OBJECTIVE: Low back pain (LBP) is a major global public health problem. Evidence shows that LBP is also related to cognitive, psychological, and lifestyle factors. Fu\'s subcutaneous needling (FSN) has been used for the treatment of musculoskeletal problems for many years. This prospective randomized controlled trial aimed to evaluate the clinical efficacy and fear avoidance beliefs of FSN in the treatment of patients with chronic non-specific LBP.
METHODS: Ninety participants with chronic non-specific LBP were randomly divided into the FSN and the traditional acupuncture (TA) groups (n = 45) and received either FSN or TA treatment for three consecutive days from December 2021 to March 2023. The primary outcome was pain intensity measured by the visual analogue scale (VAS). Secondary outcomes were trunk extensor endurance (TEE), lumbar range of motion (ROM), and the Fear Avoidance Beliefs Questionnaire (FABQ). Outcome measurements were made before the first treatment and after each treatment. Follow-up assessments of VAS and FABQ scores were conducted one month after treatment.
RESULTS: The FSN group had significantly lower VAS and FABQ scores at each time point after intervention compared to the TA group (P < 0.01). The scores of TEE and lumbar ROM were higher in the FSN group than those in the TA group (P < 0.01). Repeated measures analysis of variance (ANOVA) showed significant time effects, group effects, and interaction effects for VAS, TEE, lumbar ROM, and FABQ in both groups (P < 0.01). One month after treatment, the FSN group had significantly lower VAS and FABQ scores compared to the TA group (P < 0.05).
CONCLUSIONS: This study suggested that FSN was superior to TA in terms of clinical efficacy and fear-avoidance beliefs in the treatment of chronic non-specific LBP. FSN could be used as an effective clinical treatment.

Background/Objectives: Chronic non-specific low back pain (CNSLBP) is a prevalent condition causing significant distress and healthcare costs globally. Despite various treatments, effective management remains challenging. Pilates, recognized for its focus on core strength and postural alignment, has emerged as a promising intervention. This study investigates the impact of mind-body in Pilates for directing participants on CNSLBP outcomes. Methods: A randomized controlled trial was conducted with 67 participants, aged 18 to 65 years, suffering from CNSLBP. They were allocated into two groups: Pilates with mind-body cueing (n = 34) and Pilates without cueing (n = 33). Both groups underwent 60 min sessions twice weekly for 8 weeks. Outcome measures included pain intensity (Visual Analogue Scale), functional disability (Roland Morris Disability Questionnaire), fear of movement (Tampa Scale of Kinesiophobia), and adherence (percentage of sessions attended). Statistical significance was determined through repeated measures ANOVA. Results: Both groups showed significant improvement in pain reduction, functional ability, and kinesiophobia. However, the mind-body group demonstrated a statistically significant reduction in kinesiophobia compared to the non-cueing group (p = 0.048), indicating the potential additional benefit of mind-body cueing in managing movement-related fear in CNSLBP. Conclusions: This study underscores the effectiveness of an 8-week Pilates intervention in managing CNSLBP, highlighting the added value of mind-body cueing in reducing fear of movement. These findings suggest incorporating mind-body cueing in Pilates could enhance the therapeutic benefits, particularly for patients with high levels of movement-related fear, potentially improving long-term adherence to physical activity and rehabilitation outcomes.

Nowadays, due to lifestyle changes, the number of young people suffering from chronic non-specific low back pain (CNLBP) is gradually increasing. The recent guidelines for the treatment of low back pain emphasize that exercise therapy is the preferred treatment method for CNLBP. This study take ordinary college male students with CNLBP as objective of the study, focused into how core stability training affected the pain and muscle function of the CNLBP of youth. Herein, 60 male subjects were randomly divided into a control group and an experimental group, and conducted a randomized control trial in the Sports Rehabilitation Laboratory of Guangxi Normal University from September to October 2023. The control group received traditional waist strength training, while the experimental group received core stability training. VAS scores, pain symptoms scores and clinical efficacy grades were evaluated. Waist muscles fitness was evaluated, including back muscle strength, the prone upper body up\'s static holding time, 1-min modified sit-ups\' pcs, the supine abdominal curling\'s static holding time and the supine leg raising\'s static holding time. Waist movement function was also evaluated using oswestry disability index (ODI) questionnaire. Surface electromyographic (EMG) signals were collected from rectus abdominis, erector spinae and multifidus. The independent sample t-test was used to compare groups, and the paired sample t-test was used for the data comparison before and post-exercise within the group. The results of the study found that CNLBP was improved in both the experimental and control groups in the post-exercise. Compared to pre-exercise, there are significant decrease in the VAS scores (95%CI: 2.51 to 6.51, p = 0.000), pain symptoms scores (95%CI: 2.95 to 3.55, p = 0.000), waist movement function\'s evaluation scores for ODI (95%CI: 2.23 to 4.31, p = 0.000), rectus abdominis\' IEMG values (95%CI: 2.29 to 4.39, p = 0.000), erector spinae and multifidus\' IEMG values (95%CI: 2.18 to 4.45, p = 0.000) of experimental group in the post-exercise. Compared to pre-exercise, there are significant improvement in the back muscle strength (95%CI: 12.85 to 19.49, p = 0.000), the prone upper body up\'s static holding time (95%CI: 9.67 to 19.17, p = 0.000), the 1-min modified sit-ups\' pcs (95%CI: 8.56 to 18.12, p = 0.000), the supine abdominal curling\'s static holding time (95%CI: 6.73 to 19.14, p = 0.000), and the supine leg raising\'s static holding time (95%CI: 8.21 to 18.35, p = 0.000) of experimental group in the post-exercise. In the post-exercise,there are significant lower in the VAS scores (95%CI: 1.41 to 4.98, p = 0.000), pain symptoms scores (95%CI: 1.14 to 1.79, p = 0.011), waist movement function\'s evaluation scores for ODI (95%CI: 1.13 to 2.25, p = 0.000), rectus abdominis\' IEMG values (95%CI: 2.36 to 4.47, p = 0.000), erector spinae and multifidus\' IEMG values (95%CI: 2.24 to 4.23, p = 0.017) of experimental group than those of control group. In the post-exercise, there are significant higher in the recovery rate (p = 0.000), the prone upper body up\'s static holding time (95%CI: 4.16 to 8.32, p = 0.008), and the supine abdominal curling\'s static holding time (95%CI: 3.89 to 7.44, p = 0.000) of experimental group than those of control group. Therefore, it can be concluded that core stability training is significantly effective in treating CNLBP in youth, enhancing lower back muscle function. This therapeutic effect is primarily attributed to the improvement in muscle function.

BACKGROUND: Patients with chronic non-specific low back pain (CNLBP) often experience impaired postural control, contributing to pain recurrence. Although repetitive peripheral magnetic stimulation (rPMS) combined with core muscle training (CMT) could improve postural control, its neural mechanism remains unclear. This study aims to investigate the postural control-related cortical mechanism of the effect of rPMS on patients with CNLBP.
METHODS: This unicentric, prospective, randomized, double-blind, controlled trial was conducted in a public hospital from May to December 2023. A total of 40 patients (27 females and 13 males, mean age 29.38 ± 7.72) with CNLBP were randomly assigned to either the rPMS group (real rPMS with CMT) or the sham-rPMS group (sham-rPMS with CMT) for 12 sessions over 4 weeks. The rPMS was applied to the lumbar paravertebral multifidus muscle on the painful side. Pain and disability were quantified using the visual analog scale (VAS) and Oswestry dysfunction index (ODI) pre- and post-intervention. Furthermore, the sway area and velocity of the center of pressure (COP) were measured using a force platform. The cortical activities in 6 regions of interest during 4 tasks (standing with eyes open/closed on a stable/unstable plane) were recorded by functional near-infrared spectroscopy (fNIRS) pre- and post-intervention. The repeated measure ANOVA was applied for statistical analysis. Spearman\'s correlation was used to determine the relationships between variables.
RESULTS: After the intervention, the rPMS group showed decreased pain intensity (p = 0.001) and sway area (unstable eyes-closed task) (p = 0.046) compared to the sham-rPMS group. Additionally, the rPMS group exhibited increased activation in left primary motor cortex (M1) (p = 0.042) and reduced in left supplementary motor area (SMA) (p = 0.045), whereas the sham-rPMS group showed no significant changes. The increased activation of left M1 was negatively correlated to the reduction of pain intensity (r = - 0.537, p = 0.018) and sway area (r = - 0.500, p = 0.029) under the static balancing task. Furthermore, there was a positive correlation between sway velocity and VAS (r = 0.451, p = 0.046) post-rPMS intervention.
CONCLUSIONS: Repetitive peripheral magnetic stimulation combined with core muscle training demonstrated better analgesic effects and postural control improvements, compared to sham-stimulation. This may be attributed to the increased activation of the left primary motor cortex.
BACKGROUND: The trial was registered on ClinicalTrials.gov (ChiCTR2300070943).

暂无摘要。

Muscle structural studies on non-specific low back pain in young female nurses are rare. This study aimed to investigate the changes of lumbar extensor and flexor muscle cross-sectional area and fatty infiltration in young female nurses with chronic bilateral non-specific low back pain by lumbar spine magnetic resonance imaging to speculate on the possible pathogenesis.
The magnetic resonance imaging (MRI) data of 58 female nurses with chronic bilateral non-specific low back pain and 60 healthy female controls were analyzed retrospectively. The lumbar extensor and flexor muscle cross-sectional area/intervertebral disc cross-sectional area ratio, as well as magnetic resonance imaging signal intensity of lumbar extensor (erector spinae; multifidus) and flexor muscles (psoas muscle) were measured, calculated and compared between nurses and healthy controls by independent samples t-test. In addition, each mean MRI signal intensity of lumbar extensor or flexor muscles in nurses at different anatomical segments from lumbar vertebrae 2 (L2)-L3 to L5-sacral vertebrae 1 (S1) was also compared, and one-way Analysis of Variance (ANOVA) analyzed the mean MRI signal intensity between muscles in nurses with multiple comparisons.
There was no significant difference in lumbar extensor and flexor muscle cross-sectional area/intervertebral disc cross-sectional area ratio between nurses with chronic bilateral non-specific low back pain and healthy controls, p > 0.01. The magnetic resonance imaging signal intensity in lumbar extensor and flexor muscle was significantly higher in nurses with chronic bilateral non-specific low back pain than in healthy controls, p < 0.01. The MRI signal intensity of lumbar extensor muscle at the lower lumbar segments was higher than at the upper ones. The magnetic resonance imaging signal intensity of the extensor muscle (erector spinae; multifidus) was significantly higher than that of the flexor muscle (psoas muscle), p < 0.01.
This study showed that young nurses with chronic bilateral non-specific low back pain have lumbar extensor and flexor muscle fatty infiltration without muscle atrophy. We hypothesized that muscle fatty infiltration may occur prior to muscle atrophy. Therefore, the high fatty infiltration of the lumbar extensor and flexor muscle may be a cause or a result of chronic bilateral non-specific low back pain in young nurses.

UNASSIGNED: Chronic non-specific low back pain (CNLBP) is a complex condition characterized by pain, dysfunction, disturbed sleep, anxiety, and depression, all of which impair the quality of life. Previous studies showed that practicing Tai Chi had effects on chronic low back pain. However, there is a lack of evidence on its impact on sleep. The trial will evaluate the use of Tai Chi as a treatment for insomnia in elderly people with CNLBP.
UNASSIGNED: The study design will be a randomized, controlled, open-label trial. Participants (n = 106) will be recruited from the Hospital of Chengdu University of Traditional Chinese Medicine, Qing Yang District University for the Elderly, and Ci Tang Street Community. Participants will be randomly assigned to the Tai Chi group (n = 53) and the control group (n = 53). The Tai Chi group will undergo a Yang-style 24-form Tai Chi program for 8 weeks. The control group will have a waiting period of 8 weeks, followed by 8 weeks of Tai Chi practice. The primary outcomes of this study will be changes in sleep quality and pain intensity. Secondary outcomes of interest will include changes in the quality of pain, range of motion, physical performance, social support, and overall quality of life. Any adverse events and attendance rates will also be reported in this study.
UNASSIGNED: ChiCTR2200064977.

Chronic non-specific low back pain (CNLBP) is one of the leading causes of disability worldwide. Acupoint embedding (ACE) is widely used in China for the treatment of chronic non-specific low back pain, but there are no rigorous randomized controlled trials (RCTs) to confirm the effectiveness and safety of ACE for chronic non-specific low back pain. In this study, we design a single-center, single-blind, prospective RCT, with the aim of evaluating the efficacy and safety of ACE for CNLBP. 82 participants with CNLBP will be randomized in a 1:1 ratio into an ACE group and a sham ACE group. Participants will receive either ACE treatment or sham ACE treatment at once every 2 weeks, for an 8-week period, and followed by 6 months of follow-up. The primary outcome will be the change in visual analog scale (VAS) scores before and after treatment. Secondary outcomes will include the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ) and the Short Form 36-Health Survey (SF-36). Adverse events that occur during the course of the trial will be recorded. Data will be analyzed according to a predefined statistical analysis plan. This study was approved by the medical ethics committee of Guangzhou Panyu Hospital of Chinese Medicine (202230). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2200059245). Trial results will be published in a peer-reviewed academic journal.
UNASSIGNED: https://www.chictr.org.cn, identifier ChiCTR2200059245.

Chronic non-specific low back pain (CNLBP) is the most common musculoskeletal problem. The purpose of this study was to investigate the effects of advanced physiotherapeutic exercise programs on imaging findings and inflammatory biomarkers in soccer players with CNLBP. In total, 60 CNLBP participants were divided into virtual reality exercise (VRE; n = 20), isokinetic exercise (IKE; n = 20), and conventional exercise (n = 20) groups. Pain intensity, imaging findings (muscle cross-sectional area (CSA) and muscle thickness), and changes in inflammatory biomarkers (CRP, TNF-α, IL-2, IL-4, and IL-6) were measured at baseline and after four weeks. After four weeks of intervention, there was a significant improvement (p = 0.001) in pain intensity for the VRE vs. IKE (0.7; CI 95% 0.38 to 1.07) and VRE vs. conventional (3.0 CI 95% 2.68 to 3.31) groups. The IKE group showed a greater number of significant changes in muscle CSA and muscle thickness than the other two groups (p < 0.001). Moreover, the VRE group showed significant improvement in inflammatory biomarker measures compared with the other two groups (p < 0.001). In CNLBP, virtual and isokinetic exercises had equal effects on reducing pain intensity. Isokinetic exercise is beneficial in increasing the muscle CSA and thickness, and virtual exercises are helpful for attenuating the inflammation process in soccer players with CNLBP.

UNASSIGNED: The aim of this study was to investigate the effectiveness of whole-body vibration exercise (WBVE) and core stabilization exercise (CSE) on pain, muscle strength, and functional recovery in patients with chronic non-specific low back pain (NLBP).
UNASSIGNED: Between June 2016 and July 2017, a total of 74 patients with NLBP (12 males, 62 females; mean age: 44.7±8.9 years; range, 24 to 64 years) were included in this prospective, randomized-controlled study. The patients were randomly assigned to WBVE group (WBVEG, n=25), CSE group (CSEG, (n=25), and home exercise group as the control group (CG, (n=24). All groups performed 24 sessions of exercise for a total of eight weeks. Clinical outcome was measured using the Visual Analog Scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), computerized isokinetic muscle strengths (IMS) and progressive isoinertial lifting evaluation (PILE) test.
UNASSIGNED: The VAS and RMDQ scores in WBVEG and CSEG statistically significantly decreased (p<0.05). The difference between the pre-treatment and at three-month VAS scores during intense activity were significantly different in both WBVEG and CSEG than the CG (p<0.05). The IMS values, except for the isokinetic flexion total work (IKFTW), increased significantly in all three groups (p<0.05). The IKFTW values increased significantly in the WBVEG and CSEG (p<0.05). A statistically significant increase in the functional work performance with PILE was observed in all three groups (p<0.05). The differences between the pre-treatment and three-month PILE test (ground to back and back to shoulder) were significantly different in both WBVEG and CSEG than the CG (p<0.05).
UNASSIGNED: In the treatment of chronic NLBP, WBVE and CSE appear to be effective in pain and functionality. Although there was a significant improvement in muscle strength and functional work performance in all three groups, greater improvements were observed in the WBVEG and CSEG than the CG.