• Juan Yang, Jeffrey S Brault, Mark A Jensen, Alexander Do, Qingyu Ma, Xuan Zhou, Longbin Shen, Canghuan Zhao, Kwok Chee Philip Cheong, Kejie He, Yu Guo, Zhuoming Chen, Shujie Tang, Yong Tang, Celia Ia Choo Tan, Jiaxu Chen, and Brent A Bauer.
• Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States.
• JMIR Res Protoc. 2021 Jan 27; 10 (1): e20615.

BackgroundChronic nonspecific low back pain (CNLBP) is one of the most common complex pain conditions, and it is strongly associated with high rates of disability. Even though several studies on Tui na for CNLBP have been reported, to our knowledge there has been no systematic review of the currently available publications.ObjectiveThis study aims to develop a protocol for a systematic review and meta-analysis that will evaluate the effectiveness and safety of Tui na therapy for patients with CNLBP.MethodsAn electronic literature search of PubMed, Embase, MEDLINE, Cochrane Library, Springer, Scopus, World Health Organization International Clinical Trials Registry Platform, Physiotherapy Evidence Database (PEDro), Clarivate Analytics, and Chinese biomedical databases (the China National Knowledge Infrastructure, Wan-fang database, Chinese Scientific Journals Database, and Chinese Biomedical Literature Databases) will be conducted. Studies will be screened by two reviewers independently based on titles and abstracts, followed by a full-text reading with eligibility criteria. Randomized controlled trials involving Tui na for patients with CNLBP will be reviewed. The primary outcomes of the study are improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event of Tui na intervention. Methodological quality and risk of bias will be assessed with the Cochrane Collaboration Risk of Bias Tool. If studies are sufficient, a meta-analysis of the effectiveness will be performed. If possible, we will evaluate publication bias using funnel plots. If substantial heterogeneity between studies is present, and there are sufficient studies, subgroup analyses will be conducted to explain the study findings.ResultsThe review database searches will be initiated in December 2020, with findings expected by January 2021.ConclusionsThis protocol will establish a framework of a high-quality literature synthesis on the impact of Tui na treatment in patients with CNLBP. The proposed review will determine whether Tui na is effective and safe for CNLBP patients.Trial RegistrationPROSPERO CRD42020166731; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=166731.International Registered Report Identifier (Irrid)PRR1-10.2196/20615.©Juan Yang, Jeffrey S. Brault, Mark A. Jensen, Alexander Do, Qingyu Ma, Xuan Zhou, Longbin Shen, Canghuan Zhao, Kwok Chee Philip Cheong, Kejie He, Yu Guo, Zhuoming Chen, Shujie Tang, Yong Tang, Celia Ia Choo Tan, Jiaxu Chen, Brent A. Bauer. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 27.01.2021.

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