Effects of traditional Chinese mind-body exercises for patients with chronic fatigue syndrome: A systematic review and meta-analysis

Author: Lingjun Kong#1, Jun Ren#1, Sitong Fang1, Yunlong Li1, Zhiwei Wu2,3, Xin Zhou2,3, Qiukui Hao4, Min Fang1,3, Yu-Qing Zhang5,6,7
Affiliation: <sup>1</sup> Department of Tuina, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. <sup>2</sup> Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. <sup>3</sup> Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China. <sup>4</sup> School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. <sup>5</sup> CEBIM (Center for Evidence Based Integrative Medicine) - Clarity Collaboration, Guang&#x27;anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. <sup>6</sup> Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. <sup>7</sup> Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.
Conference/Journal: J Glob Health
Date published: 2023 Nov 24
Other: Volume ID: 13 , Pages: 04157 , Special Notes: doi: 10.7189/jogh.13.04157. , Word Count: 271


Background:
Chronic fatigue syndrome (CFS) is a global public health concern. We performed this systematic review of randomised controlled trials (RCTs) to evaluate the effects and safety of traditional Chinese mind-body exercises (TCME) for patients with CFS.

Methods:
We comprehensively searched MEDLINE, Embase, Web of Science, PsycINFO, Cochrane Library, CNKI, VIP databases, and Wanfang Data from inception to October 2022 for eligible RCTs of TCME for CFS management. We used Cochran's Q statistic and I2 to assess heterogeneity and conducted subgroup analyses based on different types of TCME, background therapy, and types of fatigue. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.

Results:
We included 13 studies (n = 1187) with a maximal follow-up of 12 weeks. TCME included Qigong and Tai Chi. At the end of the treatment, compared with passive control, TCME probably reduces the severity of fatigue (standardised mean differences (SMD) = 0.85; 95% confidence interval (CI) = 0.64, 1.07, moderate certainty), depression (SMD = 0.53; 95% CI = 0.34, 0.72, moderate certainty), anxiety (SMD = 0.29; 95% CI = 0.11, 0.48, moderate certainty), sleep quality (SMD = 0.34; 95% CI = 0.10, 0.57, low certainty) and mental functioning (SMD = 0.90; 95% CI = 0.50, 1.29, low certainty). Compared with other active control therapies, TCME results in little to no difference in the severity of fatigue (SMD = 0.08; 95% CI = -0.18, 0.34, low certainty). For long-term outcomes, TCME may improve anxiety (SMD = 1.74; 95% CI = 0.44, 3.03, low certainty) compared to passive control. We did not identify TCME-related serious adverse events.

Conclusions:
In patients with CFS, TCME probably reduces post-intervention fatigue, depression, and anxiety and may improve sleep quality and mental function compared with passive control, but has limited long-term effects. These findings will help health professionals and patients with better clinical decision-making.

Registration:
PROSPERO: CRD42022329157.


PMID: 37994837 DOI: 10.7189/jogh.13.04157