Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial

Abstract Background Tuina therapy (Tuina) is commonly utilized for managing knee osteoarthritis (KOA), yet the available evidence is limited. This study aimed to evaluate the effectiveness of Tuina compared to widely accepted manual physical therapy (mPT) for patients with KOA. Methods Between Oct 2...

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Main Authors: Peihong Ma, Luping Liu, Sina Li, Meiling Cai, Siyu Han, Zhiwen Weng, Qianji Chen, Yixuan Gao, Lingyun Zhang, Guiyun Wu, Xiaoming Yang, Yang Zhang, Duoduo Li, Changxin Liu, Ya’nan Sun, Shiyan Yan, Xiyou Wang, Changhe Yu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Complementary Medicine and Therapies
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Online Access:https://doi.org/10.1186/s12906-025-04850-w
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author Peihong Ma
Luping Liu
Sina Li
Meiling Cai
Siyu Han
Zhiwen Weng
Qianji Chen
Yixuan Gao
Lingyun Zhang
Guiyun Wu
Xiaoming Yang
Yang Zhang
Duoduo Li
Changxin Liu
Ya’nan Sun
Shiyan Yan
Xiyou Wang
Changhe Yu
author_facet Peihong Ma
Luping Liu
Sina Li
Meiling Cai
Siyu Han
Zhiwen Weng
Qianji Chen
Yixuan Gao
Lingyun Zhang
Guiyun Wu
Xiaoming Yang
Yang Zhang
Duoduo Li
Changxin Liu
Ya’nan Sun
Shiyan Yan
Xiyou Wang
Changhe Yu
author_sort Peihong Ma
collection DOAJ
description Abstract Background Tuina therapy (Tuina) is commonly utilized for managing knee osteoarthritis (KOA), yet the available evidence is limited. This study aimed to evaluate the effectiveness of Tuina compared to widely accepted manual physical therapy (mPT) for patients with KOA. Methods Between Oct 2019 and Oct 2021, patients with KOA (Kellgren-Lawrence score II or III) were randomly assigned in a 1:1 ratio to receive Tuina or mPT, with eight 20-min sessions over 3 weeks. Assessments were performed at baseline, week 4, 8, and 16. The primary outcome was the change of total Western Ontario and McMaster University Osteoarthritis Index (WOMAC) from baseline to week 4. Secondary outcomes included WOMAC subscales, knee pain measures, performance-based tests, quality-of-life measures, and safety assessments. Patients, evaluators, and statisticians were blinded to treatment group assignment. All main analyses were by intention-to-treat. Results Of the 140 patients allocated to Tuina or mPT, 127 completed the treatment. There was significant intervention × time interaction observed in the WOMAC-total (F(2, 266) = 3.87, P = 0.02), there was no statistically significant between groups at week 4 (between-group difference: −1.00, 95%CI: −5.33 to 3.33, P = 0.79, Bonferroni correction). By week 8, Tuina showed significantly consistent improvement compared to mPT (between-group difference: −4.33, 95%CI: −8.34 to −0.31, P = 0.03, Bonferroni correction), whereas there were no statistically significant differences between groups at week 16 (between-group difference: 0.74, 95%CI: −3.67 to 5.15, P = 0.37, Bonferroni correction). Most secondary outcomes showed no significant between-group differences, except for the Timed Up and Go Test Time favoring mPT (0.94, 95%CI: 0.03 to 1.85, P = 0.04). No serious adverse events occurred. One patient in the mPT group took the medication and no patients received other therapies for KOA. Conclusions Tuina produced beneficial effectiveness similar to mPT in treating KOA. Trial registration NCT03966248, Registered on 29/05/2019, ClinicalTrials.gov.
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spelling doaj-art-ee9768223e4541ea9a77e1d93fdd8f7b2025-08-20T03:06:48ZengBMCBMC Complementary Medicine and Therapies2662-76712025-04-0125111410.1186/s12906-025-04850-wComparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trialPeihong Ma0Luping Liu1Sina Li2Meiling Cai3Siyu Han4Zhiwen Weng5Qianji Chen6Yixuan Gao7Lingyun Zhang8Guiyun Wu9Xiaoming Yang10Yang Zhang11Duoduo Li12Changxin Liu13Ya’nan Sun14Shiyan Yan15Xiyou Wang16Changhe Yu17Acupuncture and Moxibustion Department, Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicinePediatrics Department, Inner Mongolia Xing’an Meng People’s HospitalAcupuncture and Moxibustion Department, Langfang TCM HospitalTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineAcupuncture and Moxibustion Department, Luohu District Chinese HospitalTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineMedical Insurance Payment Department, Beijing Municipal Bureau of Medical InsuranceTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTraditional Chinese Medicine Department, Xuanwu Hospital Capital Medical UniversityAcupuncture and Moxibustion Department, Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineTuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese MedicineAbstract Background Tuina therapy (Tuina) is commonly utilized for managing knee osteoarthritis (KOA), yet the available evidence is limited. This study aimed to evaluate the effectiveness of Tuina compared to widely accepted manual physical therapy (mPT) for patients with KOA. Methods Between Oct 2019 and Oct 2021, patients with KOA (Kellgren-Lawrence score II or III) were randomly assigned in a 1:1 ratio to receive Tuina or mPT, with eight 20-min sessions over 3 weeks. Assessments were performed at baseline, week 4, 8, and 16. The primary outcome was the change of total Western Ontario and McMaster University Osteoarthritis Index (WOMAC) from baseline to week 4. Secondary outcomes included WOMAC subscales, knee pain measures, performance-based tests, quality-of-life measures, and safety assessments. Patients, evaluators, and statisticians were blinded to treatment group assignment. All main analyses were by intention-to-treat. Results Of the 140 patients allocated to Tuina or mPT, 127 completed the treatment. There was significant intervention × time interaction observed in the WOMAC-total (F(2, 266) = 3.87, P = 0.02), there was no statistically significant between groups at week 4 (between-group difference: −1.00, 95%CI: −5.33 to 3.33, P = 0.79, Bonferroni correction). By week 8, Tuina showed significantly consistent improvement compared to mPT (between-group difference: −4.33, 95%CI: −8.34 to −0.31, P = 0.03, Bonferroni correction), whereas there were no statistically significant differences between groups at week 16 (between-group difference: 0.74, 95%CI: −3.67 to 5.15, P = 0.37, Bonferroni correction). Most secondary outcomes showed no significant between-group differences, except for the Timed Up and Go Test Time favoring mPT (0.94, 95%CI: 0.03 to 1.85, P = 0.04). No serious adverse events occurred. One patient in the mPT group took the medication and no patients received other therapies for KOA. Conclusions Tuina produced beneficial effectiveness similar to mPT in treating KOA. Trial registration NCT03966248, Registered on 29/05/2019, ClinicalTrials.gov.https://doi.org/10.1186/s12906-025-04850-wTuina therapyKnee osteoarthritisPhysical therapyRandomized controlled trial
spellingShingle Peihong Ma
Luping Liu
Sina Li
Meiling Cai
Siyu Han
Zhiwen Weng
Qianji Chen
Yixuan Gao
Lingyun Zhang
Guiyun Wu
Xiaoming Yang
Yang Zhang
Duoduo Li
Changxin Liu
Ya’nan Sun
Shiyan Yan
Xiyou Wang
Changhe Yu
Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
BMC Complementary Medicine and Therapies
Tuina therapy
Knee osteoarthritis
Physical therapy
Randomized controlled trial
title Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
title_full Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
title_fullStr Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
title_full_unstemmed Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
title_short Comparative effectiveness of Tuina therapy versus manual physical therapy for knee osteoarthritis: a randomized controlled trial
title_sort comparative effectiveness of tuina therapy versus manual physical therapy for knee osteoarthritis a randomized controlled trial
topic Tuina therapy
Knee osteoarthritis
Physical therapy
Randomized controlled trial
url https://doi.org/10.1186/s12906-025-04850-w
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