Background: Although traditional Chinese Yijinjing Qigong Exercise (YJJQE) is popularly used in China, to alleviate symptoms of people with knee osteoarthritis (KOA), no randomized controlled trials (RCTs) are available to evaluate the effects of YJJQE in patients with KOA. The purpose of this trial is to assess the clinical efficacy of YJJQE for patients with KOA.Methods: A total of 50 participants clinically diagnosed with KOA are randomly (1:1) assigned to the YJJQE group (n = 25) and to the stretching training exercise (STE) group (n = 25), for a 40-min exercise session twice a week for 12 weeks. All outcome measures are collected at baseline and at 12-week ending intervention, which includes the primary outcomes of Western Ontario and McMaster Universities Osteoarthritis Index Scale (WOMAC), the secondary outcomes of visual analog scale (VAS), mental component summary (MCS), physical component summary (PCS), Beck depression inventory (BDI), perceived stress scale (PSS), Berg balance scale (BBS), and the Gait functional mobility data.Results: The YJJQE group did not have any significant changes compared to the control group on the WOMAC score after the 12-week intervention (P > 0.05), though the YJJQE group demonstrated better performance in MCS, BDI, and PSS (P = 0.002, P = 0.001, and P = 0.026, respectively) than the control group. No serious adverse events occurred in either group, and only mild muscle soreness was reported during both exercise treatments.Conclusion: Because no difference between both groups was shown, with regards to the primary outcome measurement (WOMAC), it can hardly explain that the YJJQE had an advantageous effect on patients experiencing the pain and dysfunction of knee osteoarthritis. However, compared to the control group, YJJQE appeared to be associated with improvements in psychological well-being including reduced stress, anxiety, depression, and mood disturbance to manage KOA. Further trials with larger sample sizes and follow-up studies will be required.Clinical Trial Registration:https://www.chictr.org.cn/edit.aspx?pid=60357&htm=4, ChiCTR2000037256.

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.

Background: In December 2019, pneumonia associated with the 2019 novel coronavirus (COVID-19) emerged in Wuhan, China. The number of cases has increased rapidly. Patients with severe disease have a poor prognosis, and there are no effective therapies for COVID-19. Only rapid advice guidelines for symptomatic supportive care have been used. A traditional Chinese medicine rehabilitation (TCMR) program consisting of acupressure therapy and Liu Zi Jue Qigong can be used as a complementary therapy for COVID-19. Hence, we designed a randomized trial to evaluate the efficacy and advantages of TCMR for treating patients with severe COVID-19.Methods/design: This is a parallel-design, two-arm, analyst assessor-blinded, randomized controlled trial. A total of 128 patients with COVID-19 aged from 20 to 80 years will be recruited and assigned randomly into a guideline therapy group and a guideline therapy plus TCMR group at a 1:1 ratio. Patients in both groups will receive guideline therapy. The patients in the intervention group will perform acupressure therapy and Liu Zi Jue Qigong exercises in addition to conventional treatments twice a day and will be persistent from admission to discharge. The primary outcome will be measured with the Modified Medical Research Council Dyspnea Scale, and the secondary outcomes will include the Activities of Daily Living Barthel Index Scale, Patient Health Questionnaire-9 Scale, and the Respiratory Symptoms Scale. The assessments of the clinical scales will be performed at three points (before treatment, the 7th day during hospitalization, and the discharge day). Adverse events will be noted and recorded for the safety evaluation.Discussion: This trial will provide high-quality evidence of the value of TCMR, which consists of acupressure therapy and Liu Zi Jue Qigong exercises, for treating patients with severe COVID-19.Trial registration: Chinese Clinical Trial RegistryChiCTR2000029994. Registered on 18 February 2020

This study uses two-sample MR analysis with GWAS summary statistics to evaluate the causal relationship between metabolic syndrome and low back pain. A two-sample Mendelian randomization analysis used GWAS summary statistics for low back pain from the FinnGen database and metabolic syndrome data, including waist circumference, hypertension, fasting blood glucose, HDL cholesterol, and triglyceride levels. Various methods like inverse variance weighted, MR-Egger, weighted median, and mode assessed the causal relationship, with sensitivity analyses addressing heterogeneity and pleiotropy. Our analysis found a statistically significant causal association between essential hypertension (OR 2.38, 95% CI 1.42–3.96; P_adj = 0.002), metabolic syndrome (OR 1.05, 95% CI 1.01–1.10; P_adj = 0.023) and waist circumference (OR 49, 95% CI 1.32–1.68; P_adj < 0.001) and low back pain (OR 1.41, 95% CI 1.30–1.53, P_adj < 0.001). In contrast, fasting blood glucose (FBG), HDL cholesterol, and triglycerides showed no significant associations with low back pain across all MR methods. The results of sensitivity analyses indicated that the heterogeneity and pleiotropy were unlikely to disturb the causal estimate. Our study indicates that increased essential hypertension, metabolic syndrome and waist circumference is causally associated with a higher risk of low back pain. Interventions targeting metabolic syndrome components, particularly blood pressure control and weight management, could help reduce the risk of low back pain. Further research is needed to explore the underlying biological pathways linking these metabolic factors to low back pain.

Background: Functional constipation (FC) is a common health issue in children, impacting their health-related quality of life. Chinese pediatric therapeutic massage, also called Chinese pediatric Tuina, a traditional Chinese manual manipulation therapy, has been utilized for managing FC in children. This study examined the effects of 2 types of pediatric Tuina therapy, regular and Han’s style, on FC in children diagnosed based on the Rome IV criteria and with the type of food stagnation accompanied by interior heat/inflammation in traditional Chinese medicine. Methods: The study involved 196 children aged 1 to 7 years (mean [M] age 2.7 ± 1.5 years) diagnosed with FC for 3 to 6 months based on Rome IV criteria and traditional Chinese medicine’s diagnosis of food stagnation with internal heat/inflammation. Two groups of 98 participants each were randomly formed. One group received regular pediatric Tuina therapy, while the other received Han’s style pediatric Tuina therapy for 2 sessions. Each session lasted for 7 days with a one-day break, and a 3-day break was scheduled between the 2 sessions. Bristol stool scale, scale of defecation difficulty, scale of stooling duration, scale of stooling frequency, and abdominal bloating were assessed at pretreatment, post-first session, post-second session, and 1-week after the second session. Paired t -tests and independent t -tests were used to examine significant differences in measures among data collected from different time points within each group and between the 2 groups, respectively. Results: Both types of Tuina therapy (regular and Han’s style) demonstrated significant improvements in all measures compared to pre-Tuina ( P < .05). Han’s style Tuina showed significantly better effects ( P ≤ .01) than regular Tuina. Conclusion: Chinese pediatric Tuina therapy significantly improved FC symptoms caused by food stagnation with interior heat/inflammation in the studied population, with Han’s style having certain advantages. The Chinese Tuina therapy used in the study could be recommended as an alternative management approach for FC in children.

Compare long-term efficacy and recurrence of Chinese ointment(Co) massage, Tuina, and combined acupuncture for knee osteoarthritis (KOA). A multicenter, prospective, observational real-world study was conducted in multiple cities in China. 2143 KOA patients (83.76 % female) were prospectively assigned by preference to Co (n = 312), Tuina (n = 403), Co+acupuncture (n = 237), or Tuina+acupuncture (n = 1362) groups. Treatments involved 5-10 sessions. The Visual Analog Scale (VAS) assessed the average degree of knee joint pain, while the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Lequesne Index evaluated knee joint dysfunction in terms of functionality and severity. The 2 years recurrence rate of KOA was also calculated. All groups showed significant post-treatment WOMAC, VAS, and Lequesne score reductions. The Co group had the lowest VAS scores at 2-10 months. Recurrence rates (lowest to highest) were Co group, Tuina group, Tuina+acupuncture group, Co+acupuncture group. The overall maximum recurrence rate was 33.97 % at 2 years, stabilizing after 18 months. KL grade II patients had the best long-term outcomes (recurrence 16.16 %-30.85 % over 2-24 months). No serious adverse events occurred. Traditional Chinese medicine (TCM) conservative treatments (Co therapy, Tuina, and combined acupuncture) demonstrated safety for KOA management. Patients with lower KL grades (0-III) derived greater clinical benefit from longer courses (≥10 sessions), with effects sustained for up to 2 years. Co therapy or acupuncture-integrated regimens provided optimal early improvement (within the first 5 sessions) for pain and mobility. Intensive combination protocols offered no additional cumulative benefit for patients with mild symptoms.