Effects of digitalized traditional Chinese exercises on the physical and mental health and quality of life of older adults: a systematic review and meta-analysis of randomized controlled trials.

Abstract

This study aims to systematically evaluate the effects of digitalized traditional Chinese exercises (TCEs) on physical function, cognitive function, mental health, and quality of life in older adults. Searches were conducted in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and Wan Fang databases from their inception until 28 September 2025 to identify relevant randomized controlled trials. Outcome measures included physical function, cognition, depression, and quality of life. The Cochrane Risk of Bias Assessment Tool and GRADE criteria were used to assess the quality of the studies. Statistical analyses were performed using RevMan 5.3 and Stata 17.0. Sixteen trials involving 1,604 participants were included in this study. Low to moderate-certainty evidence showed that digitalized TCEs significantly improved functional mobility (WMD = -0.81; 95% CI, -1.28 to -0.33; p = 0.0009; I 2 = 76%), balance function (SMD = 0.88; 95% CI, 0.68 to 1.08; p < 0.00001; I 2 = 0%), and global cognition (WMD = 1.98; 95% CI, 1.44 to 2.52; p < 0.00001; I 2 = 84%). In addition, moderate-certainty evidence indicated small but statistically significant improvements in quality of life (SMD = 0.17; 95% CI, 0.03 to 0.30; p = 0.01; I 2 = 3%). However, digitalized TCEs did not significantly improve grip strength (WMD = -0.26; 95% CI, -1.15 to 0.62; p = 0.56; I 2 = 0%; low certainty evidence) or depression (SMD = -0.71; 95% CI, -1.48 to 0.05; p = 0.07; I 2 = 95%; very low certainty evidence). This study demonstrates that digitalized TCEs can significantly improve multiple health indicators in older adults, aligning with the WHO's concept of healthy aging and offering a promising intervention to promote it. It is important to note that long-term participation is crucial for sustaining these health benefits; therefore, enhancing exercise adherence among older adults is essential. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251053317, identifier CRD420251053317.