Baduanjin Exercise Across Clinical Conditions: An Umbrella Review.

BACKGROUND

Baduanjin (BDJ) is a traditional Chinese mind-body exercise increasingly evaluated in rehabilitation and chronic disease care. The growth of systematic reviews has made the literature difficult to interpret because review volume, methodological quality, certainty of evidence, and overlap of primary trials are rarely considered together. This umbrella review aimed to map the clinical condition spectrum of BDJ research and to appraise the credibility and redundancy of the existing review evidence.

METHODS

Eight English and Chinese databases were searched from inception to April 2026 for systematic reviews and meta-analyses in which BDJ was a standalone or separable intervention. Eligible reviews were mapped by clinical condition. Representative core reviews were selected using prespecified hierarchical criteria. Methodological quality, certainty of evidence, and primary-trial overlap were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), grading of recommendations assessment, development and evaluation (GRADE), and corrected covered area (CCA), respectively.

RESULTS

A total of 261 reviews were included. Thirty-one core reviews underwent AMSTAR 2 appraisal, 21 condition-outcome pairs underwent GRADE assessment, and 10 review clusters underwent CCA analysis. Review activity was concentrated in cardiovascular/cardiac rehabilitation, musculoskeletal pain, cognitive/neurological rehabilitation, endocrine/metabolic disorders, psychological/sleep/emotional conditions, oncology/postoperative rehabilitation, and respiratory disease. AMSTAR 2 ratings were moderate in one review, low in 18, and critically low in 12. Nineteen condition-outcome pairs were rated low certainty and 2 very low certainty. Several clusters showed high or very high primary-trial overlap.

CONCLUSIONS

BDJ has been reviewed widely, but the evidence is methodologically uneven, frequently overlapping, and of low or very low certainty. Current findings should be interpreted as uncertain evidence signals rather than practice recommendations.