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Wareham DM, Fuller JT, Douglas TJ, Han CS, Hancock MJ. Swimming for low back pain: A scoping review. Musculoskelet Sci Pract 2024; 71:102926. [PMID: 38522227 DOI: 10.1016/j.msksp.2024.102926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/01/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Guidelines recommend exercise for treatment of chronic low back pain and prevention, but the amount and quality of evidence for different exercise modes is highly variable. Swimming is commonly recommended by health professionals, but the extent and quality of research supporting its relationship with back pain is not clear. OBJECTIVES The aim of this scoping review was to map the extent, characteristics and findings of research investigating the relationship between swimming and low back pain. DESIGN Scoping review. METHOD Four electronic databases (MEDLINE, EMBASE, CINAHL, and SPORT Discus) were searched from inception to February 2023. We included primary studies and reviews that reported an association between swimming and low back pain. Hydrotherapy studies were excluded. RESULTS 3093 articles were identified, and 44 studies included. Only one randomised controlled trial and one longitudinal cohort study were included. Most studies were cross-sectional (37/44; 84.1%), included competitive athletes (23/39; 59.0%), and did not primarily focus on the association between swimming and low back pain in the aims (41/44; 93.2%). Instead, most data available were largely incidentally collected or a secondary outcome. The reported associations between swimming and low back pain were highly variable regardless of whether the comparison was to other sports (odds ratio: 0.17 to 17.92) or no sport (odds ratio: 0.54 to 3.01). CONCLUSION Most available literature investigating swimming and low back pain is cross-sectional in design. We did not identify any clear pattern of association between swimming and low back pain, based on the available literature.
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Affiliation(s)
- Deborah M Wareham
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park 2109, NSW, Australia.
| | - Joel T Fuller
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park 2109, NSW, Australia.
| | - Tayla J Douglas
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park 2109, NSW, Australia.
| | - Christopher S Han
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
| | - Mark J Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park 2109, NSW, Australia.
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Rossi R, Cutter CJ, Beitel M, Covelli M, Fiellin DA, Kerns RD, Vassilieva S, Olabisi D, Barry DT. Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241245095. [PMID: 38606900 DOI: 10.1177/29767342241245095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Many patients who receive treatment for opioid use disorder (OUD) report experiencing chronic pain (CP), which is associated with high levels of ongoing nonmedical opioid use and low retention in OUD treatment. In pilot studies of patients with OUD receiving buprenorphine or methadone who had CP, cognitive behavioral therapy (CBT) attenuated nonmedical opioid use compared with treatment-as-usual (TAU), but patients in both treatment arms exhibited similar pain improvements. Adding exercise and stress reduction to this model may augment pain-related outcomes. With funding from National Institutes of Health, we plan to conduct a randomized clinical trial of 316 patients with OUD and CP to test the effectiveness of TAU compared with Stepped Care for Patients to Optimize Whole Recovery (SC-POWR) to reduce nonmedical opioid use and pain (primary outcomes) (Aim 1) and decrease pain intensity and interference, alcohol use, anxiety, depression and stress, and improve sleep (secondary outcomes) (Aim 2). Eligible participants will be randomized to receive TAU (buprenorphine or methadone and at least once a month individual or group counseling) or SC-POWR (ie, TAU and up to 12 CBT sessions) for 24 weeks. Based on prespecified nonresponse criteria, SC-POWR may be stepped up at week 6 to receive onsite weekly group sessions of exercise (Wii Fit, Tai Chi) and "stepped up" again at week 15 to receive weekly group sessions of stress reduction (relaxation training, auricular acupuncture). They will be followed for another 24 weeks to evaluate durability of treatment response for illicit opioid use, alcohol use, pain, anxiety, depression, stress, sleep, and retention in medications for OUD (Aim 3).
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Affiliation(s)
- Raiza Rossi
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Christopher J Cutter
- Yale Child Study Center, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | | | - David A Fiellin
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Robert D Kerns
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Svetlana Vassilieva
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Declan T Barry
- Yale Child Study Center, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- APT Foundation, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Oakes H, de Vivo M, Mills H, Stephensen D. Recommending swimming to people with low back pain: A scoping review. J Bodyw Mov Ther 2023; 36:274-281. [PMID: 37949572 DOI: 10.1016/j.jbmt.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/12/2023] [Accepted: 05/25/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND It is common practice for health professionals to recommend swimming to people with low back pain (LBP) despite limited evidence. The aim of this review was to gain an understanding of the current evidence base supporting the recommendation of swimming to people with LBP. METHODS A scoping review was conducted searching five electronic databases, CINAHL, MEDLINE, PEDro, PubMed, and SPORTdiscus using the keywords back pain AND swim*. The studies were grouped by study design and the following uncertainties were considered; the impact of swimming on the spine and LBP, evidence of swimming increasing or reducing the risk of LBP and the use of swimming in LBP rehabilitation programmes. RESULTS 25 studies met the eligibility criteria; including sixteen observational studies exploring the relationship between swimming and LBP, three biomechanical studies investigating the impact of swimming on the spine, and five interventional studies of which four integrated swimming into a rehabilitation programme and one used swimming to modify lumbar lordosis. CONCLUSION The review confirmed there is limited research and only low-level evidence to support the recommendation of swimming to people with LBP. Observational studies make up the greater proportion of research undertaken in the field; the data indicates that swimming is a low-risk form of exercise but not without risk. The findings from biomechanical research suggest that lumbar lordosis does not increase excessively when swimming breaststroke, but certain swimming techniques could negatively impact LBP and interventional trials illustrate that there are various ways to integrate swimming into a rehabilitation programme.
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Affiliation(s)
- Helen Oakes
- Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1QU, United Kingdom; East Kent Hospitals University NHS Foundation Trust, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent, CT1 3NG, United Kingdom.
| | - Marlize de Vivo
- Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1QU, United Kingdom.
| | - Hayley Mills
- Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1QU, United Kingdom.
| | - David Stephensen
- East Kent Hospitals University NHS Foundation Trust, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent, CT1 3NG, United Kingdom.
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Yang H, Wang X, Wang X, Yang J, Zhang W, Ding Y, Sang T, Chen W, Wang W. Effect of mindfulness-based mind-body therapies in patients with non-specific low back pain-A network meta-analysis of randomized controlled trials. Front Aging Neurosci 2023; 15:1148048. [PMID: 37455934 PMCID: PMC10340124 DOI: 10.3389/fnagi.2023.1148048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Background/objectives Although mindfulness-based mind-body therapy (MBMBT) is an effective non-surgical treatment for patients with non-specific low back pain (NLBP), the best MBMBT mode of treatment for NLBP patients has not been identified. Therefore, a network meta-analysis (NMA) was conducted to compare the effects of different MBMBTs in the treatment of NLBP patients. Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for randomized controlled trials (RCTs) applying MBMBT for the treatment of NLBP patients, with all of the searches ranging from the time of database creation to January 2023. After 2 researchers independently screened the literature, extracted information, and evaluated the risks of biases in the included studies, the data were analyzed by using Stata 16.0 software. Results A total of 46 RCTs were included, including 3,886 NLBP patients and 9 MBMBT (Yoga, Ayurvedic Massage, Pilates, Craniosacral Therapy, Meditation, Meditation + Yoga, Qigong, Tai Chi, and Dance). The results of the NMA showed that Craniosacral Therapy [surface under the cumulative ranking (SUCRA): 99.2 and 99.5%] ranked the highest in terms of improving pain and disability, followed by Other Manipulations (SUCRA: 80.6 and 90.8%) and Pilates (SUCRA: 54.5 and 71.2%). In terms of improving physical health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Pilates (SUCRA: 72.3%) and Meditation (SUCRA: 55.9%). In terms of improving mental health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Meditation (SUCRA: 70.7%) and Pilates (SUCRA: 63.2%). However, in terms of improving pain, physical health, and mental health, Usual Care (SUCRA: 7.0, 14.2, and 11.8%, respectively) ranked lowest. Moreover, in terms of improving disability, Dance (SUCRA: 11.3%) ranked lowest. Conclusion This NMA shows that Craniosacral Therapy may be the most effective MBMBT in treating NLBP patients and deserves to be promoted for clinical use. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, PROSPERO [CRD42023389369].
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Affiliation(s)
- Huanying Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiangfu Wang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Xuetao Wang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jianxia Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Wanqian Zhang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Yanfang Ding
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Tingrui Sang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Weiguo Chen
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Wanhong Wang
- Department of Traditional Chinese Nursing, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
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Roren A, Daste C, Coleman M, Rannou F, Freyssenet D, Moro C, Lefèvre-Colau MM, Nguyen C. Physical activity and low back pain: A critical narrative review. Ann Phys Rehabil Med 2022; 66:101650. [PMID: 35240326 DOI: 10.1016/j.rehab.2022.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/05/2022] [Accepted: 02/10/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Non-specific low back pain (LBP) is the leading cause of years lived with disability worldwide. Physical activity is an integral part of LBP treatment. OBJECTIVE To critically review available evidence regarding the efficacy of physical activity for people with LBP. METHODS Up to date critical narrative review of the efficacy of physical activity for the managment LBP. The process of article selection was unsystematic; articles were selected based on authors' expertise, self-knowledge and reflective practice. RESULTS Therapeutic physical activity for LBP includes a wide range of non-specific and specific activities. The efficacy of physical activity on pain and activity limitations has been widely assessed. In acute and subacute LBP, exercise did not reduce pain compared to no exercise. In chronic low back pain (CLBP), exercise reduced pain at the earliest follow-up compared with no exercise. In a recent systematic review, exercise improved function both at the end of treatment and in the long-term compared with usual care. Exercice also reduced work disability in the long-term. We were unable to establish a clear hierarchy between different exercise modalities. Multidisciplinary functional programs consistently improved pain and function in the short- and long-term compared with usual care and physiotherapy and improved the long-term likelihood of returning to work compared to non-multidisciplinary programs. CONCLUSION Physical activity of all types is an effective treatment for CLBP.
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Affiliation(s)
- Alexandra Roren
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité, ECaMO Team, Paris 75004, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France.
| | - Camille Daste
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France
| | - Marvin Coleman
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Laboratoire de l'Institut des Sciences du Sport-Santé de Paris, URP 3625, Université Paris Cité, Paris, France
| | - François Rannou
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Faculté des Sciences Fondamentales et Biomédicales, Université Paris Cité, Sorbonne Paris Cité, Paris 75006, France
| | - Damien Freyssenet
- Laboratoire Inter-universitaire de biologie de la motricité (LIBM), EA 7424, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Cedric Moro
- Inserm/UPS UMR1297, Université Paul Sabatier, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Equipe MetaDiab, Toulouse, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité, ECaMO Team, Paris 75004, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France
| | - Christelle Nguyen
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Faculté des Sciences Fondamentales et Biomédicales, Université Paris Cité, Sorbonne Paris Cité, Paris 75006, France
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Wan R, Shi J, Hu K, Wang Y, Jiang X, Yan W, Cao M, Wang Y. Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: study protocol for a randomised controlled trial. Trials 2022; 23:951. [PMID: 36414978 PMCID: PMC9682833 DOI: 10.1186/s13063-022-06909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tai Chi (TC), as one of mild to moderate exercise therapies specifically recommended by clinical practice guideline from the American College of Physician, is a viable option for chronic non-specific low back pain (CNLBP) treatment. Nevertheless, limited studies focused on the effect of different weekly frequencies of TC in elders with CNLBP. This superiority study aims to compare the differences of TC with different weekly frequencies in elders with CNLBP on the premise of proving its effectiveness, and identifying whether mindfulness mediates the effect of TC on treatment outcomes. METHODS In total, 284 senior citizens with CNLBP will be recruited in this single-centre, randomised, single-blinded (outcome assessors, data managers and the statistician), parallel controlled trial. Participants will be randomly divided into either one of three TC groups (1, 3, or 5 sessions/week, on the basis of weekly health educational lectures) or weekly health educational lectures, sustaining for 12 weeks, followed by 12 weeks of follow-up after the end of intervention. The primary outcome (the changes of LBP intensity at rest) will be measured at baseline before randomisation and immediately after the completion of weeks 4, 8 and 12 of the intervention, and the end of follow-up (week 24) using the visual analogue scale (VAS, 0-10 cm) to put a mark on the VAS scale to show how severities of their average low back pain have been over the past 24 h. Secondary outcomes, including Beck Depression Inventory-II, Pain Catastrophising Scale and Five Facet Mindfulness Questionnaire, Oswestry Disability Index and Short Form-36, will be measured at baseline and immediately after the completion of week 12 of the intervention and end of follow-up. The intention-to-treat and per-protocol principles will be used to analyse outcomes with a setting at α = 0.05 as statistical significance. DISCUSSION This comprehensive and detailed protocol will be the first trial to compare the effectiveness of different weekly frequencies of TC in elders with CNLBP. The outcomes may provide valuable data about the choice of the ideal number of sessions to further normalise the application of exercise for clinicians. TRIAL REGISTRATION Chinese clinical trial registry ChiCTR2200058190 . Registered on 1 April 2022.
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Affiliation(s)
- Ruihan Wan
- grid.411504.50000 0004 1790 1622College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China ,grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
| | - Jian Shi
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.443556.50000 0001 1822 1192College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Kun Hu
- grid.443556.50000 0001 1822 1192College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Yafei Wang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
| | - Xue Jiang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.412543.50000 0001 0033 4148Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Wangwang Yan
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China ,grid.412543.50000 0001 0033 4148Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Mali Cao
- Department of Rehabilitation, Changsha Social Work College, Changsha, China
| | - Yuling Wang
- grid.488525.6Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655 China
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Yeh CH, Kawi J, Grant L, Huang X, Wu H, Hardwicke RL, Christo PJ. Self-Guided Smartphone Application to Manage Chronic Musculoskeletal Pain: A Randomized, Controlled Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14875. [PMID: 36429591 PMCID: PMC9691217 DOI: 10.3390/ijerph192214875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The goal of this study is to evaluate the feasibility and efficacy of an auricular point acupressure smartphone app (mAPA) to self-manage chronic musculoskeletal pain. METHODS A prospective, longitudinal, randomized, controlled pilot trial was conducted using a three-group design (self-guided mAPA (n = 14); in-person mAPA (n = 12); and control (n = 11)). The primary outcomes included physical function and pain intensity. RESULTS After a 4-week APA intervention, participants in the in-person mAPA group had improved physical function of 32% immediately post-intervention and 29% at the 1M follow-up. Participants in the self-guided mAPA group had higher improvement (42% at post-intervention and 48% at the 1M follow-up). Both mAPA groups had similar degrees of pain intensity relief at post-intervention (45% for in-person and 48% for the self-guided group) and the 1M follow-up (42% for in-person and 45% for the self-guided group). Over 50% of the participants in each group reached at least 30% reduced pain intensity at post-intervention, and this was sustained in the mAPA groups at the 1M follow-up. Approximately 80% of the participants in both mAPA groups were satisfied with the treatment outcomes and adhered to the suggested APA practice; however, participants in the self-guided group had higher duration and more frequency in APA use. The attrition rate was 16% at the 1M follow-up. No adverse effects of APA were reported, and participants found APA to be beneficial and the app to be valuable. CONCLUSIONS The study findings indicate that participants effectively learned APA using a smartphone app, whether they were self-guided or received in-person training. They were able to self-administer APA to successfully manage their pain. Participants found APA to be valuable in their pain self-management and expressed satisfaction with the intervention using the app.
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Affiliation(s)
- Chao Hsing Yeh
- Cizik School of Nursing at UTHealth, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Jennifer Kawi
- School of Nursing, University of Nevada, Las Vegas, NV 89154, USA
| | - Lauren Grant
- School of Nursing, University of Nevada, Las Vegas, NV 89154, USA
| | - Xinran Huang
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Hulin Wu
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Robin L. Hardwicke
- McGovern School of Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Paul J. Christo
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
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Wang XQ, Xiong HY, Du SH, Yang QH, Hu L. The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review. Front Aging Neurosci 2022; 14:935925. [PMID: 36299610 PMCID: PMC9590689 DOI: 10.3389/fnagi.2022.935925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Increasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP. Methods A systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability. Results A total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality). Conclusion The neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.
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Affiliation(s)
- Xue-Qiang Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Huan-Yu Xiong
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Li Hu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Zhou X, Kong L, Ren J, Song P, Wu Z, He T, Lv Z, Zhang S, Sun W, Zhang J, Cai J, Zhu Q, Fang M. Effect of traditional Chinese exercise combined with massage on pain and disability in patients with lumbar disc herniation: A multi-center, randomized, controlled, assessor-blinded clinical trial. Front Neurol 2022; 13:952346. [PMID: 36158965 PMCID: PMC9490580 DOI: 10.3389/fneur.2022.952346] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Herniation of the nucleus pulposus caused by disc degeneration and other reasons can cause low back pain and disability. In China, traditional Chinese exercises (TCEs) and traditional Chinese massage (TCM) are widely used to improve symptoms of pain and disability in patients with lumbar disc herniation (LDH). The safety and efficacy of combination therapy have not been studied. Objectives To assess the effect of traditional Chinese exercise combined with massage vs. traditional Chinese massage alone on pain, disability, lumbar mobility and gait performance in patients with LDH. Methods Multi-center, randomized clinical trial conducted at 4 hospitals in China and enrolling 272 patients with LDH. Participants were randomly assigned to TCEs plus TCM group or TCM alone group. The combined therapy group received 18 Tai Chi training sessions (30-min sessions 3 times a week) and regular TCM treatments over 6 weeks. The control group received TCM therapy alone and was instructed to maintain their usual daily physical activity. Outcome variables measured included Visual Analog Scale (VAS), Short Form of McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI), lumbar spine range of motion (ROM) and gait performance. Results Among the 272 randomized participants, 259 completed the study. The mean VAS score was 51.77 mm at baseline in the TCEs plus TCM group, and 50.93 mm for the TCM alone group. The reduction in the VAS score at week 6 was greater in the TC group than in the TCM group with a mean difference of 4.05 (95% CI, 2.15-5.95; P < 0.001), and the ODI score with between-group differences of 3.57 points (95% CI, 2.84-4.30 points; P < 0.001). Similar significantly different results were observed in SF-MPQ, walking speed, cadence, and lumbar ROM. No serious adverse events were reported throughout the study period. Conclusion Compared with TCM alone, TCEs combined with TCM treatment performed better in reducing pain and improving disability. The combination therapy could be considered a valuable treatment option for LDH patients, with potential therapeutic utility for middle-aged and elderly patients with LDH.
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Affiliation(s)
- Xin Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Jun Ren
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pengfei Song
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiwei Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Tianxiang He
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhizhen Lv
- The Third Clinical School of Medicine, Zhejiang University of Traditional Chinese Medicine, Zhejiang, China
| | - Shuaipan Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wuquan Sun
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiafu Zhang
- Shanghai First People's Hospital, Shanghai, China
| | - Junhao Cai
- Shanghai Traditional Chinese Medicine Hospital, Shanghai, China
| | - Qingguang Zhu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther 2022; 52:505-521. [PMID: 35722759 DOI: 10.2519/jospt.2022.10671] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine which type of exercise is best for reducing pain and disability in adults with chronic low back pain (LBP). DESIGN Systematic review with a network meta-analysis (NMA) of randomized controlled trials (RCTs). LITERATURE SEARCH Six electronic databases were systematically searched from inception to July 2021. STUDY SELECTION CRITERIA RCTs testing the effects of exercise on reducing self-perceived pain or disability in adults (aged 18-65 years) with chronic LBP. DATA SYNTHESIS We followed the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, incorporating NMAs of health care interventions) statement when reporting our NMA. A frequentist NMA was conducted. The probability of each intervention being the most effective was conducted according to surface under the cumulative ranking curve (SUCRA) values. RESULTS We included 118 trials (9710 participants). There were 28 head-to-head comparisons, 7 indirect comparisons for pain, and 8 indirect comparisons for disability. Compared with control, all types of physical exercises were effective for improving pain and disability, except for stretching exercises (for reducing pain) and the McKenzie method (for reducing disability). The most effective interventions for reducing pain were Pilates, mind-body, and core-based exercises. The most effective interventions for reducing disability were Pilates, strength, and core-based exercises. On SUCRA analysis, Pilates had the highest likelihood for reducing pain (93%) and disability (98%). CONCLUSION Although most exercise interventions had benefits for managing pain and disability in chronic LBP, the most beneficial programs were those that included (1) at least 1 to 2 sessions per week of Pilates or strength exercises; (2) sessions of less than 60 minutes of core-based, strength, or mind-body exercises; and (3) training programs from 3 to 9 weeks of Pilates and core-based exercises. J Orthop Sports Phys Ther 2022;52(8):505-521. Epub: 19 June 2022. doi:10.2519/jospt.2022.10671.
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Wang R, Zhu D, Wang L, Liu J, Zou J, Sun Y, Jiang Y, Hu HY, Deng ZW, Weng LM, Zheng KY, Kiartivich S, Wang XQ. Tai Chi Quan Versus Physical Therapy on Pain and Cognitive Performance for Elderly People With Chronic Low Back Pain: Study Protocol for a Randomized Controlled Trial. Front Aging Neurosci 2022; 14:900430. [PMID: 35783144 PMCID: PMC9243751 DOI: 10.3389/fnagi.2022.900430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesChronic low back pain has become a major cause of global disability and caused a huge economic burden to society. Physical therapy is a vital strategy for rehabilitation of chronic low back pain. Although several trials have shown that Tai Chi Quan is a beneficial treatment, the comparative effectiveness of Tai Chi Quan versus physical therapy is unknown. We are conducting a randomized controlled trial to assess the effectiveness of Tai Chi Quan versus that of physical therapy in treating chronic low back pain.MethodsWe will perform a single-blind randomized controlled trial on elderly people with chronic low back pain. 138 participants will be randomly assigned to the Tai Chi Quan group (60-min classes, three times per week for 12 weeks) or physical therapy group (10 min of evaluation and warm-up, 40 min of therapist-directed exercise therapy, and 10 min of relaxation, three times per week for 12 weeks) with an allocation of 1:1. The participants will be followed up for 40 weeks for the study of long-term effects. The primary outcomes include pain intensity and back-related function at 12 weeks. Secondary outcomes include lumbar quantitative sensory testing, balance, cognitive function, psychosocial function, cost-effectiveness, compliance and adverse events. We will perform the intention-to-treat analysis for withdrawal and missing data.DiscussionThe study will be the first randomized trial with comparative-effectiveness of Tai Chi Quan and physical therapy for chronic low back pain. Standardized protocol, large sample size, and comprehensive outcomes are important features in this trial. This study aims to determine the feasibility and effectiveness of Tai Chi Quan for low back pain. The results of this study will be beneficial for elderly people with low back pain and medical rehabilitation personnel.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR2000029723.
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Affiliation(s)
- Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Dong Zhu
- School of International Education, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Jing Liu
- Department of Martial Arts, Shanghai University of Sport, Shanghai, China
| | - Jun Zou
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yang Sun
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yan Jiang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hao-Yu Hu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Zhi-Wei Deng
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Lin-Man Weng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Kang-Yong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Suparata Kiartivich
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Xue-Qiang Wang,
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Walking, Cycling, and Swimming for Nonspecific Low Back Pain: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2022; 52:85-99. [PMID: 34783263 DOI: 10.2519/jospt.2022.10612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the effectiveness of walking/running, cycling, or swimming for treating or preventing nonspecific low back pain (LBP). DESIGN Intervention systematic review. LITERATURE SEARCH Five databases were searched to April 2021. STUDY SELECTION CRITERIA Randomized controlled trials evaluating walking/running, cycling, or swimming to treat or prevent LBP were included. DATA SYNTHESIS We calculated standardized mean differences (SMDs) and 95% confidence intervals (CIs). Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS No trials assessed LBP prevention or addressed acute LBP. Nineteen trials (2362 participants) assessed treatment of chronic/recurrent LBP. Low-certainty evidence suggests that walking/running was less effective than alternate interventions in reducing pain in the short term (8 trials; SMD, 0.81; 95% CI: 0.28, 1.34) and medium term (5 trials; SMD, 0.80; 95% CI: 0.10, 1.49). High-certainty evidence suggests that walking/running was less effective than alternate interventions at reducing disability in the short term (8 trials; SMD, 0.22; 95% CI: 0.06, 0.38) and medium term (4 trials; SMD, 0.28; 95% CI: 0.05, 0.51). There was high-certainty evidence of a small effect in favor of walking/running compared to minimal/no intervention for reducing pain in the short term (10 trials; SMD, -0.23; 95% CI: -0.35, -0.10) and medium term (6 trials; SMD, -0.26; 95% CI: -0.40, -0.13) and disability in the short term (7 trials; SMD, -0.19; 95% CI: -0.33, -0.06). Scarcity of trials meant few conclusions could be drawn regarding cycling and swimming. CONCLUSION Although less effective than alternate interventions, walking/running was slightly more effective than minimal/no intervention for treating chronic/recurrent LBP. J Orthop Sports Phys Ther 2022;52(2):85-99. Epub 16 Nov 2021. doi:10.2519/jospt.2022.10612.
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Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Therapeutic Effects of Traditional Chinese Exercises on Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Pain Res Manag 2021; 2021:5584997. [PMID: 34055119 PMCID: PMC8131159 DOI: 10.1155/2021/5584997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/23/2021] [Indexed: 01/03/2023]
Abstract
Background The number of patients with musculoskeletal pain, which seriously affects people's quality of life, has increased. Traditional Chinese exercises are accepted and practiced to strengthen the body. Objective This study aims to explore the efficacy of traditional Chinese exercises for the treatment of musculoskeletal pain. Methods A comprehensive search of randomized controlled trials (RCTs) related to traditional Chinese exercises on patients with musculoskeletal pain was completed using PubMed, SinoMed, CNKI, VIP, and Wanfang Med Online databases. All RCTs published until February 2021 were considered. Two researchers independently screened the literature according to the predesigned inclusion and exclusion criteria, and data was extracted and assessed for their risk of bias via the Cochrane collaboration tool. Meta-analysis was performed using RevMan5.2 and Rx64 4.0.2 software. Results A total of 45 RCT studies with 3178 patients were included. Traditional Chinese exercises were able to effectively alleviate patients with musculoskeletal pain (MD = −1.54, 95% confidence interval (−1.88, −1.19), P < 0.01). Among them, the Yi Jin Jing exercise was superior to other exercises, while Wu Qin Xi showed no significant effects. Besides, traditional Chinese exercises had significant positive effects on the dysfunction and stiffness of the waist and knee joints. Traditional Chinese exercises could effectively relieve the clinical symptoms of patients with musculoskeletal pain. Particularly, the Yi Jin Jing exercise presented the most significant positive effect on pain reduction.
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Kawi J, Yeh CH, Li M, Caswell, BS K, Mazraani, MD M, Lukkahatai, PhD, RN N, Mensah, RN S, Taylor J, Budhathoki C, Christo P. Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial. Glob Adv Health Med 2021; 10:2164956120987531. [PMID: 33623727 PMCID: PMC7876936 DOI: 10.1177/2164956120987531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/14/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal pain (CMP) is the most common self-reported chronic pain condition. Current treatment for CMP is limited. METHODS This was a two-phase study. In Phase 1, three auricular point acupressure (APA)-naïve participants were recruited to explore their experiences of APA and a smartphone app was developed based on their feedback. In Phase 2, a prospective longitudinal study was used to examine the effectiveness of the smartphone app to self-manage CMP. RESULTS Phase 1 resulted in the successful development of the APA smartphone app. In Phase 2, after four weeks of APA, participants reported reduced pain intensity (30%), pain interference (35%), and disability (40%), as well as improved physical function (47%). The mean score for the participants' perception of treatment efficacy was 4.94 (SD = 2.08, scale of 0-7) indicating that approximately 70% of participants rated global improvements with noticeable changes. The majority (88%, n = 22) of the participants were satisfied with the treatment: 32% [8] were very satisfied and 56% [n = 14] were somewhat satisfied. The average frequency of pressing APA seeds per day was 2.93 times (SD = 2.27, range 0-10) and 1.60 minutes per time (SD = 2.64, range 0-10); the participants were able to adhere to the suggested pressing time per day, although they only pressed the ear points about 53% of the suggested time. CONCLUSION It is feasible for individuals to learn APA from the smartphone app and successfully self-administer APA to manage their pain. Participants found the app useful and were satisfied with the information provided through the app.
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Affiliation(s)
- Jennifer Kawi
- School of Nursing, University of Nevada, Las Vegas, Las Vegas,
Nevada
| | - Chao Hsing Yeh
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Mengchi Li
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Keenan Caswell, BS
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | | | | | - Sylvanus Mensah, RN
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Janiece Taylor
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Paul Christo
- School of Medicine, Johns Hopkins University School of Medicine,
Baltimore, Maryland
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Urits I, Schwartz RH, Orhurhu V, Maganty NV, Reilly BT, Patel PM, Wie C, Kaye AD, Mancuso KF, Kaye AJ, Viswanath O. A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care. Adv Ther 2021; 38:76-89. [PMID: 33184777 PMCID: PMC7854390 DOI: 10.1007/s12325-020-01554-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Non-pharmacologic alternative therapies for pain have been around for a long time, some for hundreds of years. They have been used throughout history to treat many issues. RECENT FINDINGS Currently, alternative medicine is most frequently used to treat musculoskeletal pain, and between 59 and 90% of patients utilizing alternative therapies for chronic pain claimed they were helpful and can serve as an effective adjunctive for the treatment of chronic pain. Some examples of alternative therapies that will be discussed in this review include acupuncture, tai chi, osteopathic manipulation, and chiropractic care. Acupuncture, traditionally a Chinese practice, is becoming more popular across the world to attempt to relieve pain. It involves the placement of thin needles at various points in the body. The efficacy of acupuncture for pain is heavily debated. More research and discussion are necessary to determine the exact role it plays in the treatment of chronic pain. Tai chi is also a traditional Chinese practice that is often used as a form of meditation and for potential health benefits. Tai chi involves a series of complex movements such as squatting combined with deep breathing to achieve relaxation and pain reduction. Osteopathic manipulative treatment (OMT) is a technique used by both osteopathic physicians (DO) as well as other health professionals to manage a wide range of conditions in any given patient. The technique involves utilization and manipulation of the musculoskeletal system to achieve potential health benefits. OMT has been used as therapy for many issues but is commonly used for pain conditions. Alternative therapies may serve as an effective adjunctive treatment modality for the management of chronic pain conditions. There has been a tremendous amount of research dictating the effectiveness of alternative therapies for chronic pain management. The purpose of this review is to provide a comprehensive evidence-based update of alternative therapy used for the management of chronic pain conditions.
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Nduwimana I, Nindorera F, Thonnard JL, Kossi O. Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials. Medicine (Baltimore) 2020; 99:e21969. [PMID: 32871946 PMCID: PMC7458239 DOI: 10.1097/md.0000000000021969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP. METHODS We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects. RESULTS Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD) = -0.34; 95% CI, -0.65 to -0.03; P = .03) and activity limitation (SMD = -0.30; 95% CI, -0.50 to -0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = -1.47; 95% CI, -2.26 to -0.68; P = .0003) and activity limitation (SMD = -1.17; 95% CI, -1.80 to -0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up. CONCLUSION MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.
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Affiliation(s)
- Ildephonse Nduwimana
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Félix Nindorera
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Jean Louis Thonnard
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Oyene Kossi
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Rehabilitation, University Hospital of Parakou
- National School of Public Health and Epidemiology, University of Parakou, Parakou, Bénin
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[Pain treatment in old age: special features and recommendations]. Z Gerontol Geriatr 2020; 54:605-610. [PMID: 32681466 DOI: 10.1007/s00391-020-01766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND For geriatric patients with chronic pain, a comprehensive well-coordinated pain management is pivotal to ensure the best possible pain relief and to minimize as far as possible preventable negative side effects of treatment. OBJECTIVE Description of the difficulties in pain management of geriatric patients with respect to general basic rules that are worth paying attention to and presentation of pharmacological and non-pharmacological treatment options. METHODS This article describes the special features of pain management in older patients and gives recommendations on the use of analgesics and potential drug interactions in geriatric patients with organ dysfunction. Furthermore, individual substance groups are described with respect to their use in geriatric patients based on the recent literature. CONCLUSION The aim of an individualized pain treatment in older and multimorbid patients is the relief of pain to an appropriate level, preservation of mobility, self-reliance and autonomy of each individual. The ability to participate in social activities as well as improvement in the quality of life need to be the focus of pharmacological and non-pharmacological treatment.
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Lee TL, Sherman KJ, Hawkes RJ, Phelan EA, Turner JA. The Benefits of T'ai Chi for Older Adults with Chronic Back Pain: A Qualitative Study. J Altern Complement Med 2020; 26:456-462. [PMID: 32379976 DOI: 10.1089/acm.2019.0455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To determine the perceived benefits of t'ai chi in older adults with chronic low-back pain (cLBP). Design: A qualitative analysis from a randomized controlled feasibility trial. Subjects: Eighteen participants (65+ years old) with cLBP of at least moderate intensity. Intervention: A 36-week intervention beginning with twice weekly classes for 12 weeks, weekly classes for 6 weeks, biweekly classes for 6 weeks, and monthly classes for 12 weeks. Participants were asked to practice at home on nonclass days and videos were provided to assist in that process. Outcome Measures: Participants in the focus groups were asked to provide feedback on their experiences with the study as well as the benefits of their t'ai chi practice. We used demographic and class attendance data to describe the sample. Results: Regarding the benefits of t'ai chi practice, five major themes were identified: functional benefits, pain reduction/pain relief, psychospiritual benefits, the importance of social support in learning t'ai chi, and the integration of t'ai chi into daily activities. The most common functional benefits were improvements in balance, flexibility, leg strength, and posture. Some reported pain reduction or pain relief, but others did not. Increased relaxation, mindfulness, and a sense of connectedness were subthemes that emerged from psychospiritual benefits. Social support benefits included motivation to attend class and group support while learning a new skill. Finally, improved body awareness allowed participants to integrate t'ai chi skills into their daily activities. Conclusions: This qualitative analysis demonstrates the multifaceted benefits of t'ai chi for older adults living with cLBP.
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Affiliation(s)
- Tamsin L Lee
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Karen J Sherman
- Kaiser Permanente WA Health Research Institute, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Rene J Hawkes
- Kaiser Permanente WA Health Research Institute, Seattle, WA, USA
| | - Elizabeth A Phelan
- Department of Medicine and Health Services, University of Washington, Seattle, WA, USA
| | - Judith A Turner
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Qin J, Zhang Y, Wu L, He Z, Huang J, Tao J, Chen L. Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e17099. [PMID: 31517838 PMCID: PMC6750325 DOI: 10.1097/md.0000000000017099] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP). METHODS Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model. RESULTS The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = -1.27, 95%CI -1.50 to -1.04, P < .00001, I = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = -1.70, 95% CI -2.63 to -0.76, P = .0004, I = 89%); personal care (WMD = -1.93, 95% CI -2.86 to -1.00, P < .0001, I = 90%); lifting (WMD = -1.69, 95% CI -2.22 to -1.15, P < .0001, I = 66%); walking (WMD = -2.05, 95% CI -3.05 to -1.06, P < .0001, I = 88%); standing (WMD = -1.70, 95% CI -2.51 to -0.89, P < .0001, I = 84%); sleeping (WMD = -2.98, 95% CI -3.73 to -2.22, P < .00001, I = 80%); social life (WMD = -2.06, 95% CI -2.77 to -1.35, P < 0.00001, I = 80%) and traveling (WMD = -2.20, 95% CI -3.21 to -1.19, P < .0001, I = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59-8.86, P < .00001, I = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92-4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = -2.19, 95% CI -2.56 to -1.82, P < .00001). CONCLUSION We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.
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Affiliation(s)
- Jiawei Qin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou
| | - Yi Zhang
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou
| | - Lijian Wu
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou
| | - Zexiang He
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou
- Collaborative Innovation Center for Rehabilitation Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Gao C, Chen G, Yang H, Hua Z, Xu P, Wong M, He C. Relative effectiveness of different forms of exercises for treatment of chronic low back pain: protocol for a systematic review incorporating Bayesian network meta-analysis. BMJ Open 2019; 9:e025971. [PMID: 31217314 PMCID: PMC6588985 DOI: 10.1136/bmjopen-2018-025971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Exercise is considered as an effective intervention in the management of patients with chronic low back pain (cLBP). However, the relative effectiveness as well as the hierarchy of exercise interventions have not been well established, although various exercise options are available. Therefore, the present protocol proposes to conduct a network meta-analysis (NMA) aiming to evaluate the effectiveness of different forms of exercise for treatment of cLBP. METHODS AND ANALYSIS Medline, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Central Register of Controlled Trials, and the Physiotherapy Evidence Database will be searched to identify all randomised controlled trials that evaluate the effectiveness of exercise in the treatment of cLBP. There will be no restrictions on date or language. Two authors will screen the literature and extract data independently based on predesigned rules, and evaluate the risk of bias of included studies using the Cochrane Risk of Bias Tool. Disagreements will be resolved through discussion or consultation with a senior reviewer. The primary outcomes of this study will be pain relief and improvement in function or disability for all interventions. Traditional pairwise meta-analysis and Bayesian NMA will be conducted to compare the effectiveness of different exercise interventions. The ranking probabilities for all interventions will be estimated and the hierarchy of each intervention will be summarised as surface under the cumulative ranking curve. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument. ETHICS AND DISSEMINATION Ethical approval and informed consent are not required since this is a protocol for a meta-analysis with no confidential personal data to be collected. The results of this NMA will be submitted to a peer-reviewed journal for publication. PROSPERO REGISTRATION NUMBER CRD42018090576.
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Affiliation(s)
- Chengfei Gao
- Center of Rehabilitation Medicine, Sichuan University, Chengdu, China
- Biomedical Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
- Department of Physical Medicine and Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guanghui Chen
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Hui Yang
- Department of Physical Education, Qufu Normal University, Rizhao, China
| | - Zhen Hua
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Peng Xu
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Mansang Wong
- Biomedical Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chengqi He
- Center of Rehabilitation Medicine, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
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Liu J, Yeung A, Xiao T, Tian X, Kong Z, Zou L, Wang X. Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030517. [PMID: 30759778 PMCID: PMC6388249 DOI: 10.3390/ijerph16030517] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 12/17/2022]
Abstract
Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population.
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Affiliation(s)
- Jing Liu
- Department of Martial Arts, Shanghai University of Sport, Shanghai 200438, China.
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| | - Tao Xiao
- College of Mathematics and Statistics, Shenzhen University, Shenzhen 518060, China.
| | - Xiaopei Tian
- Department of Physical Education, Qiannan Normal University for Nationalities, Guizhou 558000, China.
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China.
| | - Liye Zou
- Lifestyle (Mind-Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China.
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai 200438, China.
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Matsuwaka ST, Liem BC. The Role of Exercise in Treatment of Lumbar Spinal Stenosis Symptoms. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2018. [DOI: 10.1007/s40141-018-0171-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: Updated Systematic Review and Meta-Analysis. Phys Ther 2017; 97:227-238. [PMID: 27634919 DOI: 10.2522/ptj.20160246] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/31/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tai chi is recommended for musculoskeletal conditions; however, the evidence for its clinical effectiveness is uncertain. PURPOSE The aim of this study was to determine whether tai chi is beneficial for clinical outcomes in people with musculoskeletal pain. DATA SOURCES Seven databases were searched: Embase, PEDro, AMED, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Central Register of Controlled Trials. STUDY SELECTION Randomized controlled trials of tai chi for people with a chronic musculoskeletal condition were included. DATA EXTRACTION Two reviewers extracted data and rated risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were calculated for individual trials and pooled effect sizes were calculated using a random-effects model. DATA SYNTHESIS Fifteen studies were identified; these studies included people with osteoarthritis (80%), back pain (13%), and headache (7%). Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach, moderate-quality evidence was found that tai chi was more effective than no treatment or usual care at short term on pain (SMD=-0.66 [95% CI=-0.85, -0.48]) and disability (SMD=-0.66 [95% CI=-0.85, -0.46]). The evidence for other outcomes was of low or very low quality and there was little information regarding long-term effects. Thus, although the number of publications in this area has increased, the rigor has not, hindering physical therapists' ability to provide reliable recommendations for clinical practice. LIMITATIONS The evidence provided in this review is limited by trials with small sample sizes, low methodological quality, and lack of long-term assessment. CONCLUSIONS In order for tai chi to be recommended as an effective intervention, more high-quality trials with large sample sizes assessing tai chi versus other evidence-based treatments at short term and at long term are needed.
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