Effectiveness of traditional mind-body exercises on fall risk test scores and balance in older adults

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the effects of traditional mind-body exercises on fall risk test scores and balance in older adults. METHODS: The systematic search covered multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu (VIP), with the search period spanning from the inception of each database to December 10, 2025. We included randomized controlled trials evaluating the effects of traditional mind-body exercises on fall risk test scores and balance in older adults. Study quality was assessed using the Cochrane Risk of Bias Tool. Meta-analysis was performed using Stata 15 software and a random-effects model. RESULTS: A total of 31 randomized controlled trials involving 3622 participants were included. Pooled analyses showed lower fall risk test scores (standardized mean difference [SMD] = -0.56, 95% confidence interval [CI]: -0.84 to -0.28) and higher Berg Balance Scale scores (WMD = 2.60, 95% CI: 1.47-3.72) in the intervention groups than in the control groups. Heterogeneity was very high for Berg Balance Scale scores (I2 = 95.6%). Subgroup results for fall risk test scores were Baduanjin (BDJ) [SMD = -0.82, 95% CI (-1.25, -0.38)] and Tai Chi (TC) [SMD = -0.41, 95% CI (-0.70, -0.11)]. For Berg Balance Scale scores, results were BDJ [WMD = 2.91, 95% CI (1.02, 4.8)], TC [WMD = 2.37, 95% CI (0.83, 3.9)], and Wuqinxi (WQX) [weighted mean difference (WMD) = 4.80, 95% CI (1.40, 8.20)]. Examples of protocols used in the included trials included Tai Chi twice weekly for 55 minutes per session over 8 weeks, Baduanjin 3 times weekly for 40 minutes per session over 12 weeks, and Wuqinxi 4 times weekly for 60 minutes per session over 12 weeks. CONCLUSION: Low-certainty evidence suggests that Tai Chi and Baduanjin may reduce fall risk test scores and improve balance in older adults, while Wuqinxi may improve balance. These findings should be interpreted cautiously and do not establish a reduction in actual fall incidence.