Network meta-analysis of the effects of traditional Chinese fitness exercises on mental health and physical benefits among college students

Background Traditional Chinese fitness exercises may benefit college students’ mental and physical health, but their comparative effectiveness across exercise modalities and outcomes remains unclear. Objective To compare traditional Chinese fitness exercises across mental health, body composition, and cardiorespiratory outcomes in college students. Methods Eight databases were searched from inception through September 8, 2026. Eligible RCTs in college students were assessed with RoB 2 and synthesized using Bayesian network meta-analysis. Results A total of 69 RCTs involving 6,065 college students were included. For depression, Tai Chi (TC, 95.40%), Yijin Jing (YJJ, 85.40%), and Baduanjin (BDJ, 69.23%) ranked highest, with several significant pairwise comparisons. For anxiety, TC significantly outperformed blank control (BC) and ranked highest (88.82%). Other traditional exercises (OTE, 84.53%), Wuqinxi (WQX, 67.72%), and Liuzijue + physical intervention (LZJ + PI, 65.82%) ranked highest for vital capacity (VC); Xingyiquan (XYQ, 82.89%) and Mawangdui Daoyinshu (MWDY, 82.07%) for VO 2 max; and OTE (82.52%) and XYQ (78.81%) for the step test index. TC ranked highest for body fat rate (BFR, 86.35%), whereas LZJ (81.27%), WQX (72.38%), and PI (65.44%) ranked highest for body mass index (BMI). Surface under the cumulative ranking curve (SUCRA) rankings should be interpreted alongside effect sizes and 95% CrIs. Conclusion Traditional Chinese fitness exercises may provide multidimensional benefits, with comparative advantages varying by outcome. Exercise selection should be outcome-oriented rather than based on a single universally optimal modality. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view , identifier CRD420261290192.