Baduanjin exercise for low back pain: A systematic review and meta-analysis. (April 2019)

• Record Type: Journal Article
• Authors: Li, Huanan; Ge, Di; Liu, Siwen; Zhang, Wei; Wang, Jingui; Si, Jinhua; Zhai, Jingbo
• Is Part Of: Complementary therapies in medicine. Volume 43(2019)
• Page Start: 109
• Page End: 116
• Publication Date: 2019-04
• Subjects: LBP Low back pain -- PRISMA Preferred Reporting Items for Systematic reviews and Meta-Analyses -- RCTs randomized controlled trials -- VAS visual analogue scale -- ODI Oswestry Disability Index -- JOA Japanese Orthopaedic Association -- SF-36 Short-Form 36 -- CENTRAL Cochrane Central Register of Controlled Trials -- CBM Chinese Biomedical Literatures database -- CNKI China National Knowledge Infrastructure -- WANFANG Wanfang Digital Periodicals -- VIP Chinese Science and Technology Periodicals -- ICTRP World Health Organization International Clinical Trials Registry Platform -- ChiCTR Chinese Clinical Trial Registry -- MD mean difference -- CI confidence interval -- SMD standardized mean difference -- RR risk ratio -- EG experimental group -- CG control group -- NR Not reported -- ADR Adverse Drug Reaction -- NSAIDs non-steroid anti-inflammatory drugs; Baduanjin -- Low back pain -- Systematic review; Alternative medicine -- Periodicals; Complementary Therapies -- Periodicals; Médecines parallèles -- Périodiques; Thérapeutique -- Périodiques; Alternative medicine; Electronic journals; Periodicals; 615.5
• DOI: 10.1016/j.ctim.2019.01.021
• Languages: English
• ISSNs: 0965-2299

Abstract

Highlights: Baduanjin is very popular and widely practiced for the management of LBP. This study systematically evaluated the efficacy and safety of Baduanjin for LBP. No large effects on pain or back-specific function were identified. It suggests that Baduanjin is effective for LBP. However, more large-scale, well-designed RCTs are warranted. Abstract: Introduction: Low back pain (LBP) is one of the most common public health concerns worldwide. Baduanjin is very popular and widely practiced for the management of LBP. This study aims to systematically investigate the efficacy and safety of Baduanjin exercise for patients with LBP. Methods: The PubMed, EMBASE, CENTRAL, Web of Science Core Collection, CBM, CNKI, WANFANG and VIP databases were searched from inception to August 2018 to identify potentially eligible studies. Risk of bias was assessed with the Cochrane collaboration's tool. All statistical analyses were conducted with the RevMan 5.3 software. Results: Nine studies involving 519 patients were included in this systematic review. Our meta-analysis showed that Baduanjin was associated with a small improvement in pain relief compared with general exercise (MD= -0.50, 95% CI: -0.86 to -0.15, P = 0.005). One trial indicated that Baduanjin was superior to routine drug (ibuprofen) in alleviating pain, and the effect was moderate (MD= -1.04, 95% CI: -1.52 to -0.56, P < 0.0001). A descriptive analysis showed that Baduanjin plus other active treatments (such as massage, suspension, or routine drug plus general exercise) had small to moderate effects on low back pain relief compared with active treatments alone. One trial reported that Baduanjin decreased the Oswestry Disability Index (ODI) score compared with routine drug (MD= -4.92, 95% CI= -7.81 to -2.03, P = 0.0009). Another trial found the combination of Baduanjin and electrotherapy offered better improvement than electrotherapy on back-specific function (MD= -6.03, 95% CI= -8.45 to -3.61, P < 0.00001). Three trials suggested that Baduanjin alone or in combination with other treatments achieved greater effects on the Japanese Orthopaedic Association (JOA) score improvement than other treatments. No adverse event was identified in the only study reporting on safety data. Conclusions: The present study indicated that Baduanjin is effective for LBP. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. More large-scale, well-designed RCTs are warranted.