OBJECTIVES: To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS). METHODS: The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata 15.0 random effects model. RESULTS: Nineteen RCTs including 1,315 participants were included in the analysis. The studies were found to be heterogeneous (I2 = 86.2%, p = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD -0.66, 95% CI -1.08 to -0.25, p = 0.002), improving sleep (SMD -0.35, 95% CI -0.68 to 0. 01, p = 0.041) and relieving depression (SMD -0.24, 95% CI -0.47 to -0.02, p = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD -0.20, 95% CI -0.48 to 0.09, p = 0.176). CONCLUSIONS: TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.

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