title: Treating low back pain resulted from lumbar degenerative instability using Chinese Tuina combined with core stability exercises: A randomized controlled trial.
abstract: BACKGROUND
  The therapeutic effect of Tuina combined with core stability exercises on low back pain resulted from lumbar degenerative instability is unclear. This article aims to evaluate whether core stability exercises can improve the effect of Tuina in this regard.
  
  
  METHODS
  This trial was designed as a randomized controlled trial and carried out in Qingzhou hospital of Traditional Chinese medicine between June 2011 and June 2013. Eighty-eight patients with low-grade lumbar degenerative instability were included and divided randomly into experimental and control groups, 44 in each. The experimental group were treated using Tuina combined with core stability exercises, but the control group using Tuina alone. The evaluation of Visual analogue scale (VAS), Japanese Orthopaedic Association scores (JOA) and recurrence rate were performed.
  
  
  RESULTS
  Two weeks after treatment, JOA scores increased (p<0.05) and VAS decreased (p<0.05) significantly when compared with those before treatment in both groups, but there was no significant difference (p>0.05) between the two groups. At the end of six weeks, VAS scores (p<0.05) decreased and JOA scores (p<0.05) increased significantly when compared to those before treatment in both groups. In addition, the VAS (p<0.05) scores were significantly lower, JOA scores (p<0.05) were significantly higher in experimental group than those in control group. At the final follow-up, seven cases (17.1%) in experimental group and eighteen (43.9%) in control group recurred, the control group has a significantly higher recurrence rate (p<0.05). No adverse events occurred in the trial.
  
  
  CONCLUSIONS
  Chinese Tuina combined with core stability exercises has better effect than Tuina alone in treating low back pain resulted from low-grade lumbar degenerative instability.
authors.affiliation: Department of Traditional Chinese Medicine, Medical School, Jinan University, Guangzhou 510632, China. Electronic address: wkdd2009@hotmail.com.
authors.forename: Shujie
authors.initials: S
authors.lastname: Tang
authors.affiliation: Nursing Department, Maternal and Child Health Hospital of Weifang, Shandong Province 261011, China. Electronic address: tsj697@sina.com.
authors.forename: Xiuling
authors.initials: X
authors.lastname: Qian
authors.affiliation: Pain Department, Qingzhou Hospital of Traditional Chinese Medicine, Qingzhou, Shandong Province 262500, China. Electronic address: yjiezhang@sina.cn.
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Internal Medicine, Qingzhou Hospital of Traditional Chinese Medicine, Qingzhou, Shandong Province 262500, China. Electronic address: applepkpear@163.com.
authors.forename: Yuanmei
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000628:therapy*; D008161:Lumbosacral Region / Q000503:physiopathology*; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D013122:Spinal Diseases / Q000150:complications*
keywords: Chinese Tuina; Core stability exercises; Low back pain (LBP); Lumbar degenerative instability