Effectiveness of Traditional Chinese Fitness Methods on Depressive Symptoms and Glycaemic Control in Patients With Type 2 Diabetes and Comorbid Depression: A Systematic Review and Meta-Analysis of Taijiquan and Baduanjin.
Verbatim Formal Study Abstract
To evaluate the overall effectiveness of traditional Chinese fitness methods (TCFMs)-specifically Taijiquan and Baduanjin-on depressive symptoms and glycaemic control in patients with Type 2 diabetes (T2DM) and comorbid depression.
RCTs evaluating the effectiveness of TCFMs were identified through 10 major English and Chinese databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Wiley Online Library, ProQuest, CBM, CNKI, VIP, and Wanfang Data. Risk of bias was assessed using the revised Cochrane RoB 2 tool, and evidence certainty was graded using GRADE. Meta-analyses were conducted using the DerSimonian-Laird random-effects model. Subgroup analyses were performed by intervention duration, frequency, and sample size.
Eight RCTs of Taijiquan and Baduanjin were included. All studies were conducted in China, and most had small sample sizes. Most had a high risk of bias, mainly due to a lack of blinding of participants and personnel. TCFMs were associated with significant improvements in depressive symptoms (SMD = -1.39, 95% CI [-2.22, -0.57], p = 0.001). Significant improvements were also observed for HbA1c (MD = -0.82, 95% CI [-1.18, -0.45], p < 0.0001) and FPG (MD = -0.70, 95% CI [-0.97, -0.42], p < 0.00001). The effect on 2hPBG remains inconclusive owing to limited studies. Subgroup analyses revealed no significant effect modifiers for depressive symptoms or HbA1c (all interaction p > 0.05). Sensitivity analyses confirmed the robustness of the primary findings, though heterogeneity decreased substantially after excluding high-risk studies.
This review provides preliminary evidence that TCFMs may confer benefits on mental health and glycaemic regulation in patients with T2DM and comorbid depression. However, given the low certainty of the evidence, high heterogeneity, and methodological limitations, these findings should be interpreted cautiously. The conclusions are preliminary and require confirmation in larger, rigorously designed studies.
The protocol of this systematic review was registered on PROSPERO (CRD420261287519).