Comparison of the effects of different traditional Chinese exercises on improving the motor function of stroke survivors: a network meta-analysis and systematic review

INTRODUCTION: Stroke survivors frequently present with varying degrees of sensory, cognitive, language, and motor impairments. Traditional Chinese exercises have been widely used as adjunctive rehabilitation therapies because they combine low-to-moderate intensity physical training, balance practice, proprioceptive stimulation, motor relearning, respiratory regulation, and cognitive engagement. However, intervention protocols and outcome measures vary substantially across trials, and direct head-to-head comparisons among Tai Chi, Baduanjin, Wuqinxi, Yijinjing, and standard of care remain scarce. This network meta-analysis therefore compared the relative effectiveness of different traditional Chinese exercise modalities for improving post-stroke motor outcomes. METHODS: We systematically searched Embase, Web of Science, Cochrane Library, PubMed, CNKI, VIP, and Wanfang Data from database inception to January 2026 for RCTs evaluating traditional Chinese exercises for post-stroke motor dysfunction. Eligible participants were adults with clinically diagnosed ischemic or hemorrhagic stroke in the acute, subacute, or chronic stage. The primary outcomes were upper- and lower-extremity motor function assessed using the FMA-UE and FMA-LE. Secondary outcomes were balance function assessed using the BBS and activities of daily living assessed using the BI. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). A Bayesian network meta-analysis was performed, and intervention rankings were estimated using the SUCRA. RESULTS: Fifty RCTs involving 3,718 participants were included. Compared with standard of care, Tai Chi and Wuqinxi showed statistically significant improvements in FMA-UE scores, whereas Baduanjin, Tai Chi, and Wuqinxi improved FMA-LE scores. All four exercise modalities were associated with significant improvements in BBS and BI scores. Ranking results suggested that Tai Chi had the highest probability of improving FMA-UE, Wuqinxi ranked highest for FMA-LE, Yijinjing ranked highest for BBS, and Baduanjin ranked highest for BI. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261323853, CRD420261323853.