Effectiveness of Traditional Chinese Medicine Exercise Therapy for Frailty in Older Adults and Descriptive Summary of Exercise Prescription Characteristics: A Systematic Review and Meta-Analysis.
Abstract
Objectives
To evaluate outcome-specific effects of Traditional Chinese Medicine (TCM) exercise therapy on frailty-related outcomes in older adults and descriptively summarize exercise prescription characteristics.
Design
Systematic review and meta-analysis.
Setting
AND
Participants
Randomized controlled trials involving adults aged 60 years or older with frailty, prefrailty, or eligible cognitive frailty in community, institutional, or clinical settings.
Methods
Eight databases were searched from inception to March 31, 2026. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Separate random-effects meta-analyses were conducted for key outcomes using standardized mean differences (SMDs) with Hedges' g correction. Heterogeneity was assessed using τ2 and I2 statistics, with prediction intervals calculated where appropriate. Exercise prescription characteristics were summarized descriptively.
Results
Twenty-one studies were included, with 15 contributing to the main meta-analysis. TCM exercise therapy showed favorable effects on Edmonton Frail Scale scores (SMD, 0.55; 95% CI, 0.04-1.06), Fried frailty phenotype scores (SMD, 2.70; 95% CI, 1.15-4.25), Timed Up and Go performance (SMD, 0.75; 95% CI, 0.17-1.33), Berg Balance Scale scores (SMD, 1.32; 95% CI, 1.00-1.64), and Montreal Cognitive Assessment scores (SMD, 1.02; 95% CI, 0.63-1.41). Gait speed was not significantly improved, and grip strength showed a small, imprecise effect. Heterogeneity was substantial for several outcomes. Tai Chi and Baduanjin were the most frequently represented modalities, whereas reported exercise prescription characteristics varied across studies.
Conclusions
AND IMPLICATIONS TCM exercise therapy may benefit selected frailty, mobility, balance, and cognitive outcomes, but heterogeneity and limited evidence for several outcomes warrant caution. Exercise prescription characteristics are descriptive and hypothesis generating, not evidence for an optimized frequency, intensity, time, type, volume, and progression prescription.