Effect of Chinese massage (Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis

AbstractObjectiveChinese massage (Tui Na) is one of the most popular Traditional Chinese Medicine remedies for knee osteoarthritis (OA). Several studies have subjectively evaluated the effect of Chinese massage on knee OA through self-assessment questionnaires; however, very few studies have objectively assessed the effect by measuring knee muscle strength. The purpose of this study was to assess the efficacy of Chinese massage in improving knee extensor and flexor muscle strength in patients with knee OA.MethodsThirty patients with knee OA received Chinese massage therapy three times per week for 2 weeks. Patients completed pre- and post-treatment Visual Analogue Scale (VAS) pain questionnaires, and pre- and post-treatment knee muscle strength was evaluated using the Biodex Multi-Joint System 3. Isokinetic muscle strength measurements were performed at 60 degrees/s and 180 degrees/s. The peak torque (PT), peak torque/body weight (PT/BW), total work (TW), average power (AP), hamstring/quadriceps (H/Q), and range of motion (ROM) values were recorded separately for flexors and extensors.ResultsChinese massage therapy significantly improved knee pain as assessed by the VAS in patients with knee OA (P < 0.05). Post-treatment values were significantly greater than pre-treatment values in the extensor muscles for PT (right P = 0.013, left P = 0.001), PT/BW (right P = 0.008, left P = 0.001) and TW (right P = 0.036, left P = 0.004) at 60 degrees/s. The AP increased significantly after treatment in the flexor muscles in the right knee (P = 0.009) and the extensor muscles in the left knee (P = 0.001). There were no significant differences in pre- and post-treatment ROM and H/Q at 60 degrees/s and 180 degrees/s.ConclusionChinese massage therapy decreased pain and may improve extensor muscle strength in patients with knee OA, but does not appear to improve ROM

Roles of non-coding RNA in megakaryocytopoiesis and thrombopoiesis: new target therapies in ITP

Noncoding RNAs (ncRNAs) are a group of RNA molecules that cannot encode proteins, and a better understanding of the complex interaction networks coordinated by ncRNAs will provide a theoretical basis for the development of therapeutics targeting the regulatory effects of ncRNAs. Platelets are produced upon the differentiation of hematopoietic stem cells into megakaryocytes, 1011 per day, and are renewed every 8–9 days. The process of thrombopoiesis is affected by multiple factors, in which ncRNAs also exert a significant regulatory role. This article reviewed the regulatory roles of ncRNAs, mainly microRNAs (miRNAs), circRNAs (circular RNAs), and long non-coding RNAs (lncRNAs), in thrombopoiesis in recent years as well as their roles in primary immune thrombocytopenia (ITP)

Cerebral mechanism of Tuina analgesia in management of knee osteoarthritis using multimodal MRI: study protocol for a randomised controlled trial

Background The chronic pain of patients with knee osteoarthritis (KOA) seriously affects their quality of life and leads to heavy social and economic burden. As a nondrug therapy in Traditional Chinese Medicine (TCM), Tuina is generally recognised as safe and effective for reducing the chronic pain of KOA. However, the underlying central mechanisms of Tuina for improving the pain of KOA are not fully understood. Methods/design This study will be a randomised controlled trial with a parallel-group design. A total of 60 eligible participants will be assigned to the Tuina group or healthcare education group (Education group) at 1:1 ratio using stratified randomisation with gender and age as factors. The interventions of both groups will last for 30 min per session and be conducted twice each week for 12 weeks. This study will primarily focus on pain evaluation assessed by detecting the changes in brain grey matter (GM) structure, white matter (WM) structure, and the cerebral functional connectivity (FC) elicited by Tuina treatment, e.g., thalamus, hippocampus, anterior cingulate gyrus, S1, insula, and periaqueductal grey subregions (PAG). The two groups of patients will be evaluated by clinical assessments and multimodal magnetic resonance imaging (MRI) to observe the alterations in the GM, WM, and FC of participants at the baseline and the end of 6 and 12 weeks' treatment and still be evaluated by clinical assessments but not MRI for 48 weeks of follow-up. The visual analogue scale of current pain is the primary outcome. The Short-Form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, 36-Item Short Form Health Survey, Hamilton Depression Scale, and Hamilton Anxiety Scale will be used to evaluate the pain intensity, pain feeling, pain emotion, clinical symptoms, and quality of life, respectively. MRI assessments, clinical data evaluators, data managers, and statisticians will be blinded to the group allocation in the outcome evaluation procedure and data analysis to reduce the risk of bias. The repeated measures analysis of variance (2 groups x 6 time points ANOVA) will be used to analyse numerical variables of the clinical and neuroimaging data obtained in the study. PDiscussion The results of this randomised controlled trial with clinical assessments and multimodal MRI will help reveal the influence of Tuina treatment on the potential morphological changes in cortical and subcortical brain structures, the white matter integrity, and the functional activities and connectivity of brain regions of patients with KOA, which may provide scientific evidence for the clinical application of Tuina in the management of KOA. Dissemination The results will be published in peer-reviewed journals and disseminated through the study's website, and conferences

Prediction of knee joint pain in Tai Chi practitioners: a cross-sectional machine learning approach

Objective To build a supervised machine learning-based classifier, which can accurately predict whether Tai Chi practitioners may experience knee pain after years of exercise.Design A prospective approach was used. Data were collected using face-to-face through a self-designed questionnaire.Setting Single centre in Shanghai, China.Participants A total of 1750 Tai Chi practitioners with a course of Tai Chi exercise over 5 years were randomly selected.Measures All participants were measured by a questionnaire survey including personal information, Tai Chi exercise pattern and Irrgang Knee Outcome Survey Activities of Daily Living Scale. The validity of the questionnaire was analysed by logical analysis and test, and the reliability of this questionnaire was mainly tested by a re-test method. Dataset 1 was established by whether the participant had knee pain, and dataset 2 by whether the participant’s knee pain affected daily living function. Then both datasets were randomly assigned to a training and validating dataset and a test dataset in a ratio of 7:3. Six machine learning algorithms were selected and trained by our dataset. The area under the receiver operating characteristic curve was used to evaluate the performance of the trained models, which determined the best prediction model.Results A total of 1703 practitioners completed the questionnaire and 47 were eliminated for lack of information. The total reliability of the scale is 0.94 and the KMO (Kaiser-Meyer-Olkin measure of sampling adequacy) value of the scale validity was 0.949 (&gt;0.7). The CatBoost algorithm-based machine-learning model achieved the best predictive performance in distinguishing practitioners with different degrees of knee pain after Tai Chi practice. ‘Having knee pain before Tai Chi practice’, ‘knee joint warm-up’ and ‘duration of each exercise’ are the top three factors associated with pain after Tai Chi exercise in the model. ‘Having knee pain before Tai Chi practice’, ‘Having Instructor’ and ‘Duration of each exercise’ were most relevant to whether pain interfered with daily life in the model.Conclusion CatBoost-based machine learning classifier accurately predicts knee pain symptoms after practicing Tai Chi. This study provides an essential reference for practicing Tai Chi scientifically to avoid knee pain

Efficacy of tuina in patients with chronic neck pain: study protocol for a randomized controlled trial

Abstract Background Chronic neck pain (CNP) is a common and disabling musculoskeletal disorder in developing and developed countries. Previous studies have shown that tuina and traditional Chinese massage are effective treatments for patients with CNP. However, there is little evidence to support the use of one intervention over the other. The aim of this study is to compare the effects of tuina and traditional Chinese massage in the treatment of pain and disability in patients with CNP. Methods/design This is a multicenter, assessor- and analyst-blinded, randomized controlled trial with two parallel arms: a tuina group and a traditional Chinese massage group. A total of 356 eligible CNP patients will be randomly assigned to the groups in a 1:1 ratio. The intervention in the tuina group includes both structural and relaxation massage, while the traditional Chinese massage group will receive relaxation massage only. The interventions for both groups will last for 15 min and will be carried out three times a week for a period of 4 weeks. The primary outcome will be changes in the Northwick Park Neck Pain Questionnaire. Secondary outcomes will be measured by a visual analogue scale (VAS), the Neck Disability Index (NDI), and the 36-item Short-Form Health Survey (SF-36). The data will be analyzed at the baseline, at the end of the intervention, and during the 3 months of follow-up by repeated measures analysis of variance. The significance level is 5%. The safety of tuina and traditional Chinese massage will be evaluated after each treatment session. The results of this trial will help clarify the value of tuina and traditional Chinese massage as treatments for CNP and will highlight any differences in the efficacy of the treatments. Discussion The purpose of this trial is to determine whether tuina is more effective than traditional Chinese massage in adults with CNP. This trial will, therefore, contribute to providing a solid foundation for clinical treatment of CNP, as well as future research in massage therapy. Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-17013763. Registered 8 December 2017