Effects of Baduanjin exercise on cardiac rehabilitation after percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials

Abstract Objectives To systematically evaluate the effects of Baduanjin exercise on cardiac rehabilitation after percutaneous coronary intervention (PCI). Methods From the time the database was constructed to May 28, 2025, Eight databases and two registry systems, including Web of Science, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, China Science and Technology Journal Database (VIP), Chinese Biomedical Literature database (CBM), Clinical Trials, and the China Clinical Trials Registry were searched—clinical randomized controlled trials (RCTs) of Baduanjin in treating patients after PCI were retrieved. The primary outcomes were the 6-min walk test (6MWT) and left ventricular ejection fraction (LVEF). Secondary outcomes were Major adverse cardiovascular event (MACE), Seattle Angina Questionnaire (SAQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Anaerobic threshold (AT), Metabolic equivalent of task (METs), and Maximal oxygen consumption (VO 2 max). The quality of the included studies was assessed using the Cochrane Risk of Bias assessment tool, version 2.0 (RoB 2). Meta-analysis was performed using RevMan 5.4 software. Sensitivity analysis and subgroup analysis were performed using Stata software. In addition, Publication bias was evaluated using funnel plots and Egger's test. Results A total of 56 RCTs involving 5152 patients were included in the study. Compared with the control group, the Baduanjin group showed superior improvement in LVEF (MD = 5.55%, 95% CI [4.28%, 6.82%], P < 0.01, I 2 = 94%), 6MWT (MD = 57.68m, 95% CI [40.20m, 75.17m], P < 0.01, I 2 = 100%), MACE (RR = 0.33, 95% CI [0.26, 0.42], P < 0.01, I 2 = 0%), SAQ-PL (MD = 7.49 points, 95% CI [4.78 points, 10.20 points], P < 0.01, I 2 = 91%), SAQ-AS (MD = 12.88 points, 95% CI [10.76 points, 15.00 points], P < 0.01, I 2 = 77%), SAQ-DS (MD = 11.30 points, 95% CI [5.14 points, 17.45 points], P < 0.01, I 2 = 98%), SAQ-AF (MD = 10.90 points, 95% CI [6.05 points, 15.75 points], P < 0.01, I 2 = 98%), SAQ-TS (MD = 8.04 points, 95% CI [2.30 points, 13.78 points], P < 0.01, I 2 = 98%), SAS (MD = − 7.01 points, 95% CI [− 8.05 points, − 5.96 points], P < 0.01, I 2 = 58%), SDS (MD = − 6.67 points, 95% CI [− 8.34 points, − 5.00 points], P < 0.01, I 2 = 89%), VO 2 peak (MD = 1.81 mL/kg/min, 95% CI [0.82 mL/kg/min, 2.80 mL/kg/min], P < 0.01, I 2 = 96%), AT (MD = 1.18 mL/kg/min, 95% CI [0.66 mL/kg/min, 1.69 mL/kg/min], P < 0.01, I 2 = 96%), and METs (MD = 0.61 METs, 95% CI [0.32 METs, 0.90 METs], P < 0.01, I 2 = 83%) when compared to control groups. Subgroup analysis showed that patients with chronic coronary syndromes (CCS) were more suitable as a target population. Improvement in LVEF was better with intervention duration of 1–3 months, whereas improvement in 6MWT was better with intervention longer than 3 months, and it is not recommended to combine Baduanjin with aerobic exercise. Conclusions Baduanjin can improve cardiopulmonary function, alleviate clinical symptoms, improve quality of life, adjust mental state, and reduce the incidence of MACE in patients after PCI. Systematic review registration CRD42024626379.