{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:39:29Z","timestamp":1792795169177,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,21]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Tuina has gained widespread attention and utilization for the management of chronic nonspecific low back pain (CNLBP). However, evidence-based guidance for choosing accurate and appropriate outcome measures of Tuina is lacking. The objective of this study is to systematically synthesize the existing outcome measures reported in randomized controlled trials (RCTs) evaluating Tuina therapy in CNLBP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Electronic literature searches were conducted in multiple English and Chinese databases from their inception to May 2022. RCTs were included if they involved clinical outcome measures in Tuina treatment for patients with CNLBP. Outcome instruments for each study were extracted and analyzed. Evidence from included studies were assessed using the Cochrane risk-of-bias tool.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the 735 identified articles, 17 articles with 1628 participants were included. Measurement domains in these RCTs were mainly reported in terms of pain (94%) and physical activity (71%), followed by safety (41%), Chinese medicine outcome (35%), and quality of life (12%). Moreover, several limitations with existing outcomes were reported, including lack of emphasis on the evaluation of quality of life, inadequate safety monitoring, as well as insufficient and vague Chinese medicine outcome measures. All trials were deemed to be of poor methodological quality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Pain and physical disability were the most frequently studied outcome domains in CNLBP treated by Tuina therapy. More rigorous and high-quality trials with appropriately selected outcome measures are needed in the future.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000033628","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T15:49:22Z","timestamp":1682092162000},"page":"e33628","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Clinical outcome measures reporting in randomized trials evaluating Tuina therapy for chronic nonspecific low back pain: A systematic review"],"prefix":"10.1097","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5501-4579","authenticated-orcid":false,"given":"Xuan","family":"Zhou","sequence":"first","affiliation":[{"name":"Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyu","family":"Ma","sequence":"additional","affiliation":[{"name":"Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya B.","family":"Mohabbat","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana T.","family":"Croghan","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia la choo","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Singapore General Hospital, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxu","family":"Chen","sequence":"additional","affiliation":[{"name":"Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3453-6906","authenticated-orcid":false,"given":"Brent A.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250504","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016.","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"R2-20250504","first-page":"548","article-title":"[Academic features of tuina for children in western Hunan district].","volume":"32","author":"Zhu","year":"2012","journal-title":"Zhongguo Zhen Jiu"},{"key":"R3-20250504","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain.","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"R4-20250504","first-page":"1","article-title":"The Chinese Association for the Study of Pain (CASP): consensus on the assessment and management of chronic nonspecific low back pain.","volume":"2019","author":"Ma","year":"2019","journal-title":"Pain Res Manag"},{"key":"R5-20250504","doi-asserted-by":"crossref","first-page":"493","DOI":"10.7326\/M16-2459","article-title":"Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians Clinical Practice Guideline.","volume":"166","author":"Chou","year":"2017","journal-title":"Ann Intern Med"},{"key":"R6-20250504","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"R7-20250504","first-page":"24","article-title":"Chinese massage and the introduction of massage into China before The 8th century.","volume":"6","author":"Jingwei","year":"1986","journal-title":"Anc Sci Life"},{"key":"R8-20250504","doi-asserted-by":"crossref","first-page":"e88027","DOI":"10.1371\/journal.pone.0088027","article-title":"How current clinical practice guidelines for low back pain reflect traditional medicine in East Asian countries: a systematic review of clinical practice guidelines and systematic reviews.","volume":"9","author":"Cho","year":"2014","journal-title":"PLoS One"},{"key":"R9-20250504","doi-asserted-by":"crossref","first-page":"e0117146","DOI":"10.1371\/journal.pone.0117146","article-title":"Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis.","volume":"10","author":"Yuan","year":"2015","journal-title":"PLoS One"},{"key":"R10-20250504","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/S0254-6272(13)60066-7","article-title":"Therapeutic evaluation of lumbar tender point deep massage for chronic non-specific low back pain.","volume":"32","author":"Zheng","year":"2012","journal-title":"J Tradit Chin Med"},{"key":"R11-20250504","first-page":"2021551068","article-title":"Clinical observation on warm needle combined with massage in the treatment of chronic lumbar muscle strain. Clinical observation on warm needle combined with massage in the treatment of chronic lumbar muscle strain.","volume":"36","author":"Zhao","year":"2021","journal-title":"Guangming J Chin Med"},{"key":"R12-20250504","first-page":"130","article-title":"Shexiang Jietong ointment combined with massage in the treatment of 43 cases of chronic lumbar muscle strain caused by cold-dampness and blood stasis.","volume":"28","author":"Zhang","year":"2019","journal-title":"J Med Pharm Chin Minorities"},{"key":"R13-20250504","first-page":"82","article-title":"A randomized controlled study of Tuina therapy for chronic lumbar muscle strain. Treatment of chronic lumbar muscle strain by Tuina: a randomized controlled trial.","volume":"48","author":"Yuan","year":"2014","journal-title":"Shanghai J Tradit Chin Med"},{"key":"R15-20250504","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s11726-020-1158-z","article-title":"Clinical observation of sinew-regulating bone-setting manipulations plus exercise therapy for chronic non-specific low back pain. Article.","volume":"18","author":"Yao","year":"2020","journal-title":"J Acupunct Tuina Sci"},{"key":"R16-20250504","first-page":"45","article-title":"Study on the treatment of chronic non-specific low back pain with Shen\u2019s elongated needle therapy combined with massage.","volume":"32","author":"Wang","year":"2017","journal-title":"J Hebei Tradit Chin Med Pharmacol"},{"key":"R17-20250504","first-page":"82","article-title":"Clinical observation of suspension exercise training combined with massage in the treatment of chronic nonspecific low back pain. Effects of suspension training therapy and massage on chronic nonspecific low back pain.","volume":"38","author":"Sun","year":"2015","journal-title":"J Yunnan Univ Tradit Chin Med"},{"key":"R18-20250504","first-page":"2015714678","article-title":"Lijincutong techniques combined with movable cupping on the bladder meridian therapy for lumbar muscle strain: clinical analysis of 80 cases. Lijincutong techniques combined with movable cupping on the bladder meridian therapy for lumbar muscle strain: clinical analysis of 80 cases.","volume":"42","author":"Song","year":"2015","journal-title":"Liaoning J Tradit Chin Med"},{"key":"R19-20250504","first-page":"934","article-title":"Treatment of chronic lumbar muscle strain with massage manipulation for clearing meridians and regulating internal organs. 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