PMID- 34452962 OWN - NLM STAT- MEDLINE DCOM- 20210914 LR - 20220531 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 11 IP - 8 DP - 2021 Aug 27 TI - Effect of traditional Asian exercise on patients with chronic heart failure: a protocol for network meta-analysis of randomised controlled trials. PG - e048891 LID - 10.1136/bmjopen-2021-048891 [doi] LID - e048891 AB - INTRODUCTION: Chronic heart failure (CHF) is a common disease worldwide, and imposes a substantial burden to the healthcare system. In CHF, limited exercise capacity and affected mental well-being leads to a reduced quality of life (QOL). How to improve the QOL and exercise endurance is critical for patients with CHF. Exercise therapy, such as some traditional Asian exercises (TAEs) including Taichi, Baduanjin and Yoga, plays an important role in the rehabilitation of patients with CHF. TAE is suitable for the rehabilitation of patients with CHF because of its soft movements and can relax the body and mind. Studies have shown that TAE can regulate the overall health status of the body and exercise tolerance, improve QOL and reduce rehospitalisation rate in patients with CHF. However, the difference in efficacy of TAE in patients with CHF is not yet clear. The main purpose of this study is to conduct a network meta-analysis (NMA) of randomised trials to determine the impact of TAE on patients with CHF of different types, different causes and different New York Heart Association (NYHA) heart function classifications and to provide references for different types of patients with CHF to choose appropriate exercise rehabilitation therapy. METHODS AND ANALYSIS: The literature search will be retrieved from PubMed, the Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Wanfang database, Chinese biomedical literature service system (SinoMed) and Chinese Scientific Journals Database (VIP) from the date of their inception until 1 August 2021. All randomised controlled trials that evaluated the effects of three different TAE therapies (Taichi, Baduanjin and Yoga) on patients with CHF will be included. The primary outcomes are peak oxygen uptake (peak VO(2)), exercise capacity (6-min walking distance) and QOL tested with the Minnesota Living with Heart Failure Questionnaire. Secondary outcomes include the levels of N-terminal pro brain natriuretic peptide, left ventricular ejection fraction, systolic blood pressure and diastolic blood pressure. For included articles, two reviewers will independently extract the data, and Cochrane Collaboration's tool will be used to assess risk of bias. We will perform the Bayesian NMA to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (Taichi, Baduanjin or Yoga) will be estimated by the mean ranks and surface under the cumulative ranking curve. Subgroup analysis for different types, different causes and different NYHA heart function classifications of CHF will be performed. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence contributing to each network estimate. ETHICS AND DISSEMINATION: The results will be disseminated through peer-reviewed publications. They will provide useful information to inform clinicians on the potential functions of TAE in CHF, and to provide consolidated evidence for clinical practice and further research of TAE. PROSPERO REGISTRATION NUMBER: CRD42020179304. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Xu, Jianglin AU - Xu J AUID- ORCID: 0000-0002-2006-7101 AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Zhang, Zhuo AU - Zhang Z AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Liu, Jing AU - Liu J AD - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Li, Yan AU - Li Y AUID- ORCID: 0000-0002-0729-502X AD - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Wan, Jie AU - Wan J AD - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Feng, Ruli AU - Feng R AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Jin, Jialin AU - Jin J AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Huang, Cong AU - Huang C AD - Experimental Research Centre, China Academy of Chinese Medical Sciences, Beijing, China. FAU - Mao, Tianshi AU - Mao T AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Ji, Xiang AU - Ji X AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Zhou, Kun AU - Zhou K AD - Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China linqian62@126.com dfzhk@126.com. FAU - Lin, Qian AU - Lin Q AD - Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China linqian62@126.com dfzhk@126.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210827 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 SB - IM MH - Bayes Theorem MH - *Heart Failure/therapy MH - Humans MH - *Meditation MH - Meta-Analysis as Topic MH - Network Meta-Analysis MH - Quality of Life MH - Randomized Controlled Trials as Topic MH - Stroke Volume MH - Ventricular Function, Left PMC - PMC8404441 OTO - NOTNLM OT - complementary medicine OT - heart failure OT - rehabilitation medicine COIS- Competing interests: None declared. EDAT- 2021/08/29 06:00 MHDA- 2021/09/15 06:00 PMCR- 2021/08/27 CRDT- 2021/08/28 05:32 PHST- 2021/08/28 05:32 [entrez] PHST- 2021/08/29 06:00 [pubmed] PHST- 2021/09/15 06:00 [medline] PHST- 2021/08/27 00:00 [pmc-release] AID - bmjopen-2021-048891 [pii] AID - 10.1136/bmjopen-2021-048891 [doi] PST - epublish SO - BMJ Open. 2021 Aug 27;11(8):e048891. doi: 10.1136/bmjopen-2021-048891.