Bibliometric analysis is a quantitative academic evaluation method that presents the developmental trends within specific research field (18). Through statistical techniques, this approach measures the scale of research output, identifies emerging trends, maps knowledge landscapes, and key influential authors, institutions, and publications (17–20). Compared to systematic reviews, bibliometric analysis offers a holistic view (19).

The bibliometric analysis aims to provide the knowledge structure and thematic evolution of WMH research. The data for the bibliometric analysis were sourced from the WoSCC, a major multidisciplinary database renowned for its comprehensive coverage of high-quality peer-reviewed journals across science, social sciences, arts, and humanities (20). Its powerful indexing and citation data render it particularly suitable for bibliometric research (20). As this study utilized publicly available data from WoSCC and didn’t involve any human or animal subjects, no ethical approval was required (18, 20).

This systematic review aims to summarize clinical progress in the field of WMH over the past five years (2020–2024). Research data were collected from the PubMed database. Eligible studies were required to meet the following criteria: (1) clinical trial design; (2) human participants; (3) interventions involving Wushu related practices; (4) outcomes related to psychological or mental health; (5) articles published in English; and (6) publication between 2020 and 2024. To ensure consistency regardless of the database, we selected the same terms. The specific search strategy is as follows:

(“Wushu”[tiab] OR “Chinese Martial Arts”[tiab] OR “Kung Fu”[tiab] OR “Gongfu”[tiab] OR “Taijiquan”[tiab] OR “Tai Chi”[tiab] OR “Tai Chi Chuan”[tiab] OR “Sanda”[tiab] OR “Chinese Kickboxing”[tiab]) AND (“Mental Health”[tiab] OR “Mental Illness”[tiab] OR “Psychology”[tiab] OR “Psychosocial”[tiab] OR “Wellbeing”[tiab]) AND “humans”[MeSH].

The search findings showed 377 studies focused on the WMH field. Study selection was conducted independently by two reviewers, and disagreements were resolved through discussion until consensus was reached. The included studies were limited to clinical trials published within the past five years (2020–2024). Ultimately, 23 studies were selected for systematic analysis. Given the exploratory scope of this review and the heterogeneity of study designs and outcome measures, a formal risk-of-bias assessment was not conducted.

This study employed bibliometric methods to conduct multidimensional analyses in the WMH field, including publication and citation trends, core journals, country/region contributions, institutional collaboration networks, and thematic evolution. We extracted records (Plain Text File format) for 536 final qualifying publications from the WoSCC and used Microsoft Excel 2019 for descriptive statistics (20).

For geographic visualization, the online tool Datawrapper was employed to generate a global publication distribution map (18). Furthermore, Biblioshiny (the interactive interface of the Bibliometrix R package) was utilized for Bradford’s Law analysis, collaboration network construction, keyword co-occurrence visualization, and thematic evolution trend visualization (18, 20).

Based on the previously defined search strategy, WoSCC indexed a total of 536 publications related to WMH between 1981 and 2024. Figure 2 comprehensively illustrates the annual publication volumes and citation counts within the WMH research field during this period. Publications on this topic received combined citations totaling 17,388, achieving an average citation count of 32.44 per article and an H-index of 64. During the initial phase (1981–1999), both publication volume and citation counts remained low, averaging fewer than 1 article and 4 citations annually. After 2000, publication numbers gradually increased. The annual output first reached double digits in 2012 (n=11), after which both publications and citations showed a stable growth. Over the past five years (2020–2024), an average of 60 articles per year have been published on WMH. In 2024, 75 articles were published in this field, representing a threefold increase from a decade ago. Meanwhile, the number of citations reached its peak at 2,739 that year.

In bibliometric research, Bradford’s Law is widely applied to identify core journals within specific scientific fields, providing a crucial framework for distinguishing high-output publication sources from marginal ones (18, 20). Based on Bradford’s Law, a total of 23 journals were identified as core sources for WMH research (Figure 3). In total, the 287 journals published WMH-related research. Core journals constituted only 8% of the source but contributed 33% of the total publications (n=179).

To further identify the primary channels for WMH academic research, we selected 10 most relevant journals for detailed analysis (Table 1). Journal impact indexes are obtained from the Journal Citation Reports (JCR) 2024 edition, including the Journal Impact Factor (JIF) and subject quartiles, to evaluate the academic position of relevant journals. Collectively, these journals contributed 21% of the total research output (n=114). Most journals publishing WMH research were ranked in the Q1 or Q2 categories, reflecting a strong presence in high-quality academic venues. Among them, three journals belonged to the Integrative & Complementary Medicine category, while two were classified under Medicine, General & Internal and Public, Environmental & Occupational Health. Their Impact Factors (IF) ranged from 1.4 to 9.4, with the Cochrane Database of Systematic Reviews holding the highest impact factor.

Interestingly, among the top ten most highly cited articles (Table 2), four explicitly mention the research type “Systematic Reviews” in their titles. The most frequently cited article, Reducing Frailty and Falls in Older Adults: An Investigation of Tai Chi and Computerized Balance Training (22), published in 1996, has been cited 727 times, approximately three times more than the tenth-ranked article. Among these influential works, the journal with the highest impact factor is the Journal of the American College of Cardiology (IF = 22.3, CQ=Q1). Overall, six of the ten (60%) articles were published in JCR Q1 journals, and more than half were authored by researchers from the United States.

Figure 4 was generated using the Winkel Tripel projection to minimize distortions in area, direction, and distance. Different color bands represent the number of publications from each country. In fact, there are 58 countries/regions worldwide that have made academic contributions to the development of this field. It shows the global distribution of WMH related publications, where the dark blue countries represent China (n=202) and the United States (n=174), each accounting for over 30% of the total publications.

As shown in Table 3, among the top ten countries by publication volume, citation counts exhibit significant differences. China produced the highest number of publications (n=202) but ranked second in citations (TC = 4,594). The United States leads in both total citations (TC = 7,928) and H-index (n=48). Harvard University ranks first among institutions in publications(n=34). Australia, ranked third, published only 50 articles on WMH but achieved the highest citation per article (CPA = 49.32).

Figure 5 presents a network of institutional collaborations, revealing clusters of relationshipsamong different research teams. Through active collaboration with numerous international institutions, Harvard University has maintained a central position in its cooperative relationships. This role is quantitatively supported by its highest normalized cumulative degree and betweenness centrality in the network (Supplementary Table S1). This illustrates that the institution maintains extensive direct collaborative relationships and performs a crucial bridging function among different institutional clusters. Additionally, the blue cluster in the figure indicates close cooperation among Chinese institutions specializing in physical education, including Beijing Sport University, Shanghai University of Sport, and Chengdu Sport University. This model may be driven by resource concentration and international project leadership. It reflects a trend in global scientific collaboration where knowledge and academic influence cluster around central nodes.

In fact, the authors’ productivity analysis identified the top 10 contributors in the WMH field (Table 4). Wayne, Peter M. (USA) ranked first with 12 publications, followed by Wang, Chenchen (China, 11 publications) and Yeh, Gloria (USA, 9 publications). Regarding citation impact, Wang, Chenchen holds the highest total citations (TC = 560) with the H-index of 7. However, Chan, Aileen Wai Kiu (China) achieved the highest Citations Per Article. (n=54.29). Overall, four of the top 10 authors are affiliated with U.S. institutions, while six are from Chinese research organizations.

Figure 6 shows the timeline of productivity for the 10 authors. Circle size represents the number of articles, while color intensity indicates annual citation counts. Wang, Chenchen has engaged in WMH research for over 20 years, followed by Wang, Y. from the United States in second place. In contrast, Wayne, Peter M. achieved the highest H-index (n=8) despite exploring WMH topics for only 10 years. Half of these top 10 authors began focusing on this subject within the past decade.

Keyword analysis using Biblioshiny’s word cloud map provides an efficient overview of research hotspots in the WMH field. Compared to traditional frequency tables, word clouds can help readers quickly identify the most frequent topics (18). Figure 7 shows the 25 most frequently occurring keywords in this field. The top keyword is quality-of-life (n=148), followed by exercise (n=124), tai chi (n=108), tai-chi (n=101), and physical-activity (n=73). Other frequently used terms include health (n=72), older-adults (n=72), depression (n=65), randomized controlled-trial (n=63), and mental-health (n=59).

In bibliometric research, examining the evolution of keywords provides a critical perspective for identifying research trends, emerging themes, and the structural development of a field (17–19). By tracking the co-occurrence of terms across different periods, we can uncover the dynamic changes in academic focus (18–20). Biblioshiny offers a powerful analytical tool to visualize this process, generating intuitive thematic evolution diagrams that highlight the strength and stability of connections between keywords (17, 18). Using the previous two decades (2011) and the most recent five years (2019) as key date, we got a thematic evolution trend for the WMH field (Figure 8). Analysis of high-frequency keywords and thematic evolution across these three periods reveals the changing of WMH’s research interests.

The PubMed database focuses on clinical research and directly demonstrates the practical effects of Wushu interventions (such as Tai Chi and Qigong) in the field of mental health. The inclusion criteria were clinical trial publications from 2020 to 2024. Finally, this study included a total of 23 relevant WMH studies.

This bibliometric analysis indicates a significant increase in research on WMH, particularly over the past decade. The stable growth in publications and citations shows that WMH has become an emerging interdisciplinary field attracting global attention (48, 49). The primary driver of this trend is the growing recognition that mind-body interventions such as Tai Chi and Qigong offer effective non-pharmacological strategies for improving mental health outcomes (3, 52, 57, 59, 82). For instance, the WHO Global Action Plan on Physical Activity 2018–2030 highlights traditional exercises, including Tai Chi, as promising approaches for promoting mental health (83). The peak of publications in recent years is related to the high interest in non-pharmaceutical interventions during the COVID-19 epidemic, when keeping social distance and mental health crisis stimulated people’s demand for accessibility (84). To sum up, these findings demonstrate that WMH research has gained great academic development motivation, reflecting its growing importance in the scientific communities.

A series of core journals and highly cited publications were identified through bibliometric analysis, forming the knowledge foundation of WMH research. As shown in Figure 3, this concentration emphasizes the crucial position of a small number of journals in spreading WMH academic achievements. The top ten journals span a broad disciplinary range, including psychology (multidisciplinary) (4, 7, 8), medicine (general practice and internal medicine) (52, 58), integrative (13, 55) and complementary medicine (3, 14, 39, 85, 86), public environmental and occupational health (56, 87), multidisciplinary sciences, and psychiatry (88).

This distribution indicates that WMH research is not a single discipline, but rather an interdisciplinary science spanning psychology, medicine, and public health. Some journals in Table 1 belong to fully open-access publishers, such as Frontiers Media SA (7), MDPI (84), and Hindawi LTD (85). Among the top ten most influential journals, three belong to Frontiers Media SA. This open-access publishing model increases the visibility of WMH research and facilitates the rapid dissemination of its findings.

Furthermore, analysis of the most influential publications indicates that systematic review methodologies account for a significant proportion of WMH research, reflecting the importance of synthesizing research evidence (12, 23–25, 27). The Cochrane Database of Systematic Reviews holds significant influence among journals publishing reviews, and its research findings are frequently accepted by scholars. (23, 89). The most highly cited article in Table 2, published in 1996, explored that Tai Chi effectively reduces fear of falling among older adults (22). Through randomized controlled trials, it has confirmed the positive effects of Wushu training in psychological interventions (22). It has provided the experimental evidence foundation for WMH research and indicated the practical legitimacy of Wushu in clinical trials.

It is evident that half of the ten most cited publications in WMH research originate from U.S. institutions, reflecting America’s leading position in this field (22, 25–28). Simultaneously, the geographical distribution of publications (Figure 4) further confirms the prominent contributions from the United States. However, Table 3 reveals disparities in productivity and impact among different countries. China accounts for the largest share of total publications (37.7%) but its citation rate (CPA = 22.74) follows the United States. Despite ranking second in publication volume, the United States demonstrates significantly enhanced academic influence (CPA = 45.56, H-index=48). This contrast indicates that China focuses on expanding the volume of WMH research, while the United States maintains its influence through widely cited systematic reviews and clinical trials.

It is noteworthy that countries such as Australia and the United Kingdom, despite producing fewer publications, exhibit unusually high citations per article (CPA>44). This reflects the significant impact of high-quality research from institutions like Griffith University (43, 48) and the University of London (88, 89). Additionally, Germany demonstrates the role of leading medical centers (Charité Universitätsmedizin Berlin) in enhancing national popularity(Esch 90). The integrated model combining universities and medical centers actively promotes WMH research progress. However, WMH research is still geographically unbalanced, development concentrated in a few academic centers, and globally large regions lack adequate representation in this field.

The institutional collaboration network (Figure 5) highlights the appearance of a unique knowledge cluster in WMH research. Harvard University stands as a central hub connecting numerous institutions across North America, Europe, and Asia (28). This network of links reflects the interdisciplinary and transnational nature of WMH research, bringing together medical schools, public health institutions, and traditional Chinese medicine universities within this field (28). This collaborative model covers a broader range of participants, integrate different research methodologies, and expands cross-cultural perspectives on Wushu interventions (28). However, the network remains fragmented, with most institutions concentrated within national or regional boundaries.

Regarding author productivity (Table 4, Figure 6), top contributors exhibit geographic and time concentration. Wang, Y. (25) and Ruth E. Taylor-Piliae (91) were among the earliest scholars in the United States to publish WMH articles and establishing stable citation impact. In contrast, Wang Chenchen from China is the most highly cited researcher in this field (TC = 560) and has demonstrated active publishing in recent years (92). Although China and the United States have profound academic influence in this field, dependence on a fewer number of highly productive authors will limit the diversity of perspectives. Future research should promote broader participation from underrepresented regions and interdisciplinary scholars, thereby building a more balanced research community.

To assist researchers in systematically understanding the thematic evolution within the field of WMH, this study outlines the knowledge development landscape by analyzing its intrinsic logic. Based on keyword co-occurrence analysis, we organize the knowledge structure of WMH from a psychological perspective, thereby illuminating the progression of core themes. The following discussion will explore these insights across three psychological dimensions, while also exploring research gaps and future directions.

Despite significant progress in WMH research over the past four decades, this rapid development has simultaneously exposed several critical limitations. Current research remains limited in theoretical depth, diversity of interventions, cultural adaptability, and international collaboration. They constrain theoretical development in the field but also provide new directions for future research to explore.