Jingtao Zhou, Wi-Young So, Minhye Shin
Background and Objectives: Sarcopenia and frailty are associated with falls, disability, and functional decline in older adults. This review evaluated traditional Chinese mind-body exercise (TCMBE), including Tai Chi and Health Qigong, in adults aged 60 years or older with clinically defined sarcopenia or frailty. Materials and Methods: Randomized controlled trials identified through December 2024 from six English- and Chinese-language databases were synthesized. The analyses included physical performance and secondary outcomes and explored sarcopenia and frailty as study-level subgroups. Results: Twenty-two trials involving 1660 participants were included. TCMBE was associated with a shorter Timed Up and Go Test time (mean difference [MD], -1.17 s; 95% CI, -1.80 to -0.54; p < 0.01; I2 = 74%), a higher Short Physical Performance Battery score (MD, 0.99 points; 95% CI, 0.58 to 1.40; p < 0.01; I2 = 24%), and greater grip strength (MD, 2.02 kg; 95% CI, 0.58 to 3.47; p = 0.006; I2 = 89%). The 6 min walk test estimate was borderline and imprecise (MD, 11.76 m; 95% CI, 0.10 to 23.43; p = 0.05; I2 = 0%), and no clear overall effects were observed for gait speed, the 30 s chair stand test, sit-to-stand time, Berg Balance Scale score, muscle mass, depressive symptoms, or quality of life. Several analyses showed substantial heterogeneity, and some subgroup estimates were based on only one or two studies. Conclusions: Low-certainty evidence suggests that TCMBE may produce small improvements in TUGT performance, SPPB scores, and grip strength. Very-low-certainty evidence leaves its effects on gait speed and quality of life uncertain. Risk-of-bias concerns, heterogeneity, imprecision, and uncertain clinical significance limit confidence in the current estimates. The available evidence is insufficient to support routine implementation, and larger, rigorously conducted randomized controlled trials are needed.