The effects of traditional Chinese mind-body training on physical health in university students: a multilevel meta-analysis.

Objective: To evaluate the effects of traditional Chinese mind-body practices on university students' physical health and examine whether training characteristics such as duration and frequency influence these outcomes. Methods: This systematic review and meta-analysis followed PRISMA guidelines. Randomized controlled trials (RCTs) were identified from PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) based on PICOS criteria. Effect sizes were reported as mean difference (MD) or standardized mean difference (SMD). Data were synthesized using multilevel random-effects models. Heterogeneity was assessed using the I² statistic and Cochran's Q test. Subgroup analyses and two-level random-effects meta-regression were conducted to explore potential moderators, including intervention type, frequency, session duration, intervention cycle, and total training dose. Sensitivity analyses and publication bias assessments were performed, and the certainty of evidence was evaluated using the GRADE framework. Results: Eighteen RCTs were included. Traditional Chinese mind-body practices were associated with improvements in several physical health indicators, including vital capacity (SMD = 0.34, 95% CI: 0.11 to 0.56, P = 0.003, GRADE: Moderate), BMI (MD = -0.77, 95% CI: -1.48 to -0.06, P = 0.034, GRADE: Moderate), resting heart rate (MD = -1.16, 95% CI: -2.29 to -0.04, P = 0.043, GRADE: Moderate), sit-and-reach test (MD = 2.99, 95% CI: 1.59 to 4.38, P = 0.000, GRADE: Moderate), and pull-up/sit-up performance (SMD = 0.40, 95% CI: 0.12 to 0.67, P = 0.005, GRADE: Low). The three-level model suggested improvement in the standing long jump, but this was not robust in the two-level sensitivity analysis. No significant changes were observed in handgrip strength, step test index, 50-m Sprint, or single-leg stance test (SLST). Subgroup analyses indicated that Baduanjin combined with Yijinjing, session durations of 45-60 minutes, training three to seven times per week, and intervention periods of 12-16 weeks were associated with larger improvements, although these findings were exploratory. Conclusion: Traditional Chinese mind-body training may improve several physical health indicators among university students, though effects varied across outcomes and interventions. Further large, well-designed RCTs are needed to confirm the consistency and long-term significance of these findings. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251266434, identifier CRD420251266434.