Systematic review and meta-analysis of Wuqinxi for knee osteoarthritis joint function

BackgroundIn recent years, an increasing number of studies have demonstrated the potential therapeutic effects of traditional Chinese exercises in the treatment of knee osteoarthritis (KOA). However, the effectiveness of Wuqinxi (WQX) for patients with KOA remains a subject of debate. This study aimed to systematically evaluate the effects of WQX on joint function, muscle strength, balance function, and pain in patients with KOA.MethodsA systematic search was conducted in seven electronic databases, including PubMed, Cochrane, EMBASE, Web of Science, CNKI, Wanfang, and VIP, from database inception to November 2025 to identify all randomized controlled trials (RCTs) on WQX for the treatment of KOA. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane tool. Outcome measures included joint function scores [Lysholm and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)], peak torque of the flexor and extensor muscles of the knee, balance function [including dynamic fall index (DFI), time to contact test (TCT), and overall stability index (OSI)], and Visual Analog Scale (VAS) scores. Subgroup, sensitivity, and publication-bias analyses were also performed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsA total of 9 trials involving 809 participants were included. The results showed that WQX significantly improved Lysholm scores [mean difference (MD) = 6.34, 95% confidence interval (CI): 2.32 to 10.36, p = 0.002], WOMAC scores (standardized MD (SMD) = −0.67, 95% CI: −1.08 to −0.27, p = 0.001), peak torque of the flexor and extensor muscles of the knee (SMD = 0.50, 95% CI: 0.36 to 0.65, p