Comparative efficacy of traditional Chinese medicine qigong exercise on motor and non-motor outcomes in Parkinson's disease: a network meta-analysis

BACKGROUND: This study employed a network meta-analysis (NMA) to compare the intervention effects of different TCMQE practices on primary outcome measures in PD patients and to rank their efficacy, aiming to provide guidance for clinical practice. METHOD: A systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database to identify randomized controlled trials (RCTs) evaluating traditional Chinese Qigong (QG) exercise interventions for Parkinson's disease patients. The search covered the inception of each database up to April 29, 2026. A Bayesian network meta-analysis was conducted using R software to compare the relative effects of different interventions on primary outcome measures and rank them. Two researchers independently performed literature screening and data extraction. The risk of bias in included studies was assessed using the ROB 2.0 tool. RESULTS: A total of 59 RCTs (3,743 patients) were included. Compared with conventional treatment, Baduanjin (BDJ), QG, and Tai Chi (TC) were associated with improvements in motor symptoms (UPDRS-III). BDJ, TC, and WQX improved balance (BBS), while BDJ, liuzijue (LZJ), QG, TC, and wuqinxi (WQX) showed benefits in gait performance (TUGT). WQX and Yijingjin (YJJ) were associated with improvements in quality of life (PDQ-39), and TC and BDJ with reductions in depressive symptoms (HAMD). CONCLUSION: This network meta-analysis suggests that different traditional QG interventions may be associated with improvements in motor and non-motor symptoms in Parkinson's disease. However, most pairwise comparisons showed overlapping confidence intervals, and no statistically significant differences were observed between most QG interventions. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier: CRD420251243598.