A meta-analysis of the effects of Baduanjin training on the human body temperature based on infrared thermography technology

Abstract

Background:

Baduanjin, a traditional Chinese mind-body exercise, is widely practiced to improve overall health in both elderly individuals and a growing number of young enthusiasts. Appropriate thermoregulation has been proposed as a potential physiological mechanism underlying the multiple health benefits of Baduanjin. Infrared thermography is a noninvasive functional imaging technique that provides a visual and noninvasive means of reflecting local metabolic activity and blood perfusion. However, comprehensive evidence regarding the effect of Baduanjin training on human body temperature, an objective and visual metric, remains limited. Therefore, this meta-analysis systematically evaluated the effects of Baduanjin exercise on human temperature, as quantified by infrared thermal imaging.

Methods:

A comprehensive search was performed in 5 databases, including PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and VIP Information Chinese Journal Service Platform, using PICO-based search terms until October 2025. Primary outcomes were mean skin temperature at trunk acupoints, mean skin temperature over visceral projection areas, and mean skin temperature of the trunk and limbs. Study quality was assessed using the modified Jadad scale, and meta-analysis was conducted with RevMan 5.4.

Results:

A total of 8 randomized controlled trials were included, published between 2017 and 2024. These articles involved a total of 377 participants from mainland China, including 194 in the Baduanjin group and 183 in the control group, with mean ages ranging from 19.8 to 32.2 years across studies. Compared with the control groups (routine lifestyle or traditional calisthenics exercise), Baduanjin training significantly increased the average skin temperature at trunk acupoints (mean difference [MD] = 0.74°C, 95% confidence interval [CI] [0.32, 1.16], P < .01, I² = 74%), improved the mean skin temperature over the visceral projection areas (MD = 1.01°C, 95% CI [0.62, 1.41], P < .001, I² = 0%), and improved skin temperature of the trunk and limbs (MD = 0.44°C, 95% CI [0.29, 0.59], P < .0001, I² = 68%).

Conclusion:

This meta-analysis found that Baduanjin training may have a beneficial effect on improving body temperature measured by infrared thermography. However, these findings should be interpreted with caution due to the limited number of included studies and nearly exclusive research in mainland China. Further large-scale, high-quality randomized controlled trials are essential to verify these preliminary observations.

1. Introduction

The concept of contemporary health management is undergoing a profound transformation from disease treatment to preventive health care,^[1] and the scientific value evaluation of traditional health-preserving exercises has become a key research direction. Baduanjin, as a traditional Chinese mind-body exercise, consists of 8 sets of movements with different forms and slow rhythms, each functionally corresponding to specific visceral organs, with core movement features of fluid, continuous motion and alternating between muscular relaxation and contraction.^[2] Integrated, coordinated bodily movement with breath modulation facilitates systemic blood circulation and visceral functional regulation; accordingly, Baduanjin is widely adopted for chronic disease prevention and physical fitness promotion.^[3] For example, a meta-analysis involving 2121 participants showed that practicing Baduanjin for approximately 30 minutes every day over 16.7 ± 9.2 weeks effectively reduced blood pressure (9.3 and 6.3 mm Hg of systolic blood pressure and diastolic blood pressure reductions, respectively).^[4] Its movement arrangement contains the holistic concept of “pulling one hair and moving the whole body,” which is highly consistent with the traditional Chinese medicine theory of zang-fu organs and meridians.^[5] As a low-intensity physical and mental exercise, it combines safety and adaptability. It is not only widely practiced by the elderly but also attracts an increasing number of young adults who pursue physical and mental balance.^[6,7] Thermoregulation is a key physiological process involved in exercise adaptation. Appropriate thermoregulation has been considered a potential physiological mechanism underlying the multiple health benefits of Baduanjin.^[8] Maintaining body temperature within an appropriate range ensures normal enzyme activity, cellular function, metabolic reactions, and immune defense.^[9,10] However, whether Baduanjin induces consistent temperature changes across different body regions has not yet been systematically and quantitatively evaluated.

When evaluating the effectiveness of Baduanjin exercise, objective and visual monitoring techniques are of vital importance. Infrared thermography is a noninvasive functional imaging technique that detects far-infrared radiation in the 8 to 14 μm wavelength range emanating from the human body. It generates real-time, high-resolution (up to 0.03°C) temperature distribution maps of the body surface. This technique reflects the metabolic rate of local tissues and blood perfusion conditions, thereby providing intuitive and objective evidence for assessing circulatory disorders and physiological dysregulation.^[11]

Existing Baduanjin research predominantly investigates its adjunct therapeutic effects on symptomatic and physiological improvements among cohorts with cardiovascular, respiratory, or endocrine-metabolic disorders.^[12–15] However, there are several limitations, including an overreliance on subjective outcome measures (e.g., self-reported symptom questionnaires, quality of life scales, and psychological well-being assessments), limited sample sizes within single-center designs, and inconclusive results. A study in 272 main Chinese cities indicated that nonoptimal environmental temperatures are linked to increased mortality.^[16] Body temperature, reflecting metabolic activity, may underlie the health benefits of Baduanjin training. However, systematic and comprehensive evidence regarding the effect of Baduanjin training on human body temperature, an objective and visual metric, remains limited.

This study aimed to adopt the methods of systematic review and meta-analysis to integrate the evidence from currently published randomized controlled trials (RCTs). Leveraging the objective, quantitative data afforded by infrared thermography, it aimed to assess the effects of Baduanjin on human thermal distribution and associated physiological regulation. This approach offers a robust evidence base to support its broader scientific application and popularization in clinical and community fields and to inform future research into its underlying mechanisms, thus building a bridge between traditional health maintenance practices and modern scientific verification.

2. Methods

2.1. Literature search strategy

The search was conducted to identify relevant studies in databases, including PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and VIP Information Chinese Journal Service Platform, to collect RCTs published from the establishment of each database to October 8, 2025, that focused on Baduanjin training combined with infrared thermography technology for monitoring human body temperature.

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search terms were formulated as follows: Chinese search terms: “八段锦” (“Baduanjin”), “红外热成像” (“infrared thermography”), “体温” (“body temperature”), “随机对照试验” (“randomized controlled trial”); English search terms: (“Baduanjin” OR “Eight-Section Brocade”) AND (“Infrared Thermography” OR “Thermal Imaging”) AND (“Human” OR “Patient”) AND (“body temperature”) AND (“randomized controlled trial”). The search was performed using a combination of MeSH terms (Medical Subject Headings) and free-text words. Meanwhile, the references of the included studies were manually searched to avoid missing any relevant studies. Supplementary searches were also conducted in Google Scholar and conference proceedings, resulting in a total of 486 initial articles. Detailed search strategies for each database were presented in Table S1, Supplemental Digital Content 1. This review was not prospectively registered.

2.2. Inclusion/exclusion criteria and data extraction

Exclusion criteria included studies with non-RCT designs; studies combining other exercise interventions (e.g., brisk walking, yoga); articles with incomplete infrared thermography data or unextractable data; and studies with duplicate publications or extremely low quality scores (modified Jadad score < 2).

Inclusion criteria included RCTs with or without blinding; adults older than 18; the intervention group received standardized Baduanjin training; regular lifestyle (no regular exercise) or other interventions in the control group were described; data collection using infrared thermal imaging technology (accuracy ± 0.1°C); and reporting of specific values or changes in body temperature.

Following the established criteria, 2 researchers (WX and SY) conducted an independent screening of the literature. First, the titles and abstracts were read to exclude ineligible studies, and then the full texts were reviewed to confirm the final included studies. Discrepancies were resolved by discussion or, when necessary, through consultation with the third investigator (YD).

The data collection entailed: basic study parameters (principal investigator, year of publication, and sample size); baseline characteristics of the participants (age and health status); intervention protocols (training frequency, duration, and cycle of Baduanjin, and intervention method of the control group); and detection indicators, including specific indicators and raw data (mean, standard deviation [SD]) of infrared thermography detection. In addition, the following traits were extracted for bias risk assessment: random sequence generation, allocation hiding, implementation blinding, and loss to follow-up/exit.

2.3. Quality assessment and GRADE assessment

The risk of bias of the included studies was assessed independently by 2 researchers using the modified Jadad scale.^[17] The assessment criteria comprised the following components: random sequence generation (0–2 points), allocation concealment (0–2 points), blinding (0–2 points), and loss to follow-up (0–1 point), resulting in a maximum possible score of 7. A score of 4 or above was classified as high quality, and a score below 3 was categorized as low quality. The main flaws included the absence of blinding implementation (100%). Additionally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the certainty of evidence for each key outcome.^[18]

2.4. Outcome definitions

The primary outcomes were the mean skin temperature of trunk acupoints, visceral projection areas, and trunk and limbs. Trunk acupoint temperature refers to the mean surface temperature measured at specific acupoints on the thorax and abdomen (e.g., Dazhui, Zhiyang, and Mingmen). Visceral projection temperature refers to the mean surface temperature measured at trunk regions corresponding to the anatomical projections of major organs (e.g., liver, stomach, and kidneys) based on traditional Chinese medicine meridian theory. Trunk and limb temperature refers to the mean skin temperature measured over the thorax, abdomen, hands, and feet, as some studies only reported combined temperature values for these regions.

2.5. Statistical analysis

Temperature was analyzed as a continuous outcome variable, and treatment effects were expressed as the mean difference (MD) with 95% confidence intervals (CIs). For multiarm studies with 2 control groups, the pooled mean and SD were calculated by combining the 2 control arms into a single composite control group, following the formula provided in the Cochrane Handbook to ensure valid and unbiased pooling.^[19] Specifically, for 2 control groups indexed as 1 and 2, with sample sizes N₁ and N₂, means M₁ and M₂, and SDs SD₁ and SD₂, the pooled sample size N, pooled mean M, and pooled SD were computed as follows:

$${\displaystyle \mathrm{N}={\mathrm{N}}_1+{\mathrm{N}}_2}$$

$$\begin{array}{c}{\displaystyle }M=\frac{{\mathrm{N}}_1\times M_1+{\mathrm{N}}_2\times M_2}{{\mathrm{N}}_1+{\mathrm{N}}_2}\end{array}$$

$$\begin{array}{c}{\displaystyle }\mathrm{S}\mathrm{D}=\sqrt{\frac{({\mathrm{N}}_1-1)\times \underset{1}{\overset{2}{\mathrm{S}\mathrm{D}}}+({\mathrm{N}}_2-1)\times \underset{2}{\overset{2}{\mathrm{S}\mathrm{D}}}+\frac{{\mathrm{N}}_1\times {\mathrm{N}}_2}{{\mathrm{N}}_1+{\mathrm{N}}_2}\times {(M_1-M_2)}^2}{{\mathrm{N}}_1+{\mathrm{N}}_2-1}}\end{array}$$

To statistically assess the degree of inconsistency in results across the included studies, heterogeneity was evaluated using the I² statistic. A fixed-effects model was applied for pooling data when I² < 50% (indicating low heterogeneity), whereas a random-effects model was adopted when I² ≥ 50% (indicating substantial heterogeneity). Furthermore, a sensitivity analysis was conducted by sequentially excluding studies of lower quality to verify the robustness of the pooled results. All statistical syntheses and analyses were conducted using the Review Manager (RevMan) software, version 5.4, developed by the Cochrane Collaboration.

2.6. Ethics statement

This study is a systematic review and meta-analysis of published literature, and no human subjects or original data collection were involved. Therefore, ethical approval and informed consent were not required.

3. Results

3.1. Study characteristics

As delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram (Fig. 1), a total of 486 records were identified across electronic databases. Following the identification and removal of 134 duplicate entries using EndNote software (Clarivate), 352 unique records remained for preliminary screening based on titles and abstracts. Of these, 310 articles were excluded due to irrelevant interventions, outcomes, or study designs. The remaining 42 articles subsequently underwent full-text review and detailed evaluation. Thirty-four articles were further excluded for the following reasons: non-randomized study design (n = 14), lack of outcome data obtained via infrared thermography (n = 10), and low methodological quality with modified Jadad scores < 2 (n = 10). Ultimately, a total of 8 eligible RCTs^[8,20–26] were included in the analysis, involving 377 participants (194 in the Baduanjin group and 183 in the control group).

Figure 1.

The literature screening process. CNKI = China National Knowledge Infrastructure, RCT = randomized controlled trial, VIP = VIP Information Chinese Journal Service Platform.

The 8 included studies, published between 2017 and 2024, enrolled sample sizes ranging from 29 to 120 participants and were conducted in mainland China. The mean age of participants across studies ranged from 19.8 to 32.2 years. Baduanjin was practiced 3 to 7 times per week, with each session lasting 15 to 60 minutes, over a total intervention period of 10 to 12 weeks. In 6 studies, the control groups maintained their usual lifestyle, including habitual diet and physical activity. Two studies^[20,21] explicitly reported maintaining habitual physical activity, whereas the remaining studies did not provide detailed descriptions. The key characteristics of the included studies are summarized in Table 1.

Table 1.

Basic characteristics of the included studies.

Included studies	Sample size (intervention/control group)	Age (M ± SD, intervention group)	Age (M ± SD, control group)	Baduanjin intervention group		Control group	Intervention duration (wk)	Outcome
				Frequency (d/wk)	Duration (min/d)
Sa et al[20]	15/14	19.80 ± 0.40	20.79 ± 0.41	5	60	Daily life (no regular exercise)	12	(c)
Sa et al[21]	22/21	20.32 ± 0.33	20.29 ± 0.35	5	60	Daily life (no regular exercise)	12	(a) (c)
Tian et al[22]	15/17	31.27 ± 9.22	30.12 ± 9.23	Only 1 time	15	Rest, 15 min	NA	(b)
Xiao et al[23]	30/29	19.75 ± 1.76	19.63 ± 2.04	4	60	Daily life (no regular exercise)	12	(c)
Xie et al[24]*	40/40/40†	28.44 ± 1.32	Positive control: 30.29 ± 1.84	3	30	Positive control: radio gymnastics, 3 times/wk, 30 min/time	12	(a) (c)
			Blank control: 24.31 ± 0.28			Blank control: daily life (no regular exercise)
Tian et al[8]*	40/40/40†	28.44 ± 1.32	Positive control: 30.29 ± 1.84	7	15	Positive control: radio gymnastics, 7 times/wk, 15 min/time	12	(b)
			Blank control: 24.31 ± 0.28			Blank control: daily life (no regular exercise)
Han et al[25]	20/10	32.20 ± 7.30	31.60 ± 8.10	4	30	Daily life (no regular exercise)	12	(a) (b)
Tian et al[26]	20/20	32.15 ± 8.90	28.65 ± 9.02	4	30	Daily life (no regular exercise)	12	(a)

(a) mean temperature of acupuncture points in the trunk area; (b) mean skin temperature over the visceral projection areas; (c) mean skin temperature of the trunk and limbs.

d/wk = day/week, M = mean, min/d = min/day, NA = not applicable, SD = standard deviation.

^*Three-arm study, including the Baduanjin intervention group, positive control group (radio gymnastics), and blank control group (daily life).

^†Values are presented as sample sizes for the intervention group, positive control group, and blank control group, respectively.

3.2. Bias risk assessment and GRADE assessment

We performed a comprehensive risk-of-bias assessment for the 8 included studies, and the results are presented in the risk-of-bias graph (Fig. 2). The majority of the studies demonstrated satisfactory methodology concerning sequence generation. Specifically, 7 out of the 8 studies (87.5%) reported their random sequence generation methods (e.g., random number table method and computerized randomization method). For allocation concealment, 7 studies (87.5%) stated that a random number table was used for allocation. However, the specific procedures to ensure concealment (e.g., sealed opaque envelopes or a centralized web-based system) were not detailed in these reports; the remaining 1 study failed to document allocation concealment at all. Blinding of participants and intervention deliverers was impractical in all trials, given that Baduanjin is a structured physical exercise intervention. All studies had minimal (<10%) or no loss to follow-up. Thus, the assessment yielded a score of 4 points for 7 studies and 2 points for 1 study, indicating that 87.5% of the included studies were high-quality.

Figure 2.

Risk-of-bias assessment of all selected articles using the modified Jadad scale for RCTs. (A) Risk of bias of the included RCTs; (B) a summary of risk of bias for the included RCTs. RCT = randomized controlled trial.

GRADE results were presented in Table S2, Supplemental Digital Content 2. The GRADE certainty of evidence was rated as very low for 2 outcomes (mean skin temperature at trunk acupoints and mean skin temperature of the trunk and limbs). The evidence for mean skin temperature over visceral projection areas was rated as low. Evidence downgrading was mainly attributed to a high risk of bias, substantial heterogeneity, and imprecision.

3.3. Mean skin temperature at trunk acupoints

A total of 4 studies provided quantifiable data on changes in this outcome.^[21,24–26] The study by Tian et al measured thermal data immediately following a single 15-minute session of Baduanjin training, in addition to its primary endpoint measurements.^[26] However, these immediate postexercise data were excluded from the pooled analysis to avoid duplicate inclusion of participants from the same study population. In addition, Xie et al adopted a dual-control design consisting of a blank passive control group (daily life, no regular exercise) and an active control group (radio calisthenics).^[24] For the primary meta-analysis, data from the 2 control arms in this study were combined into a single control group to maximize data utilization and provide an initial comprehensive estimate of the intervention’s effect.

Given the differences in intervention types, total intervention duration, single-session treatment time, and participant characteristics across these studies (detailed in Table 1), a heterogeneity test showed I² = 81% and P < .01, exceeding the prespecified threshold. Consequently, a random-effects model was used for pooling, which provided a more conservative estimate of the overall effect size and its CI. The pooled results showed that the Baduanjin training group had a significantly higher mean skin temperature at trunk acupoints than that of the control group (MD = 0.74°C, 95% CI [0.32, 1.16], P < .01), as shown in Figure 3A.

Figure 3.

Forest plot of meta-analysis on the effect of Baduanjin training on the mean skin temperature at trunk acupoints. (A) Overall analysis; (B) sensitivity analysis. * Two control groups in this study (a blank control group: daily life, no regular exercise and an active control group: radio calisthenics) were combined into a single control group. # Only a blank control group (daily life, no regular exercise) was retained. CI = confidence interval, SD = standard deviation.

Sensitivity analysis was conducted to explore the impact of methodological heterogeneity. In the sensitivity analysis, only blank passive control data (daily life, no regular exercise) from Xie et al^[24] were retained to guarantee comparison against untreated controls. Heterogeneity remained substantial after data refinement (I² = 78%); hence, the random-effects model was again selected for data pooling. The results of this sensitivity analysis corroborated the primary finding, indicating that the mean skin temperature at trunk acupoints remained significantly elevated in the Baduanjin group compared to the control group (MD = 0.71°C, 95% CI [0.29, 1.12], P < .001), as detailed in Figure 3B.

3.4. Mean skin temperature over the visceral projection areas

A total of 3 studies^[8,22,25] reported the mean skin temperature in this outcome. Specifically, the study by Tian et al^[22] was excluded from the pooled analysis because it reported only extreme changes in skin temperature over the visceral projection areas rather than providing the requisite baseline or post-intervention mean temperature values, which are essential for calculating a consistent MD effect size across studies. In addition, the study by Tian et al^[8] included a radio calisthenics group as an active comparator and a blank control group with no regular exercise. For the purpose of this analysis, we pooled data from these 2 arms to expand the available comparative samples on skin temperature over the visceral projection areas following a structured exercise intervention.

Heterogeneity assessment showed no significant inconsistency across included studies (I² = 0%), indicating that the observed variance was compatible with chance alone. Consequently, a fixed-effects model was applied for the meta-analysis. The pooled results indicated that the temperature difference of the visceral projection areas in the Baduanjin intervention group was higher than that in the control group (MD = 1.01°C, 95% CI [0.62, 1.41], P < .001), as shown in Figure 4.

Figure 4.

Forest plot of meta-analysis on the effect of Baduanjin training on the mean skin temperature over the visceral projection areas. CI = confidence interval, SD = standard deviation.

3.5. Mean skin temperature of the trunk and limbs

A total of 4 RCTs^{[20,21,23,24]} reported the mean skin temperature of the trunk and limbs. For the primary meta-analysis, the radio calisthenics control group in the Xie et al study^[24] was included. We pooled data from these 2 arms to expand the available comparative data. Considering variations in study protocols and participant characteristics across studies, the heterogeneity test yielded I² = 68% and P < .01, so a random-effects model was used for pooling. The pooled results from this model demonstrated a robust and significant effect. The result indicated that the temperature difference of the trunk and limbs in the Baduanjin experimental group was significantly higher than that in the control group (MD = 0.44°C, 95% CI [0.29, 0.59], P < .0001), as shown in Figure 5A. This finding suggested that Baduanjin training may have a pronounced effect on enhancing peripheral circulation or thermal regulation in the limb regions.

Figure 5.

Forest plot of meta-analysis on the effect of Baduanjin training on the mean skin temperature of the trunk and limbs. (A) Overall analysis; (B) sensitivity analysis. * Two control groups in this study (a blank control group: daily life, no regular exercise and an active control group: radio calisthenics) were combined into a single control group. # Only a blank control group (daily life, no regular exercise) was retained. CI = confidence interval, SD = standard deviation.

Sensitivity analysis only retained data from the blank control group in the study by Xie et al ^[24] so that participants across all included studies maintained their daily routines without regular exercise. A high level of heterogeneity still existed (I² = 59%), so the random-effects model was adopted for data pooling. The results of the sensitivity analysis were consistent with those of the primary analysis: the mean skin temperature of the trunk and limbs was significantly higher in the Baduanjin group than in the control group (MD = 0.42°C, 95% CI [0.28, 0.55], P < .001), as shown in Figure 5B.

4. Discussion

This meta-analysis demonstrated that Baduanjin training was associated with increases in the mean skin temperature of trunk acupoints, visceral projection areas, and the trunk and limbs, as measured by infrared thermography. Although substantial heterogeneity remained in the analyses of mean skin temperature at trunk acupoints and the trunk and limbs, sensitivity analysis indicated that the overall findings were not substantially affected by methodological variations. Although the magnitude of temperature elevation was modest, these changes may reflect meaningful physiological alterations related to local blood perfusion and metabolic activity. Elevations of 0.5°C to 1.0°C in surface temperature over trunk acupoints and visceral reflex projections have been associated with enhanced metabolic enzyme activity and improved local blood circulation,^[9,10] whereas small improvements in limb skin temperature may mitigate cold-related discomfort.^[27,28] These results provide preliminary evidence for the application of Baduanjin as a non-pharmacological intervention to improve thermoregulation in clinical and community settings.

This conclusion is consistent with several studies investigating the thermal effects of mind-body exercises. For instance, research by Matos et al^[29] on Qigong (“White Ball” standing exercise, 30 minutes, twice a week) and Wang et al^[30] on Tai Chi Chuan (a Chinese conditioning exercise, characterized by coordinated upper- and lower-limb movements with trunk rotation, 60 minutes, 5 times per week) similarly reported elevated microcirculatory perfusion and local skin temperature following regular practice, underscoring a reproducible physiological effect across similar interventions. Several mechanisms may explain the observed temperature changes. Baduanjin training, which involves gentle, sustained stretching and twisting motions, is believed to enhance local blood circulation in the chest and abdomen and microvascular perfusion, thereby delivering more metabolic heat to the acupoint areas and visceral regions.^[31] Specifically, movements in Baduanjin such as “Regulating Spleen and Stomach by Lifting One Arm” and “Raising Hands to Regulate Triple Energizer” can stimulate blood flow in thoracic and abdominal organs, increase local metabolic rate,^[24] and thereby elevate the core temperature. Second, Baduanjin requires a meditative mind and mental focus while executing body movements. The deep diaphragmatic breathing involved in Baduanjin practice may influence peripheral blood flow and heat distribution.^[32,33] Furthermore, from the perspective of traditional Chinese medicine, Baduanjin is thought to regulate the flow of Qi and blood in the meridians.^[34]

As a low-intensity physical activity beneficial to physical and mental health, Baduanjin, along with traditional exercise methods such as Tai Chi and yoga, is not only widely popular among the elderly but is also increasingly favored by the younger generation.^[7] Compared with Tai Chi and yoga, Baduanjin is more convenient and easier to perform, and does not require any auxiliary equipment. It only takes 30 minutes to complete a full set of Baduanjin exercises, including warming up and stretching. For adults who usually lack the willingness to exercise, persisting in Baduanjin exercise is particularly feasible, and it is easy to learn and adhere to.^[35,36] A large body of independent clinical research outside the present meta-analysis’s included studies has preliminarily explored the potential clinical application value of Baduanjin in chronic respiratory disease, cardiovascular conditions, osteoporosis, and pain control, as well as cognitive and emotional regulation.^{[4,12–15,37–39]} In the studies mentioned above, Baduanjin training was typically performed for 30 to 60 minutes per session, 3 to 7 times per week, with intervention durations ranging from 8 to 25 weeks. These findings imply promising health-related potential of Baduanjin, yet such merits remain to be verified in further targeted trials.

The findings of this meta-analysis indicate that Baduanjin is associated with increases in body surface temperature detected via infrared thermography. However, these findings should be interpreted with caution because all eligible studies were conducted in mainland China, and rigorous trials remain scarce worldwide. In addition, the GRADE system yielded a low certainty of evidence for Baduanjin’s effects on thermoregulation, and considerable heterogeneity existed across studies. Further large-scale, well-designed RCTs are needed for validation. All participants included in this analysis were aged 20 to 30 years. Given that older adults constitute the main practicing population of Baduanjin, relevant evidence targeting elderly groups remains insufficient. A nationwide survey conducted in China reported that 85.8% of Qigong practitioners (including those who practice Baduanjin) were aged over 50 years.^[7] Moreover, no study blinded the participants and implementers, which may lead to potential performance bias. Subgroup analysis by participant characteristics was not performed due to the limited number of studies, which restricts our ability to determine Baduanjin’s health benefits for specific groups.

This study confirmed through meta-analysis that infrared thermal imaging can effectively quantify the changes in body surface temperature caused by Baduanjin training, providing visual evidence for the scientific research of traditional Qigong. Future research should focus on the following aspects: unifying environmental control and reducing external interference. Researchers should adopt rigorous methods for random sequence generation and allocation concealment, and blind outcome assessors to minimize bias. RCTs involving people of different age groups are required to clarify the effects of Baduanjin training on temperature changes in different body parts.

5. Conclusion

This systematic review indicates that Baduanjin training may confer significant thermoregulatory benefits. Based on the extant literature, Baduanjin practice appears to significantly elevate skin temperature at trunk acupoints and over visceral projection areas and improve skin temperature of the trunk and limbs, as monitored via infrared thermography. However, these findings should be interpreted with caution. Future research should prioritize rigorously designed, high-quality RCTs with long-term follow-up to confirm the specific effects of Baduanjin on human body temperature and its underlying mechanisms.

Author contributions

Conceptualization: Xiaohua Wu, Dongliang Yang, Dongdong Huang, Yumin Sun, Yubing Shi.

Methodology: Xiaohua Wu, Dongdong Huang, Yubing Shi.

Data curation: Xiaohua Wu, Yubing Shi.

Formal analysis: Xiaohua Wu.

Software: Xiaohua Wu, Dongliang Yang, Dongdong Huang.

Visualization: Xiaohua Wu.

Validation: Fujiang Cui, Yumin Sun.

Project administration: Yubing Shi.

Supervision: Yubing Shi.

Writing – original draft: Xiaohua Wu, Dongliang Yang, Fujiang Cui.

Writing – review & editing: Yubing Shi.