Effectiveness of Tuina Therapy Combined With Yijinjing Exercise in the Treatment of Nonspecific Chronic Neck Pain: A Randomized Clinical Trial

Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia

This study evaluates the clinical impact of comprehensive nursing care on senior patients suffering from postherpetic neuralgia (PHN), a chronic neuropathic pain condition resulting from the reactivation of the varicella-zoster virus. A total of 102 elderly patients diagnosed with PHN and treated at our hospital were divided into two groups: the control group, which received conventional nursing care, and the intervention group, which received comprehensive nursing care. Comparative analyses were conducted on pain levels, sleep quality, symptoms of depression and anxiety before and after the intervention. After a two-month period of nursing care, both groups exhibited a significant reduction in pain levels (p < 0.05), with the intervention group demonstrating a more substantial decrease (p < 0.001). Sleep quality improved in both groups (p < 0.05), with the intervention group showing a significantly greater improvement (p < 0.05). Additionally, the intervention group experienced a notable reduction in anxiety and depression ratings compared to the control group. Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. These findings underscore the potential benefits of employing a comprehensive approach to managing PHN in the elderly population.

Effect of Tui-Na versus positional release techniques on pregnancy-related low back pain in the third-trimester: A randomized comparative trial

BACKGROUND

Researchers are prioritizing the development of an effective treatment approach for third-trimester pregnancy-related low back pain (LBP), a prevalent and costly disorder. Therefore, this study aimed to examine the effects of Tui-Na (TN) versus positional release techniques (PRT) on third trimester pregnancy-related LBP.

METHODS

Fifty pregnant women in their third trimester with low back pain were randomly assigned to 1 of 2 groups for 4 weeks of prescribed treatment (TN or PRT). The primary outcome was LBP intensity. Secondary outcomes included the Oswestry disability index for back disability and the pressure pain threshold of lumbar tender points. Two-way multivariate analysis of variance was used for the data analysis.

RESULTS

Multivariate tests indicated statistically significant effects of group (F = 10.062, P < .001, partial η2 = 0.302), time (F = 473.5, P < .001, partial η2 = 0.953), and group-by-time interactions (F = 4.045, P < .001, partial η2 = 0.148). However, the TN group, when compared to the PRT group, revealed a significant decrease in back disability (P < .001, partial η2 = 0.124) and a significant increase in pressure pain threshold at the Rt and Lt points (P = .02 and .001, partial η2 = 0.055, and 0.108, respectively). Within-group comparisons were significant for all measured variables in both the groups (P < .001).

CONCLUSION

Although both TN and PRT are beneficial treatments for third trimester pregnancy-related LBP, TN leads to more beneficial outcomes.

Tuina Promotes Repair of Chronic Cervical Muscle Injury by Regulating Satellite Cell Proliferation and Differentiation and Inhibiting Myocyte Apoptosis

Purpose

Chronic cervical muscle injury is the first common cause of the development of cervical spondylosis, and Tuina can effectively promote the repair of chronic cervical muscle injury and alleviate neck pain, but the mechanism behind its efficacy is still unknown. The proliferation and differentiation of muscle satellite cells and the apoptosis of cervical myocytes play important roles in the repair of chronic cervical muscle injuries; therefore, this study aimed to explore the potential mechanisms of Tuina to promote the repair of cervical muscle injuries in terms of the proliferation and differentiation of satellite cells and the apoptosis of myocytes.

Patients and Methods

Twenty-eight Wistar rats were randomly divided into control group, model group, Tuina group, and meloxicam group, with 7 rats in each group. Except for the control group, each group were establish a chronic cervical muscle injury model (CCMI). Meloxicam (0.79 mg/kg) was administered by gavage, and in the Tuina group, pressure was applied to the Fengchi acupoint on the affected side once a day. Morphological changes of cervical muscle tissues were detected by ultrasonic diagnostic instrument and HE staining, electrophysiological recordings of electromyographic changes, apoptosis rate was detected by TUNEL staining, and positive expression of Bax, Bcl-2, IGF-1, MyoD, and Pax-7 were detected by Immunohistochemistry and Western blot.

Results

In CCMI model rats, we observed that the cervical muscle fibers were disorganized, with irregular morphology, and the amplitude of electromyography was significantly weakened, while Tuina could significantly improve these symptoms and effectively promote the repair of chronic cervical muscle injury. Meanwhile, compared with the model group, Tuina could significantly increase the expression levels of IGF-1 (P<0.01) and MyoD (P<0.05) and decrease the expression level of Pax7 (P<0.05). In addition, we found that the number of apoptotic cells in cervical myocytes was reduced after Tuina intervention (P<0.05), and Tuina inhibited the expression of pro-apoptotic factor Bax (P<0.01) and promoted the expression of anti-apoptotic factor Bcl-2 (P<0.05).

Conclusion

Tuina can promote the proliferation and differentiation of satellite cells to repair chronic cervical muscle injury by regulating the expression of Pax7, MyoD, and IGF-1, as well as inhibiting the expression of Bax and promoting the expression of Bcl-2 to ameliorate the apoptosis of cervical myocytes in CCMI model rats.

Effects of meridian sinew tuina after identifying the treatment area under ultrasound localization combined with greater and third occipital nerve injections in cervicogenic headache: a randomized controlled trial protocol

Introduction

Cervicogenic headache (CEH) is a secondary headache characterized by chronic, unilateral headache. Ultrasound-guided injections of the greater occipital nerve (GON) and the third occipital nerve (TON) are effective in the treatment of CEH, as is meridian sinew tuina for the treatment of CEH, but the evidence of clinical efficacy of combining these two therapies is valid. Therefore, we have designed a randomized controlled trial with the aim of investigating the efficacy and safety of ultrasound localization meridian sinew tuina combined with GON and TON injections for the treatment of CEH.

Methods and analysis

In this study, we enroll 60 patients experiencing CEH. The control group receives ultrasound-guided injections of GON and TON. The intervention group is treated with ultrasound localization meridian sinew tuina combined with the injection of GON and TON. Meridian sinew tuina is performed once a day for 30 min for 3 days. The primary observational index includes the Short-Form of McGill Pain Questionnaire (SF-MPQ). The Secondary outcomes include Cervical Range of Motion (ROM) and Medical Infrared Thermography (MIT). MIT is used to measure the change in skin temperature in the area of the patient's meridian sinew tuina treatment of GON and TON before and after the intervention. There are 5 time points assessed as baseline, day 3, day 15, day 30, and day 60.

Discussion

This study proposes to combine ultrasound-guided injections of GON and TON for the treatment of CEH after identifying the treatment area of meridian sinew tuina under ultrasound localization. Meanwhile, MIT is utilized to provide objective evidence of the efficacy of CEH.

Clinical trial registration

ChiCTR2300076128.

Recent trends in Tuina for chronic pain management: A bibliometric analysis and literature review

BACKGROUND

The utilization of Tuina as a therapeutic intervention for the management of chronic pain has experienced a gradually increase in its popularity, and the purpose of this bibliometric analysis is to offer a comprehensive understanding of the current state and frontier trends, as well as to provide recommendations for future research directions.

METHODS

Publications on Tuina for chronic pain published between 2004 and 2023 were retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel, CiteSpace, VOSViewer, and the R package "bibliometrix" were used to quantitatively analyse the annual publication volume, countries/regions, journals, institutions, cited references, authors, and keywords.

RESULTS

A total of 287 publications were retrieved. The number of annual publications on the use of Tuina for treating chronic pain has gradually increased. Most publications were published in China and the United States. Notably, the most productive institution and author were identified as Shanghai University of Traditional Chinese Medicine and Min Fang, respectively. Medicine ranked first as the most influential affiliate and most productive journal. These publications came from 1650 authors, among whom Edzard Ernst had the most co-citations. Keyword analysis revealed that the new research frontier was low back pain.

CONCLUSION

The utilization of Tuina for the treatment of chronic pain has been gaining increasing recognition. Acupuncture, randomised controlled trials, systematic reviews, etc. were the main research subjects. Furthermore, low back pain is the new research frontier. This study provides an in-depth perspective on Tuina for chronic pain, which provides valuable reference material for clinicians with insights of therapeutic strategy, educators with valuable topics, and researchers with new research directions.

Traditional Chinese Rehabilitation Exercise (TCRE) for Myofascial Pain: Current Evidence and Further Challenges

Myofascial as a holistic structure emphasizes a holistic approach to intervention and treatment of fascial-related disorders such as neck pain (NP), low back pain (LBP), and knee pain. There are currently adverse effects of medication for diseases related to myofascial. Traditional Chinese rehabilitation exercise (TCRE) is a practical approach to traditional Chinese medicine and is a valuable option for intervening in myofascial-related pain. This article found some research evidence for Baduanjin, Wuqinxi, and Yijinjing in clinical studies of myofascial chain-related pain. The article summarizes the current evidence and finds that TCRE can enhance limb movement function through breathing and slow movements, increase joint movement and flexibility, and reduce joint pathology and stress-induced pain. As for future directions, focus on TCRE in improving the health of older adults and treating long-COVID syndrome, and integrate robotic and TCRE training to frame safe and effective exercise models. Relevant studies have already been registered in the Clinical Trials Registry, and some clinical study protocols have been published. TCRE can be an alternative nonpharmacological rehabilitation therapy to alleviate chronic rheumatic pain symptoms and augment public health management.

AI: Bridging Ancient Wisdom and Modern Innovation in Traditional Chinese Medicine

The pursuit of groundbreaking health care innovations has led to the convergence of artificial intelligence (AI) and traditional Chinese medicine (TCM), thus marking a new frontier that demonstrates the promise of combining the advantages of ancient healing practices with cutting-edge advancements in modern technology. TCM, which is a holistic medical system with >2000 years of empirical support, uses unique diagnostic methods such as inspection, auscultation and olfaction, inquiry, and palpation. AI is the simulation of human intelligence processes by machines, especially via computer systems. TCM is experience oriented, holistic, and subjective, and its combination with AI has beneficial effects, which presumably arises from the perspectives of diagnostic accuracy, treatment efficacy, and prognostic veracity. The role of AI in TCM is highlighted by its use in diagnostics, with machine learning enhancing the precision of treatment through complex pattern recognition. This is exemplified by the greater accuracy of TCM syndrome differentiation via tongue images that are analyzed by AI. However, integrating AI into TCM also presents multifaceted challenges, such as data quality and ethical issues; thus, a unified strategy, such as the use of standardized data sets, is required to improve AI understanding and application of TCM principles. The evolution of TCM through the integration of AI is a key factor for elucidating new horizons in health care. As research continues to evolve, it is imperative that technologists and TCM practitioners collaborate to drive innovative solutions that push the boundaries of medical science and honor the profound legacy of TCM. We can chart a future course wherein AI-augmented TCM practices contribute to more systematic, effective, and accessible health care systems for all individuals.

Tuina on knee pain and functional decline of lower limbs for patients with mild-to-moderate knee osteoarthritis in Shanghai: protocol for a multicentre, assessor-blinded, randomised controlled trial

INTRODUCTION

Knee osteoarthritis (KOA) is one of the most common osteoarthritis, imposing substantial economic and medical burdens on both individuals and society. In China, Tuina has been selected as a complementary and alternative therapy to relieve knee pain and dysfunction symptoms. However, the current evidence is insufficient to support the efficacy of Tuina therapy in addressing knee pain and improving physical function. The trial aims to compare the effectiveness of Tuina with celecoxib, which is considered as the standard treatment, and to assess its potential as an alternative therapy through changes in outcome measures.

METHODS AND ANALYSIS

A total of 360 KOA patients aged between 40 and 70 years and classified as Kellgren and Lawrence grades I-II will be recruited from eight subcentral hospitals. The participants will be randomly assigned to either the treatment group (Tuina, Biw) or the control group (celecoxib, Qd), with both groups undergoing a 4-week intervention phase followed by an 8-week follow-up phase. The primary outcome is the change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at week 4 compared with baseline. Secondary outcomes including WOMAC stiffness and function subscales, WOMAC total score, 36-item Short-Form Health Survey, Timed Up and Go test, Short Physical Performance Battery, gait analysis parameters and pain medication records will be assessed at weeks 4, 8 and 12. Any adverse events that occur during the trial will be promptly recorded.

ETHICS AND DISSEMINATION

This study has been approved by the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2023SHL-KY-16-01, 2023SHL-KY-16-02). Written informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals and conference presentations.

TRIAL REGISTRATION NUMBER

ChiCTR2300069416.

Comparative Efficacy of Mind-Body Exercise for Treating Chronic Non-Specific Neck Pain: A Systematic Review and Network Meta-Analysis

PURPOSE OF REVIEW

This systematic review and network meta-analysis aims to compare the efficacy of different mind-body exercise (MBE) interventions, including Yoga, Pilates, Qigong, and Tai Chi, in managing chronic non-specific neck pain (CNNP). We searched randomized controlled trials in PubMed, Embase, Web of Science and Cochrane Library. After screening eligible studies and extracting relevant data, risk of bias of included studies was assessed by the Cochrane Risk of Bias assessment tool, and network meta-analysis was performed by the Stata software version 16.0.

RECENT FINDINGS

Of the 1019 studies retrieved, 18 studies with 1442 subjects were included. Fourteen studies were graded as high quality. Yoga plus hot sand fomentation was the most effective in reducing pain intensity and functional disability, and improving the quality of physical life in patients with CNNP. Yoga achieved the most improvement in cervical mobility. And Pilates was the best MBE intervention for improving the quality of mental life. Overall, Yoga, Pilates, Qigong, and Tai Chi demonstrated considerable effectiveness in improving pain intensity, functional disability, cervical mobility, and quality of life in patients with CNNP. Yoga or Yoga plus heat therapy was the most effective method for patients with CNNP. Additional high-quality, large-scale, multi-center, long-term follow-up studies are necessary to fully understand the comparative effectiveness of different MBE interventions for CNNP, and to recognize the potential benefits of each MBE intervention and the need for individualized treatment approaches.

Efficacy and safety of traditional Chinese manual therapy (Tuina) in patients with non-specific chronic low back pain: a study protocol for a randomised controlled trial

INTRODUCTION

Non-pharmacological interventions play a crucial role in the management of non-specific chronic low back pain (NSCLBP). One prime example is Tuina, a traditional Chinese manual therapy that incorporates pressing, kneading and rubbing techniques to alleviate physical discomfort and enhance overall well-being. It serves as a widely used technique in China and other East Asian countries. However, the effectiveness and safety of Tuina for managing NSCLBP have not been substantiated through rigorous clinical research. We sought to carry out a randomised controlled trial with an open-label design, blinded assessors and parallel arms to assess the effectiveness and safety of Tuina as a treatment for NSCLBP. The trial aims to provide high-quality evidence regarding the efficacy and safety of Tuina in improving outcomes for patients with NSCLBP.

METHODS AND ANALYSIS

A total of 150 patients aged 18-60 years with NSCLBP will be recruited. Participants will be randomly assigned to one of the two groups. Both groups will receive standard health education. In addition, the treatment group will receive Tuina therapy, while the control group will participate in core stability exercises. Each group will undergo a total of 18 interventions over 6 weeks, with the interventions administered three times per week. The primary outcome measure is the patient's pain intensity, assessed using the Numerical Rating Scale, at week 6 following randomisation. Secondary outcomes encompass disability (measured by the Roland-Morris Disability Questionnaire), quality of life (assessed using the EuroQoL-5 dimensions questionnaire), adverse emotions (evaluated with the Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia and Depression Anxiety Stress Scale), biomechanical outcomes, socioeconomic indicators (medication use, healthcare utilisation and absenteeism), patient satisfaction, treatment adherence and other relevant factors.The statistical analysis will follow the intention-to-treat principle. Two-way repeated measures analysis of variance will be used to compare the clinical data across different time points within both groups.

ETHICS AND DISSEMINATION

The study protocol has received approval from the Ethics Committee of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine (2023-1366-133-01). All study participants will be required to give written informed consent. The findings of the study will be submitted to a peer-reviewed journal for publication and presented at scientific conferences. Additionally, the participants will receive copies of the results.

TRIAL REGISTRATION NUMBER

ChiCTR2300076257.

Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol

INTRODUCTION

Knee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to arrest the disease process and reduce the disease burden. Yijinjing exercise is an important part of physical and psychological therapies in Traditional Chinese Exercise and may be an effective treatment. However, there is no clinical efficacy assessment of Yijinjing exercise for patients with early-stage KOA. Therefore, we designed a randomised controlled trial to evaluate the effectiveness of Yijinjing exercise on patients with early-stage KOA.

METHODS AND ANALYSIS

This is a parallel-design, two-arm, analyst assessor-blinded, randomised controlled trial. In total, 60 patients with early-stage KOA will be recruited and randomly assigned to the Yijinjing exercise group (n=30) and health education group (n=30) at a ratio of 1:1, receiving 12 weeks of Yijinjing exercise or health education accordingly. The primary outcome will be measured with the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes will include the Visual Analogue Scale, Short-Form 36 Item Health Survey Questionnaire, Beck Depression Inventory, Perceived Stress Scale, Berg Balance Scale, and Gait Analysis for a comprehensive assessment. Outcome measures are collected at baseline, at 12 week ending intervention and at the 12 week, 24 week and 48 week ending follow-up. The primay time point will be 12 weeks postintervention. Adverse events will be recorded for safety assessment.

ETHICS AND DISSEMINATION

This study has been approved by the ethical application of the Shanghai Municipal Hospital of Traditional Chinese Medicine Ethics Committee (2021SHL-KY-78).

TRIAL REGISTRATION NUMBER

ChiCTR2200065178.

The top 100 highly cited articles on neck pain: A bibliometric analysis

Objective

Neck pain has emerged as a significant public health concern. This study is to unveil the present state of neck pain research, thereby furnishing invaluable insights for prospective research endeavours and clinical applications.

Methods

The study was initiated by searching the Web of Science Core Collection database, focusing on "neck pain". From the amassed results, the top 100 most cited references were imported into CiteSpace and VOSviewer, enabling a rigorous bibliometric analysis. To ensure precision, synonymous terms conveying similar meanings were harmonized. The bibliometric study encompassed countries, research institutions, authors, journals, and keyword analysis.

Results

The investigation centered on a curated compilation of 100 articles, disseminated across a diverse array of 36 scholarly journals. These seminal articles originated from 24 distinct countries, reflecting contributions from a wide spectrum of 188 research institutions. Impressively, a collaborative effort involving 385 authors emerged. Noteworthy core research countries included the United States and Australia, with the University of Queensland and the University of Toronto asserting notable influence. Prolific authors such as J. David Cassidy and Pierre Cote garnered attention. Present research endeavours pivot around the incidence of neck pain, the identification of risk factors, the efficacy evaluation of treatment modalities, and a pronounced focus on high-quality randomized controlled trials and systematic reviews.

Conclusion

The study shines a light on key research countries, influential institutions, prominent authors, and prevalent trends, effectively contributing to comprehending the knowledge landscape and research dynamics in the field of neck pain.

Effect of Traditional Chinese Non-Pharmacological Therapies on Knee Osteoarthritis: A Narrative Review of Clinical Application and Mechanism

Knee osteoarthritis (KOA) stands as a degenerative ailment with a substantial and escalating prevalence. The practice of traditional Chinese non-pharmacological therapy has become a prevalent complementary and adjunctive approach. A mounting body of evidence suggests its efficacy in addressing KOA. Recent investigations have delved into its underlying mechanism, yielding some headway. Consequently, this comprehensive analysis seeks to encapsulate the clinical application and molecular mechanism of traditional Chinese non-pharmacological therapy in KOA treatment. The review reveals that various therapies, such as acupuncture, electroacupuncture, warm needle acupuncture, tuina, and acupotomy, primarily target localized knee components like cartilage, subchondral bone, and synovium. Moreover, their impact extends to the central nervous system and intestinal flora. More perfect experimental design and more comprehensive research remain a promising avenue in the future.

Regulatory mechanism of the six-method massage antipyretic process on lipopolysaccharide-induced fever in juvenile rabbits: A targeted metabolomics approach

Objective

To investigate the mechanism of the six-method massage antipyretic process (SMAP) and its influence on the body's metabolic state.

Methods

The random number table method was used to divide 24 New Zealand 2-month-old rabbits with qualified basal body temperature into a control group, model group and massage group (n = 8 per group). The model group and massage groups were injected with 0.5 μg/ml lipopolysaccharide (1 ml/kg) into the auricular vein, and the control group was injected with the same amount of normal saline at the same temperature. One hour after modelling, the massage group was given SMAP (opening Tianmen, pushing Kangong, rubbing Taiyang, rubbing Erhougaogu, clearing the Tianheshui and pushing the spine). The change of anal temperature 5 h after moulding was recorded to clarify the antipyretic effect.

Results

After modelling, the rectal temperature of the juvenile rabbits in the three groups increased. The rectal temperature of the model group was higher than that of the control group 5 h after modelling, and the rectal temperature of the massage group was lower than that of the model group (P < 0.05). The antipyretic mechanism is related to the regulation of the synthesis of phenylalanine, tyrosine and tryptophan, as well as the pentose phosphate pathway. Compared with the model group, the plasma interleukin (IL)-1, IL-6, interferon-gamma, toll-like receptor 4, nuclear factor κB, the mechanistic target of rapamycin complex 1, indoleamine 2,3-dioxygenase 1, aryl hydrocarbon receptor, liver aspartate transaminase (AST), alanine transaminase (ALT) and l-glutamate dehydrogenase (L-GLDH) expression in the massage group were significantly decreased (P < 0.05). Compared with the model group, the massage group had significantly reduced AST, ALT and L-GLDH expression in plasma (P < 0.05).

Conclusion

The mechanism of SMAP therapy is related to regulating the expression of peripheral inflammatory factors and metabolic pathways.

Clinical Study on the Treatment of Non-isotropic Cervical Spondylosis by Neck Pain Granules Combined with Tuina

BACKGROUND

Cervical spondylotic radiculopathy is a common form of cervical spondylosis caused by degeneration of the cervical spine. Currently, non-surgical treatment is the preferred treatment method, and Chinese medicine is widely used.

OBJECTIVE

To investigate the effect of radiculopathy spondylosis by tuina spinning and lifting technique.

METHODS

Experimental Design: We conducted a 12-week, open-label, analyst-blinded, randomized clinical trial (2 weeks of intervention plus 10 weeks of observational follow-up). A total of 25 patients with radiculopathy were collected, and data was analyzed during the treatment and recovery period.

INTERVENTIONS

Neck pain granules group: a package of oral neck pain granules after meals, three times a day, treatment for 2 weeks; neck pain granules combined with massage lifting technique, treatment group: use, massage lifting technique treatment, once every two days, normal take neck pain granules, treatment for 2 weeks. All cases were followed up for 2.5 months. Main Monitoring Indicators: Visual Analog Scale, Neck Dysfunction Index score, and Tanaka jiu (Tanaka Yasuhisa Cervical Spondylosis Symptom Scale) were recorded on time, and statistical statistics were made.

RESULT

The scores of VAS and NDI were significantly more effective in the neck pain granules combined with the tuina group than in the neck pain granules group, while the Tanaka Yasuhisa Cervical Spondylosis Symptom Scale was not significantly different between the two groups.

CONCLUSION

The treatment effect of neck pain granules combined with tuina was significantly better than that of traditional Chinese medicine alone.

Scientific knowledge graph and trend analysis of Tuina: A bibliometric analysis

OBJECTIVES

Tuina is an effective complementary and alternative therapy. However, no bibliometric analysis has explored the global research status and emerging trends of tuina. Therefore, our study aimed to provide a perspective on the current state and frontier trends in the field.

DESIGN

Bibliometric analysis SETTING: Tuina-related publications between January 1, 2003, and December 31, 2022, were obtained from the Web of Science Core Collection database.

MAIN OUTCOME MEASURES

The knowledge graph software CiteSpace and VOSViewer were used to quantitatively analyse annual trends in annual publication volume, journals, countries, institutions, authors, cited references, and keywords.

RESULTS

Overall, 1877 articles were obtained. Consequently, the number of annual publications in tuina gradually increased. China published the most articles (1402 articles, 58.01%), followed by the Chinese Academy of Sciences (110 articles, 2.57%). Original and review articles were the two main types of publications. Photonics Research ranked first (101 articles, 5.38%) as the most influential affiliate and productive journal. These articles come from 8423 authors, among whom Min Fang published the most publications, and Ernst E was co-cited most often. According to the keyword co-occurrence analysis, the new research frontiers were meta-analyses.

CONCLUSION

This comprehensive bibliometric study analysed the publications on tuina and presented them visually, revealing new research trends, pivotal points, research hotspots, and frontiers. Prospective strategies and potential directions for further studies were also provided.

Efficacy of Combining Traditional Chinese Manual Therapy (Tuina) and Specific Therapeutic Neck Exercise in Young Adults with Non-Specific Chronic Neck Pain: Study Protocol for a Randomized Controlled Trial

Purpose

Non-specific chronic neck pain (NSCNP) is an increasingly common musculoskeletal disease and an important issue in the global healthcare system. Some studies have shown that the combination of manual therapy and exercise is effective in treating NSCNP but still with several limitations. Traditional Chinese manual therapy (tuina) is a Chinese manual therapy that consists of soft tissue manipulation and spinal manipulation. This study aims to design a randomized controlled trial to assess the effect of a tuina combined with specific therapeutic neck exercise modified protocol for NSCNP patients.

Patients and Methods

This is a study protocol for a randomized, participant-, assessor- and analyst-blinded controlled trial. Eighty-eight eligible NSCNP patients will be randomly allocated into tuina combined with specific therapeutic neck exercise group (TSTE group) and tuina combined with sham therapeutic neck exercise group (TS group) in a ratio of 1:1. All participants will receive 8 treatment sessions applied in 4 weeks and then be followed up for another 12 weeks. Clinical data will be collected at baseline, during treatment phase (at the 2- and 4-week) and at the 8-, 12-, 16-week follow-ups. The primary outcome is the changes in neck pain intensity (visual analogue scale). The secondary outcomes include neck disability (Neck Disability Index), cervical range of motion (ROM), neck muscle endurance, cervical muscle cross-sectional area, cervical curvature and analgesic consumption. Adverse events will be collected and recorded throughout the study.

Conclusion

We will discuss whether our tuina combined with specific therapeutic neck exercise modified protocol is more effective at improving pericervical muscle endurance, ROM, cervical muscle cross-sectional area and cervical curvature than tuina alone, thereby decreases neck pain and disability in individuals with NSCNP more effectively.

Trial Registration

Chinese Clinical Trials Registry, ChiCTR2300067903. Registered on 31 January 2023.

Resting-state functional magnetic resonance imaging reveals brain remodeling after Tuina therapy in neuropathic pain model

Tuina, a method of traditional Chinese manual manipulation, is an effective alternative therapy for neuropathic pain (NP), but its analgesic mechanism remains unclear. In this study, we used resting-state functional magnetic resonance imaging (R-fMRI) to explore the analgesic mechanism of Tuina in an NP rat model. After undergoing surgery to induce chronic compression of the dorsal root ganglion (CCD), one group of rats underwent Tuina at the ipsilateral BL40 acupoint once a day for 10 min during the 25 days following surgery while another group did not. Behavioral tests were performed at baseline, on the third day following surgery, and once a week for the next 4 weeks. R-fMRI was performed at baseline and 7 days and 28 days following surgery. Behavioral testing revealed that the Tuina group presented a significant response improvement to mechanical and thermal nociception stimuli compared to the untreated group 2 weeks following CCD surgery. Interestingly, rats submitted to Tuina presented higher measures of spontaneous neuronal activity in basal forebrain region, primary somatosensory cortex barrel field, dentate gyrus, secondary somatosensory cortex, striatum, descending corticofugal pathways, and globus pallidum of the left hemisphere 4 weeks after the CCD surgery compared to rats having undergone CCD only. In addition, on the 28th day, the ALFF signals of the left dentate gyrus, left secondary somatosensory cortex, left striatum, and bilateral primary cingulate cortex were significantly increased while those in the right dentate gyrus and bilateral periaqueductal gray were significantly decreased compared to those on the 7th day. Correlation analysis showed that the ALFF values of the left descending corticofugal pathways and globus pallidum had a positive correlation with mechanical withdrawal threshold and paw withdrawal thermal latency tests. Altogether, these results indicate that NPP induced by CCD surgery affects the plasticity of the cerebral cortex, and that Tuina alleviate pain behavior by promoting cortical remodeling.

Bibliometric Analysis of Research Trends on Tuina Manipulation for Neck Pain Treatment Over the Past 10 Years

Tuina is an effective treatment for neck pain (NP). However, there has been no bibliometric analysis of the global application and emerging trends of tuina performed for NP. Therefore, this study aimed to provide an overview of the current state and future trends in the field. Articles about tuina for NP, published from January 1, 2013, to January 1, 2023, were searched in the Web of Science Core Collection database. CiteSpace (6.1.R6) and VOSviewer (1.6.18) software were used to analyze annual trends in literature posts, countries, institutions, authors, cited references, and knowledge graphs of keyword co-occurrence, clustering, and burst using standard bibliometric indicators. The final analysis comprised 505 valid documents. The results demonstrate that the number of articles in the field of tuina therapy for NP has gradually increased over the years, showing the most active countries, institutions, journals, and authors. There were 323 keywords in the field, 322 research authors, and 292 research institutions, with the USA having the most publications (n = 140). The most published institution is Vrije University Amsterdam, and the most published journal is the Cochrane Database of Systematic Reviews. Peter R Blanpied is the most influential and most-cited author. Interventions (dry needling, massage therapy, and muscle energy techniques), common treatment sites for NP (upper trapezius), and complications (cervicogenic headache) are the top three frontiers mentioned in the field of tuina research for NP. The bibliometric study showed the current status and trends in clinical research on treating patients with NP using tuina, which may help researchers identify topics of interest and scope for future research in this field.