Abstract
Methods PubMed, Embase, Cochrane Library, and three Chinese databases, namely, China National Knowledge Network, Wanfang, and China Biomedical Network, were searched from the time of their inceptions through August, 2021. We retrieved the studies on the application of TCE-based cardiac rehabilitation in patients with HF. Based on the standard evaluation methods of Cochrane Reviewer's Handbook 5.1.0, two authors independently assessed the risk of bias and evaluated the methodological quality of the studies included. The RevMan 5.3 software was used for further meta-analysis. Additionally, the GRADEpro GDT web version was used to assess the quality of the evidence in these studies. Results Nine randomized controlled trials involving 721 patients were included in this analysis. The meta-analysis revealed that the TCE (experimental group) effectively improved the patient's motor function and endurance compared to walking or other activities (control group) (mean difference, MD = 68.23, 95% CI [54.55, 81.91]; P < 0.00001). From each subgroup analysis, the exercising ability of the experimental group was higher than that of the control group. The quality of life's score in the experimental group was lower than that of the control group (MD = −9.51, 95%CI [−17.84, −1.18]; P=0.03). The plasma B-type natriuretic peptide content in the experimental group was lower than that in the control group (MD = −59.77, 95%CI [−82.85, −36.7]; P < 0.00001). The number of hospitalizations (MD = −0.83, 95%CI [−0.98, −0.68]; P < 0.00001) and hospital costs in the experimental group (MD = −1.6, 95%CI [−1.89, −1.31]; P < 0.00001) were lower than those in the control group. However, no significant differences were observed in the left ventricular ejection fraction and maximal oxygen consumption between the two groups (MD = 1.38, 95%CI [−3.08, 5.84] and P=0.54; MD = −0.04, 95%CI [−1.62, 1.54] and P=0.96, respectively). From the current analysis, TCE can be considered a relatively safe exercise method. According to the GRADE evaluation results on the evidence level, the studies included were of moderate quality, low quality, or very low quality. Conclusions Our systematic review showed that TCE had potential benefits in improving patients' cardiac function, motor function, and quality of life. Therefore, TCE might be an effective adjuvant therapy in patients with HF. However, given the inclusion of the low-quality elucidations, further rigorous studies are urgently needed to confirm these results.
Highlights
Heart failure (HF) is mainly manifested by breathing difficulties during daily activities, generalized weakness, and liquid retention in the feet, legs, ankles, or stomach; it is a consequence of several cardiovascular diseases [1]
Traditional Chinese exercise (TCE) has the advantages of being simple and easy to learn with unlimited space and time and good compliance compared to the modern exercise rehabilitation regimen
Considering the growing number of randomized control trials on the TCE-based cardiac rehabilitation training used in heart failure (HF) patients, we conducted a systematic review and meta-analysis on the applications of TCE-based cardiac rehabilitation training in patients with HF. e research questions were as follows: (1) does the TCE-based cardiac rehabilitation training have a better clinical effect on the HF when compared to aerobic exercises or daily activities? (2) How are the evidence levels of relevant studies’ results?
Summary
Heart failure (HF) is mainly manifested by breathing difficulties during daily activities, generalized weakness, and liquid retention in the feet, legs, ankles, or stomach; it is a consequence of several cardiovascular diseases [1]. Is training constitutes a comprehensive medical treatment that integrates drug prescription, exercise plan, psychological scheme, diet plan, and risk factor control (including smoking cessation). Such an integrated approach is conducive to disease management and rehabilitation in patients with cardiovascular diseases at different stages. TCE has the advantages of being simple and easy to learn with unlimited space and time and good compliance compared to the modern exercise rehabilitation regimen It can meet the daily exercise needs in patients with HF. E research questions were as follows: (1) does the TCE-based cardiac rehabilitation training have a better clinical effect on the HF when compared to aerobic exercises or daily activities? Considering the growing number of randomized control trials on the TCE-based cardiac rehabilitation training used in HF patients, we conducted a systematic review and meta-analysis on the applications of TCE-based cardiac rehabilitation training in patients with HF. e research questions were as follows: (1) does the TCE-based cardiac rehabilitation training have a better clinical effect on the HF when compared to aerobic exercises or daily activities? (2) How are the evidence levels of relevant studies’ results?
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