PURPOSE: Traditional Chinese medicine possesses distinct advantages in the treatment of acute lumbar sprains, and Tuina (Chinese massage) is a commonly employed therapeutic method. This study employed a Bayesian meta-analysis to assess the efficacy and safety of Tuina therapy for acute lumbar sprain with the aim of providing more evidence-based medical substantiation for clinical practice.
PATIENTS AND METHODS: Randomized controlled trials of Tuina therapy for acute lumbar sprains published in CNKI, CSPD, CCD, CBM, PubMed, Embase, Cochrane Library, and Web of Science were searched up to August 7, 2024. The included studies were assessed for the risk of bias using Cochrane's randomized controlled trial bias risk assessment tool.
RESULTS: Eleven studies involving 810 patients were included in this meta-analysis. Two types of interventions were included: Tuina alone and Tuina combined with conventional treatment. The included studies had a low risk of bias. Three outcome indicators were analyzed. The results of the network meta-analysis showed that, compared with conventional treatment, Tuina alone or in combination with other interventions had a significant advantage in terms of efficacy (P < 0.05). The order of the surface under the cumulative ranking curve (SUCRA) was: Tuina (0.79) and Tuina combined with conventional treatment (0.70). Regarding the visual analog scale score, Tuina combined with the other interventions showed significant advantages (P < 0.05). The order of SUCRA was: Tuina combined with conventional treatment (0.80), followed by Tuina alone (0.64). Regarding the modified Japanese Orthopaedic Association scores, Tuina combined with conventional treatment had a significant advantage (P < 0.05). The order of SUCRA was Tuina combined with conventional treatment (0.98), followed by Tuina alone (0.26).
CONCLUSION: The results suggest that Tuina has significant advantages over conventional treatment.
| Discipline Area | Score |
|---|---|
| Physician |  |
| Rehab Clinician (OT/PT) |  |
Rehab Clinician (OT/PT) rater
I would have liked more information about "conventional treatments" in this study... I am a bit skeptical that the "conventional intervention" (based on the Introduction) followed current best practices in the treatment of acute low back pain.
Rehab Clinician (OT/PT) rater
Tuina, either as a standalone treatment or combined with other methods, was compared to unspecified conventional treatment methods. However, since these treatments are not clearly defined, the results are of limited value.
Rehab Clinician (OT/PT) rater
The authors state "Regarding allocation and concealment, implementing blinding methods was challenging due to the unique nature of Tuina; however, its impact on the results was minimal." It is difficult to see how the impact of this would be minimal and how all included articles would be rated as having low risk of bias due to participant bias. Unfortunately, I could not access the original articles to assess the actual impact as I am only monolingual and none of the included articles appear to be available in English. Another potential factor that often seems to be neglected in evaluating bias is the effect of the belief of the practitioner.
, McMaster University