, SBE significantly improved left ventricular ejection fraction (LVEF: SMD = 0.98, 95% CI: 0.80–1.15, P = 0.000), 6 min walking distance (6-MWD: SMD = 1.20, 95% CI: 0.97–1.43, P = 0.000), and clinical efficacy (RR = 3.82, 95% CI: 2.83–5.17, P = 0.000), while reducing left ventricular end-diastolic diameter (LVEDD: SMD = −1.03, 95% CI: −1.29 to −0.76, P = 0.000), left ventricular end-systolic diameter (LVESD: SMD = −0.74, 95% CI: −0.96 to −0.52, P = 0.000), B-type natriuretic peptide (BNP: SMD = −1.36, 95% CI: −1.77 to −0.96, P = 0.000), and N-terminal pro-B-type natriuretic peptide (NT-pro BNP: SMD = −1.11, 95% CI: −1.41 to −0.82, P = 0.000). Furthermore, SBE significantly decreased total and subdomain scores of the Minnesota Living with Heart Failure Questionnaire (MLHFQ), including the total score (SMD = −1.17, 95% CI: −1.38 to −0.96, P = 0.000), psychological (SMD = −1.89, 95% CI: −2.43 to −1.34, P = 0.000), emotional (SMD = −1.86, 95% CI: −2.08 to −1.63, P = 0.000), and other domains (SMD = −2.04, 95% CI: −2.73 to −1.35, P = 0.000). Subgroup analyses indicated that a 12-week intervention achieved the greatest improvement in cardiac function, while interventions longer than 12 weeks produced the most pronounced enhancement in QoL.

Current evidence suggests that SBE is an effective, safe, and practical adjunctive intervention for CHF, capable of improving both cardiac function and QoL. Further high-quality multicenter RCTs are warranted to confirm these findings and explore long-term outcomes.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251175888, identifier CRD420251175888.