Background. Researchers are highly interested in the study of nonspecific low back pain (NSLBP). However, few have attempted to collect global data, analyze the emerging trends, and conduct reviews from the perspectives of visualization and bibliometrics. Purpose. We aimed to evaluate research situation and capture subsequent developmental dynamics regarding NSLBP via CiteSpace. Methods. Publications on NSLBP in recent 19 years were retrieved from the Web of Science Core Collection (WoSCC). We used CiteSpace to analyze publication outputs, document types, countries, institutions, journals, authors, references, and keywords. Knowledge foundation, hot topics, and future direction were then stated. Results. A total of 1099 papers were collected, and the trend of annual publications maintained growth with small fluctuations. Australia (188) and the University of Sydney (76) were the most prolific country and institution, respectively. The Netherlands (0.84) and the University of Sydney (0.47) had the maximum centrality, thus indicating that they have importance in this field. The journal Spine (publication: 87, cocitation counts: 942) ranked first in terms of the volume of publications and cocitation counts. Maher CG (52) who published the most papers and Waddell G (286) who was cited most frequently were the leading authors, thus making strong academic influences. “Motor control exercise” was the largest cluster, which contained most related research articles. 14 references with the strongest citation counts were cited until 2018, thus implying the future development trend. Current hotspots were treatment, meta-analysis, method, and risk factors. Spine, efficacy, adult, and meta-analysis can be regarded as research frontiers. Conclusion. This study offers insights into the trend of NSLBP to determine major research countries and institutions, core journals, pivotal authors, overall development tendency, hot topics, and research frontiers. Moreover, it will help researchers extract hidden valuable information for further study.

Introduction Although task-oriented training (TOT) may provide added therapeutic value to stroke survivors, current TOT guidance offers insufficient advice on standardisation, particularly choices of intensity, for clinical practice. Therefore, this study aims to explore the effects of different intensities of TOT on motor function and self-care ability of stroke survivors. Methods and analysis This randomised controlled clinical trial will recruit 72 participants from a tertiary hospital, diagnosed with decreased self-care ability and upper limb motor dysfunction post-stroke. All participants will be randomly assigned to one of three experimental groups or the control group to undergo intervention for 8 weeks. The participants in the control group (n=18) will receive traditional occupational therapy, while those in the experimental groups will receive different intensities of TOT (50%, 75% and 100% intensity for groups A, B and C, respectively). This protocol designed a more innovative and optimised TOT programme to explore the optimal intensity of TOT on stroke survivors. The primary outcome is Canadian Occupational Performance Measure, and the secondary outcomes include Modified Barthel Index, Wolf Motor Function Test and Motor Activity Log. Ethics and dissemination The Second Affiliated Hospital of Hainan Medical University Ethics Committee approved the medical and ethical protocol for this study (LW2022015). All participants will sign an informed consent form. The results will be presented in scientific conferences and published in peer-reviewed journals. Trial registration number ChiCTR2200056390.

Background. Depressive complications in chronic pain are detrimental to rehabilitation. This study was aimed at determining the influence of the presence of depressive symptoms on the efficacy of physical therapy among participants with chronic low back pain (CLBP). Methods. Data was collected from a randomized controlled trial on 113 participants with CLBP. Participants were reallocated into the depressed or nondepressed groups based on the 50-cutoff point of the self-rating depression scale. All patients received 60 min sessions of physical therapy twice a week for 12 weeks. The primary outcome was back-related disability. Secondary outcomes included pain ratings, sleep quality, life quality, other psychological outcomes, and minimal clinically important differences. These outcomes were collected at baseline, 12, 26, and 52 weeks. Results. 31 (27.4%) were accompanied by depressive symptoms. At 12 weeks, the initial depression score was only associated with anxiety score ( [0.531 to 1.860], ) and depression score ( [0.200 to 1.284], ) in the depressed group, but the initial depression score was associated with anxiety score ( [0.138 to 0.681], ), depression score ( [0.658 to 1.184], ), sleep quality ( [0.018 to 0.199], ), and pain anxiety ( [0.034 to 0.897], ) and negatively associated with life quality ( [−1.267 to −0.363], ) in the nondepressed group. Conclusions. Physical therapy is effective to CLBP with depressive symptoms. A higher initial depression score may weaken the efficacy of physical therapy in the nondepressed group. Depressive complications may adversely influence intervention efficacy for CLBP. This trial is registered with ChiCTR1800016396.

Objective: To examine whether kinesiophobia, anxiety, and depression mediate the effects of therapeutic aquatic exercise (TAE) versus physical therapy modalities (PTMs) on pain and disability in patients with chronic low back pain (CLBP). Methods: This study was a secondary analysis of data derived from a previously conducted randomized controlled trial, applying mediation analysis to explore potential psychological mediators. A total of 113 participants received 60‐min sessions of TAE or PTMs twice weekly for 3 months. The Roland–Morris Disability Questionnaire (RMDQ) and the numeric rating scale (NRS) were employed to measure the main outcome; the mediators included the Tampa Scale for Kinesiophobia (TSK), the Self‐Rating Anxiety Scale (SAS), and the Zung Self‐Rating Depression Scale (SDS). All mediation models reported causal pathway parameters, including intervention‐mediator and mediator‐outcome coefficients, with decomposition of total effect into direct and indirect effect (IE). Results: The mediation analysis found that kinesiophobia and depression mediated the effects of TAE compared with PTMs on the average pain (TSK [IE ‐0.203, 95% confidence interval, CI, −0.467 to −0.025]; SDS [IE −0.173, 95% CI −0.426 to −0.010]), the current pain (TSK [IE −0.151, 95% CI −0.371 to −0.013]; SDS [IE −0.220, 95% CI −0.495 to −0.030]), and the most severe pain (SDS [IE −0.186, 95% CI −0.476 to 0.004]) at 12 months. Meanwhile, kinesiophobia and depression mediated the TAE intervention effects on disability at 12 months (TSK [IE ‐0.174, 95% CI −2.176 to −0.270]; SDS [IE −0.555, 95% CI −1.470 to −0.014]). Anxiety mediated the effect of TAE on disability at 3 months (IE −0.365, 95% CI −0.832 to −0.065). Conclusion: Kinesiophobia, anxiety, and depression mediated noticeable improvements in pain and disability for patients with CLBP when conducting TAE intervention. Trial Registration: Chinese Registry of Clinical Trial: ChiCTR1800016396