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Background As an important treatment for chronic nonspecific low back pain (CNSLBP) , the effect of acupuncture on CNSLBP has been studied by numerous randomized controlled trials (RCTs) with the development of research on acupuncture. However, there are some problems in the selection of outcome indicators, which severely hinder the generation of high-quality clinical evidence. Objective To describe the outcome measures used in RCTs of acupuncture for CNSLBP, providing a basis for the carrying out of relevant research. Methods Four Chinese databases (CNKI, VIP, Wanfang Data and SinoMed) and three English databases (PubMed, Embase and Cochrane Library) were systematically searched for literature on CNSLBP treated with acupuncture published from January 1, 2017 to March 15, 2022, and the NSLBP core outcome set (COS) used in studies published from database inception to March 15, 2022. According to the enrolment criteria to analyze the following aspects: basic characteristics, classification of clinical outcome indicators, use of composite indicators, and the application of TCM Criteria for Diagnosis and Treatment of Diseases & Syndromes (hereinafter referred to as TCMCDTDS) . In addition, 11 studies published from database inception to March 15, 2022 were enrolled to analyze their basic characteristics and use of COSs of NSLBP. In addition, to analyze the studies' basic characteristics and use of NSLBP COS. The similarities and differences between COSs of NSLBP and outcome measures in the RCTs in recent five years were compared. Results Of the included 49 RCTs, four are in English and the other 45 are in Chinese, involving 4 272 cases aged from 18 to 69 years (2 049 in the treatment group, and 2 223 in the control group) . The course of CNSLBP was reported in 38 RCTs. A total of 33 outcome indicators were used in all the RCTs, divided into assessing pain, dysfunction, quality of life, activities of daily living, treatment safety, patient satisfaction, disease recognition, psychological status indicators, and other indicators. The outcome indicator number in one RCT were from 1 to 8. The outcomes were measured twice in 42 RCTs, namely before and after treatment. Safety was reported in only two RCTs. The indicator of "effective rate" in the TCMCDTDS was used in 77.55% (38/49) of the RCTs. The COSs of NSLBP in the aforementioned 11 studies include indicators assessing pain, dysfunction, quality of life, psychological status, social functioning and patient satisfaction. Three of the studies graded the domains of outcome measures in terms of importance, four covered patient satisfaction indicators, five covered psychological assessment indicators, nine used different measurement tools for different outcomes, and one used COSs of NSLBP treated with TCM. Conclusion The COSs of NSLBP used in studies and outcome measures in the included RCTs have similarities in the contents involving pain level, dysfunction, quality of life, psychological status and patient satisfaction, and differences in the selection of the type of outcome domain, direction of attention, and measurement tools. The RCTs used both primary and secondary outcome measures, had unclear measurement time points, great heterogeneity in the number of used outcome measures, and non-standard application of outcome measures, and valued efficacy outcomes but undervalued safety indicators. In view of this, we put forward the recommendation on the use of outcome measures for future relevant studies: according to the research characteristics, choosing the recognized outcome measures with reference to available COSs of NSLBP and common measurement tools.

ObjectiveTo observe the effect of sling exercise therapy (SET) on lumbar function of patients with chronic nonspecific low back pain (CNLBP).MethodsA total of 90 patients with CNLBP in the outpatient department of the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, were divided randomly into conventional Tuina group, exercise training group, and sling exercise group, with 30 cases in each group. The conventional Tuina group received conventional Tuina techniques for lumbar diseases; the exercise training group received the crouching tiger rushing movement in the Yijinjing exercise; the sling exercise group received SET, and the main exercise type was prone bridging training. The treatment time was 15 minutes a time, once a day, for a total of 10 days in three groups. Before and after treatment, the spinal testing and evaluation system was used to measure the maximum strength of psoas muscle flexion and extension; the root mean square (RMS) value of surface electromyography was used to evaluate the muscle activation level of transverse abdominis and multifidus from sitting to standing positions; Roland-Morris disability questionnaire (RMDQ) and Oswestry disability index (ODI) were used to assess the lumbar function.ResultsCompared with that before treatment, the maximum strength of psoas muscle flexion and extension, the RMS value of the transversus abdominis and multifidus from sitting to standing in the three groups increased significantly after treatment, the RMDQ and ODI scores decreased significantly, and the differences were statistically significant (PPP

Objective The aim of this study was to assess the effectiveness of the Baduanjin qigong exercise on chronic nonspecific low back pain in community-based group of elderly population. Methods Totally 76 patients with chronic nonspecific low back pain were randomly divided into the experimental group(n=37)and the control group(n=39). The control group received routine care and health education about chronic nonspecific low back pain, and the experimental group received Baduanjin qigong exercise additionally. The primary and secondary outcomes measures of this trial were pain intensity and back functional disability. The Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) questionnaires were used to obtain data, which were measured respectively before intervention and three months later. Results Patients in the experimental group had a greater improvement than the controls in VAS scores after a 12-week intervention of Baduanjin exercise(P＜0. 01). The total score of ODI , dimensional scores of Lifting, Walking and Social Life in the experimental group were lower than those in the control group(P＜0. 05) . Conclusion Baduanjin qigong exercise appears to be slightly to moderately effective on relieving pain and improving function. (目的 探讨运用中医气功八段锦运动干预社区老年慢性非特异性下腰痛患者的效果。方法 将76例慢性非特异性下腰痛患者随机分为对照组和试验组, 对照组39例患者给予慢性非特异性下腰痛常规护理和健康教育, 试验组在对照组基础上进行中医气功八段锦运动干预。分别在干预前、干预12周后采用视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)问卷评价患者的疼痛程度和腰部功能情况。结果 干预12周后, 两组疼痛程度均较干预前下降, 且试验组疼痛程度低于对照组, 差异有统计学意义(P＜0. 01)。干预12周后, 试验组ODI总分及提物、步行、社会生活条目得分低于对照组, 差异有统计学意义(P＜0. 05)。结论 中医气功八段锦运动干预可有效缓解老年慢性非特异性下腰痛患者的腰部疼痛, 改善腰部功能。)

Objective:To observe the clinical efficacy of the wearable back trainer combined with massage on chronic nonspecific low back pain patients.Methods:A total of 56 chronic nonspecific low back pain patients were randomly assigned to three groups. The treatment group (n=19) was treated with wearable device treatments based on massage for two weeks, once a day, eight minutes each time, five times a week, while the control group (n=19) received massage only for two weeks, once a day, 20 minutes each time, and the blank group (n=18) rest only with closely observation. The therapeutic effect of three groups were evaluated by VAS and ODI scores before the treatment, one week after treatment and two weeks after treatment respectively.Results:There was no statistical difference among the three groups in VAS score before treatment (P> 0.05). There were statistical differences among the three groups in VAS score one week after treatment and two weeks after treatment respectively (P< 0.05); the score showed a downward trend with time, the decreasing amplitude of VAS score in the treatment group was higher than that of control group two weeks after treatment (P< 0.05), and the decreasing amplitude of VAS score in the treatment group and the control group was higher respectively than that of blank group one week after treatment and two weeks after treatment (P< 0.05). There was no statistical difference among the three groups in ODI score before treatment and one week after treatment (P> 0.05). There were statistical differences among the three groups in ODI score two weeks after treatment respectively (P< 0.05); the score showed a downward trend with time in the treatment group and the control group, the decreasing amplitude of ODI score in the treatment group was higher than that of control group two weeks after treatment (P< 0.05), and the ODI value in the blank group was decreased one week after treatment and increased two weeks after treatment.Conclusion:The clinical efficacy of the wearable back trainer combined with massage has good effect on patients of chronic nonspecific low back pain, and the effect of the combined therapy is better than simple massage therapy especially in pain relief.

Objective:To observe the clinical curative effect of Baduanjin training in the therapy of chronic nonspecific low back pain.Methods:A total of 60 cases of chronic nonspecific low back pain were randomly divided into observation group and control group with 30 cases in each group. The control group only was treated by conventional rehabilitation therapy, the observation group was trained by Baduanjin practice on the basis of the control group. The patient's pain was assessed by Visual Analogue Scale (VAS), the patient's confidence in daily activities was assessed by the Pain Self-efficacy Questionnaire (PSEQ), the patient's anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS), the patient's functional status were assessed by the Oswestry Disability Index (ODI) before treatment and at the end of the treatment.Results:At the end of 8 weeks treatment, the VAS, HADS and ODI scores of the observation group and the control group were significantly lower than before treatment, the PSEQ was significantly higher than before the treatment, with statistically significant differences (PP

The incidence of chronic nonspecific low back pain is high, which leads to patients'dysfunction and affects their overall health. Conservative treatment is the major intervention approach for nonspecific low back pain. Multidisciplinary integrated rehabilitation therapy is usually applied. The close association between respiration and chronic nonspecific low back pain has been founded in recent years. Respiratory mechanics and chemical abnormalities can lead to chronic nonspecific low back pain. The main manifestation is the appearance and recurrence of pain and other complications. The occurrence of low back pain can also lead to abnormal breathing patterns. Therefore, it is especially necessary to study this disease from respiratory aspect. Here we analyze the pathological mechanism of chronic nonspecific low back pain, expounds the principle of prevention and treatment of this disease, and introduces relevant clinical studies from two aspects of modern rehabilitation medicine and traditional Chinese medicine to enrich its treatment system, so as to explore the intervention method of breathing training and improve treatment effects.

Objective: To compare the clinical efficacy and possible mechanism of warming acupuncture combined with "three steps and seven methods" of tuina and simple "three steps and seven methods" of tuina in treatment of chronic nonspecific low back pain (NLBP) of yang deficiency and cold-dampness blockage., Methods: A total of 138 patients were randomized into an observation group (69 cases, 5 cases dropped off) and a control group (69 cases, 7 cases dropped off). In the control group, "three steps and seven methods" of tuina was applied. On the basis of the treatment in the control group, warming acupuncture was applied at Shenshu (BL 23), Yaoyangguan (GV 3), Mingmen (GV 4), Weizhong (BL 40) and ashi points. The treatment was given once a day, 6 times a week for 3 weeks in both groups. Before and after treatment, the short form of McGill pain questionnaire (SF-MPQ) score, Oswestry disability index (ODI) score, finger-to-floor distance (FFD), Schober test distance, fear-avoidance beliefs questionnaire (FABQ) score and yang deficiency and cold-dampness blockage score were observed, the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and thromboxane B 2 (TXB 2 ) were detected in both groups. The recurrence rate was evaluated in follow-up of 6 months after treatment., Results: After treatment, the scores of PRI, PPI, VAS, ODI, FABQ and FFD, yang deficiency and cold-dampness blockage scores were decreased compared before treatment in both groups ( P <0.01), and those in the observation group were lower than the control group ( P <0.01); the Schober test distances were increased compared before treatment in both groups ( P <0.01), and that in the observation group was larger than the control group ( P <0.01). After treatment, the serum levels of TNF-α, IL-1β, IL-6 and TXB 2 were decreased compared before treatment in both groups ( P <0.01), and those in the observation group were lower than the control group ( P <0.01). In follow-up, the recurrence rate was 12.8% (6/47) in the observation group, which was lower than 34.3% (12/35) in the control group ( P <0.05)., Conclusion: Warming acupuncture combined with "three steps and seven methods" of tuina can effectively alleviate pain in patients with chronic NLBP of yang deficiency and cold-dampness blockage, improve activity and dysfunction of waist, the clinical efficacy is superior to simple "three steps and seven methods" of tuina , its mechanism may be relate to the inhibition of inflammatory reaction.