Journal
MEDICINE
Volume 102, Issue 9, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000033018
Keywords
Chinese massage; chronic nonspecific low back pain; low back pain; review; Tuina
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This study aimed to systematically evaluate the efficacy and safety of Tuina in the treatment of CNLBP. Fifteen RCTs involving 1390 patients were included. The results showed that Tuina had a significant effect on pain and physical function, but not on quality of life. The evidence quality of the study results was determined to be low level, and more large-scale RCTs are needed to further confirm the findings.
Objective:Chronic nonspecific low back pain (CNLBP) is a serious medical and social problem resulting in functional decline and decreased work ability. Tuina, a form of manual therapy, has been sparsely used to treat patients with CNLBP. To systematically assess the efficacy and safety of Tuina for patients with CNLBP. Methods:Multiple English and Chinese literature databases were searched until September 2022 for randomized controlled trials (RCTs) of Tuina in the treatment of CNLBP. The methodological quality was assessed using the Cochrane Collaboration's tool, and certainty of the evidence was determined with the online Grading of Recommendations, Assessment, Development and Evaluation tool. Results:Fifteen RCTs with 1390 patients were included. Tuina demonstrated a significant effect on pain (SMD: -0.82; 95% CI -1.12 to -0.53; P < .001; I-2 = 81%) and physical function (SMD: -0.91; 95% CI -1.55 to -0.27; P = .005; I-2 = 90%) when compared to control. However, Tuina resulted in no significant improvement for quality of life (QoL) (SMD: 0.58; 95% CI -0.04 to 1.21; P = .07; I-2 = 73%;) compared to control. The Grading of Recommendations, Assessment, Development and Evaluation evidence quality was determined to be low level for pain relief, physical function, and QoL measurements. Only six studies reported adverse events; none were serious. Conclusion:Tuina might be an effective and safe strategy for treating CNLBP in terms of pain and physical function, but not for QoL. The study results should be interpreted with caution for their low-level evidence. More multicenter, large-scale RCTs with a rigorous design are required to further confirm our findings.
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