Table 2. Outcomes of included meta-analyses.
| Studies (author, year) and outcomes | Estimated effect (95% CI) | Heterogeneity (I2), % | Publication bias, P value | |
|---|---|---|---|---|
| Chen et al [ 24 ], 2014 | ||||
| Motion | 1.00 (0.45 to 1.56) | 56 | N/Aa | |
| Välimäki et al [ 25 ], 2014 | ||||
| Cognition | 4.67 (–1.76 to 11.1) | 8 | N/A | |
| Satisfaction | 5.1 (1.03 to 9.17) | 0 | N/A | |
| Cheok et al [ 26 ], 2015 | ||||
| Balance | 0.39 (–0.25 to 1.04) | 85 | .02 | |
| Chen et al [ 27 ], 2015 | ||||
| BIb | −0.5 (−2.4 to 0.13) | 27 | N/A | |
| Balance | −0.5 (−0.7 to 0.37) | 0 | N/A | |
| Christensen et al [ 28 ], 2016 | ||||
| HbA1cc | –0.10 (–0.33 to 0.14) | 0 | .71 | |
| Howes et al [ 29 ], 2017 | ||||
| Balance | 0.56 (0.25 to 0.87)d | 66 | .10 | |
| Mobility | –0.12 (–0.48 to 0.03) | 6 | .54 | |
| Cognition | –0.65 (–1.03 to –0.28) | 58 | .07 | |
| Fear | 0.28 (–0.50 to 1.05) | 0 | .55 | |
| Bukola and Paula [ 30 ], 2017 | ||||
| Pain | –0.64 (–1.10 to –0.17)d | 61.3 | N/A | |
| Laver et al [ 31 ], 2017 | ||||
| Gait | 0.09 (–0.04 to 0.22)d | 10 | N/A | |
| Balance | 0.39 (–0.09 to 0.86)d | 10 | N/A | |
| Mobility | –4.76 (–8.91 to –0.61)d | 50 | N/A | |
| Motion | 0.01 (–0.60 to 0.61)d | 0 | N/A | |
| Scheffler et al [ 32 ], 2018 | ||||
| Pain | 0.69 (0.40 to 0.98)d | 72 | No | |
| Anxiety | 0.36 (0.20 to 0.52)d | 0 | No | |
| Wang et al [ 33 ], 2019 | ||||
| Pain | –0.25 (–0.48 to –0.02)d | 32 | N/A | |
| Balance | 29.36 (–6.99 to 65.71)d | 88 | N/A | |
| Eijlers et al [ 18 ], 2019 | ||||
| Pain | 1.30 (0.68 to 1.91) | 93 | No | |
| Anxiety | 1.32 (0.21 to 2.44) | 96 | No | |
| Lei et al [ 13 ], 2019 | ||||
| Gait | 0.15 (–0.50 to 0.19) | 32 | High | |
| Balance | 0.22 (0.01 to 0.42)d | 0 | High | |
| Mobility | –1.95 (–2.81 to –1.06)d | 60 | High | |
| Kim et al [ 34 ], 2019 | ||||
| Cognition | 0.42 (0.24 to 0.60) | 5 | .001 | |
| Physical fitness | 0.41 (0.16 to 0.65) | 0 | <.001 | |
| Emotion | 0.14 (0.07 to 0.36) | 36 | .20 | |
| Execution | 0.07 (0.34 to 0.49) | 66 | .34 | |
| Feasibility | 0.12 (0.10 to 0.34) | 54 | .30 | |
| Perrochon et al [ 35 ], 2019 | ||||
| Motion | 0.53 (–0.35 to 1.42) | 0 | .58 | |
| Satisfaction | 0.08 (0.03 to 0.13) | 0 | .001 | |
| Safety | 0.17 (–0.02 to 0.36) | 1 | .15 | |
| Zeng et al [ 36 ], 2019 | ||||
| Anxiety | –3.03 (–6.20 to 0.15) | 95 | .001 | |
| Depression | –1.11 (–3.17 to 0.96) | 0 | .51 | |
| Fatigue | –2.50 (–4.28 to –0.73)d | 16 | .27 | |
| Pain | –1.63 (–4.15 to 0.89) | 94 | .001 | |
| Cognition | 0.40 (4.64 to 5.44) | 36 | N/A | |
| Corregidor-Sanchez et al [ 37 ], 2020 | ||||
| Motion | –0.56 (–0.90 to –0.21) | 55 | High | |
| Custodio et al [ 38 ], 2020 | ||||
| Pain | –0.46 (–0.91 to –0.01)d | 82 | No | |
| Anxiety | –3.37 (–4.57 to –2.81)d | 71 | No | |
| De Miguel-Rubio et al [ 19 ], 2020 | ||||
| Balance | 3.42 (2.54 to 4.29)d | 70 | N/A | |
| De Miguel-Rubio et al [ 39 ], 2020 | ||||
| BI | –0.37 (–1.38 to 0.64) | 68 | N/A | |
| De Miguel-Rubio et al [ 40 ], 2020 | ||||
| ROMe | –0.93 (–1.95 to 0.09) | 0 | N/A | |
| Balance | –0.27 (–0.82 to 0.27) | 56 | N/A | |
| Ding et al [ 41 ], 2020 | ||||
| Pain | –0.64 (–1.05 to –0.22) | 69 | N/A | |
| Dominguez-Tellez et al [ 42 ] , 2020 | ||||
| Motion | 1.53 (0.51 to 2.54)d | 92 | No | |
| QOLf | 2.37 (–0.25 to 4.98) | 0 | No | |
| MBIg | 0.77 (0.05 to 1.49)d | 95 | No | |
| Georgescu et al [ 43 ], 2020 | ||||
| Pain | 0.95 (0.32 to 1.57)d | 86 | No | |
| Cognition | 0.94 (0.33 to 1.56)d | 51 | No | |
| Lauwens et al [ 44 ], 2020 | ||||
| Pain | 0.94 (0.92 to 1.27) | 52 | N/A | |
| Lopez-Valverde et al [ 45 ], 2020 | ||||
| Pain | –0.67 (–1.58 to 0.24) | 0 | .18 | |
| Anxiety | 0.20 (–0.48 to 0.87) | 0 | .54 | |
| Low et al [ 46 ], 2021 | ||||
| Satisfaction | 0.45 (–0.07 to 0.97) | 70 | N/A | |
| Dissatisfaction | 0.72 (0.25 to 1.20) | 44 | N/A | |
| Czech et al [ 47 ], 2021 | ||||
| Pain | −2.85 (−3.57 to −2.14)d | 0 | N/A | |
| Fear | −0.19 (−0.58 to 0.202) | 94 | N/A | |
| Anxiety | N/A | 93 | N/A | |
| Satisfaction | N/A | 83 | N/A | |
| Fandim et al [ 48 ], 2021 | ||||
| Motion | –0.08 (–0.45 to 0.29) | 6 | No | |
| Balance | 1.43 (0.61 to 2.24)d | 53 | No | |
| Chen et al [ 49 ], 2021 | ||||
| BI | 0.23 (0.13 to 0.34)d | 0 | .28 | |
| Jung et al [ 50 ], 2021 | ||||
| Cognition | 0.45 (0.20 to 0.71) | 42 | .58 | |
| Li et al [ 51 ], 2021 | ||||
| Balance | 0.66 (N/A) | 64 | .23 | |
| QOL | –0.28 (N/A) | 0 | <.001 | |
| MBI | 0.62 (N/A) | 0 | <.001 | |
| Depression | –0.75 (N/A) | 80 | .75 | |
| Sajeev et al [ 52 ], 2021 | ||||
| Pain | –0.43 (–0.67 to –0.20)d | 81 | N/A | |
| Anxiety | –0.61 (–0.88 to –0.34)d | 89 | N/A | |
| Yen and Chiu [ 53 ], 2021 | ||||
| Cognition | 0.53 (0.32 to 0.73)d | 2 | .57 | |
| Memory | 0.51 (0.06 to 0.96)d | 58 | .50 | |
| Attention | 0.49 (–0.10 to 1.08) | 88 | .44 | |
| Execution | 0.05 (–0.37 to 0.46) | 81 | .79 | |
| Depression | –1.00 (–1.51 to –0.45) | 55 | .90 | |
| Zhang et al [ 54 ], 2021 | ||||
| Motion | 3.01 (1.91 to 4.11) | 70 | N/A | |
| Balance and gait | 3.51 (2.10 to 4.92) | 80 | N/A | |
| Cognition | 0.81 (−0.41 to 2.03) | 66 | N/A | |
| MBI | 7.02 (4.96 to 9.08) | 18 | N/A | |
| Zhang et al [ 55 ], 2021 | ||||
| Cognition | 0.32 (–0.43 to 1.06) | 89 | .29 | |
| Attention | 0.78 (0.23 to 1.33)d | 6 | .04 | |
| Depression | 0.20 (–0.25 to 0.64) | 16 | .55 | |
| QOL | 3.01 (1.51 to 4.31) | 12 | .17 | |
| Zhong et al [ 56 ], 2021 | ||||
| Cognition | 0.42 (0.04 to 0.79) | 3 | No | |
| Attention | 0.09 (−0.26 to 0.44) | 0 | No | |
| Blasco-Peris et al [ 57 ], 2022 | ||||
| QOL | 0.22 (−0.37 to 0.81) | 3 | N/A | |
| Depression | 0.17 (−0.36 to 0.70) | 0 | N/A | |
| Bu et al [ 58 ], 2022 | ||||
| Anxiety | –6.47 (–7.21 to –5.73)d | 83 | No | |
| Depression | –4.27 (–4.64 to –3.91)d | 0 | No | |
| Pain | –1.32 (–2.56 to –0.09)d | 87 | No | |
| Fatigue | 8.80 (8.24 to 9.36)d | 0 | No | |
| Chan et al [ 59 ], 2022 | ||||
| Balance | 0.12 (–0.66 to 0.89)d | 0 | N/A | |
| Motion | 0.13 (–0.65 to 0.91)d | 0 | N/A | |
| Chen et al [ 60 ], 2022 | ||||
| Anxiety | –0.35 (–0.70 to 0.01) | 0 | N/A | |
| Depression | –0.48 (–0.84 to –0.12)d | 0 | N/A | |
| Chen et al [ 61 ], 2022 | ||||
| Cognition | 3.00 (2.28 to 3.71) | 7 | No | |
| BI | 6.14 (4.56 to 7.72) | 0 | No | |
| MBI | 6.06 (1.27 to 10.85) | 86 | No | |
| Chen et al [ 62 ], 2023 | ||||
| Anxiety | −0.91 (−1.43 to −0.39)d | 86 | Low | |
| Czech et al [ 2 ], 2022 | ||||
| Pain | –0.47 (–0.78 to –0.15)d | 41 | N/A | |
| ROM | 0.44 (−0.23 to 1.11) | 50 | N/A | |
| Huber et al [ 63 ], 2022 | ||||
| Cognition | 0.43 (0.22 to 0.64)d | 24 | N/A | |
| Kim et al [ 64 ], 2022 | ||||
| Depression | −0.54 (−0.79 to –0.29) | 73 | No | |
| Mo et al [ 65 ], 2022 | ||||
| Pain | –0.59 (–1.15 to –0.04) | 78 | No | |
| Fatigue | –0.53 (–0.88 to –0.18) | 15 | No | |
| Depression | –0.60 (–1.04 to –0.15) | 29 | No | |
| Satisfaction | –0.68 (–1.25 to –0.11) | 55 | No | |
| Obrero-Gaitán et al [ 66 ], 2022 | ||||
| Pain | –1.03 (–1.52 to –0.54)d | 7 | .09 | |
| Anxiety | –1.79 (–2.7 to –0.91)d | 32 | .55 | |
| Depression | –2.7 (–4.39 to –0.99)d | 46 | .92 | |
| QOL | 0.76 (0.42 to 1.11)d | 0 | .90 | |
| Saliba et al [ 67 ], 2022 | ||||
| Pain | 2.54 (0.14 to 4.93)d | 99 | N/A | |
| Anxiety | 0.89 (0.16 to 1.63)d | 95 | N/A | |
| Simonetti et al [ 68 ], 2022 | ||||
| Anxiety | –0.34 (–0.62 to –0.11)d | 39 | No | |
| Suleiman-Martos et al [ 69 ], 2022 | ||||
| Anxiety | –10.62 (–13.85 to –7.39)d | 84 | No | |
| Tas et al [ 20 ], 2022 | ||||
| Pain | –0.67 (–0.89 to 0.45)d | 68 | .30 | |
| Anxiety | –0.74 (–1.00 to 0.48)d | 59 | .56 | |
| Thi et al [ 70 ], 2022 | ||||
| Pain | –0.93 (–2.63 to 0.76) | 86 | N/A | |
| Wang et al [ 16 ], 2023 | ||||
| Fear | −0.53 (−0.90 to −0.17)d | 64 | N/A | |
| Wang et al [ 71 ], 2022 | ||||
| Fear | −1.52 (−2.18 to –0.86) | 51 | N/A | |
| Anxiety | −2.79 (−4.07 to –1.54) | 0 | N/A | |
| Pain | −2.17 (−3.37 to –0.97) | 92 | N/A | |
| He et al [ 72 ], 2022 | ||||
| Pain | –1.13 (–2.01 to –0.26)d | 97 | No | |
| Zhang et al [ 73 ], 2022 | ||||
| Anxiety | –2.07 (–3.81 to –0.34) | 95 | N/A | |
| Fatigue | –0.92 (–4.47 to 2.62) | 99 | N/A | |
| Zhang et al [ 74 ], 2022 | ||||
| BI | 0.31 (0.10 to 0.51) | 31 | No | |
| Grip | 0.40 (0.08 to 0.71) | 0 | No | |
| Motion | 0.71 (0.43 to 0.99) | 0 | No | |
| Wong et al [ 75 ], 2023 | ||||
| Anxiety | –1.17 (–2.06 to –0.28)d | 42 | N/A | |
| Liu et al [ 76 ], 2023 | ||||
| Depression | –0.75 (–1.35 to –0.15) | 92.2 | N/A | |
| Hao et al [ 77 ], 2023 | ||||
| Pain | –1.53 (–2.55 to –0.50) | 34 | N/A | |
| Fatigue | 0.86 (0.44 to 1.28) | 97 | N/A | |
| Anxiety | –3.02 (–5.27 to –0.77) | 34 | N/A | |
| Motion | –0.66 (–1.02 to –0.31) | 47 | N/A | |
| QOL | 0.53 (0.14 to 0.93) | 34 | N/A | |
| Kodvavi et al [ 78 ], 2023 | ||||
| Anxiety | –0.73 (–1.08 to –0.39)d | 22 | Low | |
| Pain | –0.25 (–0.44 to –0.05)d | 67 | Low | |
| Parra et al [ 79 ], 2023 | ||||
| Loss | 0.13 (0.02 to 0.24) | N/A | Low | |
| Chen et al [ 80 ], 2023 | ||||
| Balance | 0.62 (0.29 to 0.95) | 68 | Low | |
| Cognition | 0.90 (0.61 to 1.19) | 16 | Low | |
| Kavradim et al [ 81 ], 2023 | ||||
| Anxiety | –0.85 (–1.55 to –0.14) | 91.92 | High | |
| Motion | 0.54 (0.01 to 1.08)d | 1.702 | High | |
| Stress | –0.36 (–0.60 to –0.11) | 0 | High | |
| Depression | –0.39 (–0.68 to –0.11) | 73.979 | High | |
| Shen et al [ 82 ], 2023 | ||||
| Balance | 1.35 (0.58 to 1.86) | 44 | N/A | |
| MBI | 5.26 (1.70 to 8.82) | 72 | N/A | |
| Bok et al [ 83 ], 2023 | ||||
| Balance | –0.113 (–0.547 to 0.32) | 73.3 | N/A | |
| Tian et al [ 84 ], 2023 | ||||
| Anxiety | –4.93 (–8.00 to –1.87) | NA | High | |
| Depression | –2.89 (–5.46 to –0.32) | 7.05 | High | |
| Pain | –1.2 (–2.05 to –0.50) | 66 | High | |
| Cognition | 2.69 (1.95 to 3.44) | 10 | High | |
| Motion | –0.79 (–5.00 to 3.42) | 25 | High | |
| Grip | 0.38 (–0.19 to 0.96) | 9 | High | |
| Yan et al [ 85 ], 2023 | ||||
| Anxiety | –1.74 (–2.46 to –1.02) | 95 | .75 | |
| Pain | –1.5 (–2.22 to –0.91) | 91 | .81 | |
| Heart rate | –10.54 (–20.26 to –0.81) | 99 | .60 | |
| Gao et al [ 86 ], 2023 | ||||
| Anxiety | –0.77 (–1.24 to –0.31) | 85 | N/A | |
| Wu et al [ 87 ], 2023 | ||||
| Anxiety | –0.83 (–1.25 to –0.42) | 82 | N/A | |
| Pain | –0.86 (–1.36 to –0.35) | 85 | N/A | |
| Depression | –0.46 (–0.74 to –0.18) | 76 | N/A | |
| Fear | –0.82 (–1.60 to –0.03) | 69 | N/A | |
| Distress | –1.16 (–1.96 to –0.37) | 72 | N/A | |
| QOL | 1.01 (–0.67 to 2.70) | 94 | N/A | |
| Ren et al [ 88 ], 2023 | ||||
| Motion | 1.30 (0.08 to 2.51) | 88 | .19 | |
| Lee et al [ 89 ], 2023 | ||||
| Balance | 0.62 (0.14 to 1.10) | 80.92 | High | |
| Burrai et al [ 90 ], 2023 | ||||
| Anxiety | –6.57 (–11.59 to –1.54) | 92 | N/A | |
| Fatigue | –0.18 (–0.46 to 0.09) | 0 | N/A | |
| Pain | –1.95 (–6.96 to 3.06) | 99 | N/A | |
| Percy et al [ 91 ], 2023 | ||||
| Motion | −0.91 (−1.38 to −0.44) | 95 | N/A | |
| Balance | −0.54 (−1.80 to 0.71) | 74 | N/A | |
a
N/A: not applicable.
b
BI: Barthel Index.
c
HbA1c: hemoglobin A1c.
d
Significant at the P<.05 level.
e
ROM: range of motion.
f
QOL: quality of life.
g
MBI: modified Barthel Index.