Tuina versus physiotherapy or a combination of both for the management of chronic nonspecific low back pain: A randomized controlled trial
Author: Qingyu Ma1, Xuan Zhou1, Huifang Liang1, Yu Guo1, Kejie He2, Longbin Shen3, Qiao Fan4, Juan Yang5, Tan Ia Choo Celia6, Brent A Bauer5, Jiaxu Chen7
Affiliation:
1 School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
2 Department of Acupuncture, First Affiliated Hospital of Jinan University, Guangzhou, China.
3 Rehabilitation Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, China.
4 Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
5 Mayo Clinic Department of Medicine, Rochester, Minnesota, USA.
6 Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
7 School of Traditional Chinese Medicine, Jinan University, Guangzhou, China. Electronic address: chenjiaxu@hotmail.com.
Conference/Journal: Complement Ther Med
Date published: 2024 Oct 10
Other:
Pages: 103098 , Special Notes: doi: 10.1016/j.ctim.2024.103098. , Word Count: 320
Objective:
To rigorously evaluate the short-term and long-term effectiveness of Tuina (TN), alone and in combination with physiotherapy (PT), for Chronic nonspecific low back pain (CNLBP) through a comprehensive, high-quality clinical trial.
Methods:
This randomized, single-blind trial was conducted from September 2020 to July 2023, involving 204 CNLBP patients from the First Affiliated Hospital of Jinan University. Participants underwent a baseline assessment, 6 treatment sessions over 8 weeks, a post-treatment evaluation in the 9th week, and a 20-week follow-up. Participants were randomly assigned to TN, PT, or a combination of TN and PT (TP) groups. Each treatment involved 6 sessions with a minimum 7-day interval, each lasting 30minutes. Primary outcome was the change in Visual Analog Scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Range of Motion (ROM) of the spine, Traditional Chinese Medicine Syndrome Scale (TCMSS), and adverse events (AE).
Results:
Among the 204 participants, 67.16% were female, and 88.73% completed the 20-week follow-up. All groups showed significant reductions in VAS scores post-treatment and at follow-up. Secondary outcomes improved significantly, with notable decreases in ODI and TCMSS scores. Pairwise comparisons within groups indicated statistical significance, particularly in ODI scores, with clinical relevance. No significant differences were found between the groups. ROM and SF-36 showed statistical but not clinical significance. Only one AE (0.49%) was reported, with no severe incidents.
Conclusion:
All treatment groups, including TN, TP, and PT, demonstrated significant reductions in VAS scores for CNLBP patients, with effects lasting up to 20 weeks. While TN and TP showed substantial improvements in secondary outcomes, particularly in ODI scores, no significant differences were found between the groups. These findings suggest that all treatments can be effective for managing CNLBP, supporting clinical practitioners in selecting appropriate interventions for patients, especially for those unable to engage in active exercises, utilizing passive movements like TN to enhance health outcomes.
Keywords: Chronic nonspecific low back pain; Physiotherapy; Tuina; randomized controlled trial.
PMID: 39395482 DOI: 10.1016/j.ctim.2024.103098
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