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Chuna (or tuina) manual therapy for musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials |
Lee N-W, Kim G-H, Heo I, Kim K-W, Ha I-H, Lee J-H, Hwang E-H, Shin B-C |
Evidence-Based Complementary and Alternative Medicine 2017;(8218139):Epub |
systematic review |
OBJECTIVE: To review the literature and systematically evaluate the effectiveness of chuna (or tuina) manual therapy (C(T)MT) on pain and function for musculoskeletal disorders. METHODS: We searched 15 English, Chinese, Japanese, and Korean databases using relevant keywords. All randomized controlled trials (RCTs) of C(T)MT for musculoskeletal disorders were considered, and we limited analyses to studies with a low-risk bias for randomization and/or allocation concealment. RESULTS: Sixty-six RCTs with 6,170 participants were included. One sham-controlled RCT showed that C(T)MT relieved pain more effectively than a sham control (SMD -3.09 (-3.59 to -2.59)). For active-controlled RCTs, pooled meta-analysis showed that C(T)MT had statistically significant effects on pain reduction, especially compared to traction (p < 0.00001), drugs (p = 0.04), and physical therapies (p < 0.0001). For functional improvement, combined effects of C(T)MT with drugs (p = 0.04) and traction (p = 0.05) also showed similar positive effects. CONCLUSIONS: This systematic review suggests that C(T)MT is safe and effective for pain reduction and functional improvement for musculoskeletal diseases; however, the evidence for functional improvement was not as strong as for pain reduction. For future studies, high-quality RCTs such as sham-controlled studies with standardized interventions are needed to provide sufficient evidence on the effects of C(T)MT for musculoskeletal diseases. Protocol registration number is CRD42016038307 4/7/2016.
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