To explore possible factors related to the increased likelihood of retirement from practice and increased number of complaints and concerns received by osteopaths in practice 10 years or more.
Online cross-sectional survey.
UK osteopathic healthcare.
UK-based osteopaths registered with the General Osteopathic Council.
570 questionnaires were eligible for analysis. Respondents were mostly women (57.5%), working in England (90.7%), white or white British (91.8%), 50–59 years of age (29.6%) and practicing for 0–5 years (16.9%). Osteopaths who had been in practice for 10 years or more were significantly (² tests, p
Osteopaths who have been in practice for 10 years or more have some significantly different demographics and aspects of clinical practice and patient management to those in practice less than 10 years. However, it is not clear whether these differences are influential in decisions for leaving practice or the increased number of concerns and issues received.
Considering the proven anti-inflammatory effects of curcumin, we aimed to investigate the effect of curcumin supplementation on fatigue and musculoskeletal health (primary outcomes) and depression and its side effects (secondary outcomes) in postmenopausal women.
This was a parallel-group, double-blind, randomised placebo-controlled superiority trial.
The trial was conducted at two general clinics in Tabriz, Iran, in 2023.
A total of 74 postmenopausal women were enrolled. The participants were women aged between 40 years and 60 years with normal menopause and at least 1 year after amenorrhoea.
They were randomly assigned (1:1 allocation ratio) using a block randomisation method to receive either 500 mg curcumin capsules (intervention group, n=37) or identical placebo capsules (control group, n=37) twice daily for 8 weeks. Both participants and researchers were blinded to the group assignments.
Data were collected using the questionnaires of demographic characteristics, short form of the perimenopausal fatigue scale, musculoskeletal health, Beck Depression Inventory (BDI-13) and the side effects checklist. Independent t, ANCOVA and Mann-Whitney U tests were used to compare the results between the two groups.
A total of 74 women were randomised, with 33 in the curcumin group and 31 in the placebo group completing the study and being included in the final analysis. After the 8-week intervention, ANCOVA adjusting for baseline values revealed that the curcumin group showed a statistically significant improvement in musculoskeletal health (mean difference (MD): 5.3; 95% CI: 3.3 to 7.4; p
In this trial, an 8-week supplementation with curcumin was more effective than placebo at improving musculoskeletal health and reducing fatigue score in postmenopausal women. The study was not able to demonstrate a significant effect on depression.
Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N72. Last updated version: 18 October 2022. Actual start of recruitment: 23 January 2023.
Acute pain in the postoperative period of cardiac surgery is mostly treated with opioid analgesics. However, with the risk of adverse reactions and complications, strategies which do not involve opioid analgesics can be considered, such as aromatherapy. This systematic review aims to analyse the effectiveness of aromatherapy in relieving pain in post-cardiac surgery patients.
Two researchers will independently and simultaneously conduct searches and select studies from the following databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature on Health Sciences, Scopus, Web of Science, Cochrane (Library) and clinical trial registries (clinicaltrials.com), with no language or publication date restrictions. Randomised and quasi-randomised clinical trials on the use of aromatherapy for pain relief in postcardiac surgery patients will be included. Then, two researchers will independently examine the studies based on inclusion criteria, extract data from the included studies and assess the risk of bias using the Risk of Bias 2 tool and the Risk of Bias in Non-randomized Studies of Interventions tool from Cochrane. Data will be synthesised using Review Manager software. The strength of the evidence will be evaluated using the Grading of Recommendation Assessment, Development and Evaluation approach. The literature search, study selection, review and meta-analysis stages will be conducted from early October 2025 to April 2026.
This study is based on secondary data, and therefore ethical approval from a research ethics committee was not required. The results will be disseminated through publication in a peer-reviewed scientific journal.
CRD42024568532.
Migraine, a major headache disorder of high prevalence, affects approximately one billion individuals globally and imposes a substantial socioeconomic burden. Acupuncture, as a modality of complementary and alternative medicine, is increasingly used by patients for migraine management. Nevertheless, the effectiveness of acupuncture in randomised controlled trials (RCTs) for this condition remains a subject of debate. The varying non-specific effects of different sham acupuncture (SA) techniques complicate the accurate assessment of true therapeutic effectiveness of acupuncture. This protocol details a systematic review and network meta-analysis (NMA) aimed at comprehensively evaluating both the effectiveness of acupuncture compared with various sham controls and the differential non-specific effects of different SA methods in migraine. Our aims involve: (1) evaluating the effectiveness of acupuncture relative to SA controls in migraine treatment; (2) comparing the effect sizes across different SA methods and (3) identifying potential factors that influence the outcomes associated with various sham interventions.
We will undertake a thorough investigation using multiple databases, including Wanfang Data, Cochrane Library, Web of Science, Embase, ClinicalTrials.gov, PubMed, Chongqing VIP Database, SinoMed, Cochrane Central Register of Controlled Trials, Chinese Clinical Trial Register, International Traditional Medicine Clinical Trial Registry and China National Knowledge Infrastructure, spanning from their initial records up to 12 November 2024. The inclusion criteria are RCTs that compare acupuncture with SA controls for migraine treatment. Studies with waiting-list or no-treatment controls will be included only if they also contain an SA arm. Studies focusing exclusively on chronic migraine patients (≥15 headache days per month) will be excluded. Two independent reviewers will perform study selection, data extraction using a standardised prepiloted form and risk of bias assessment. The primary outcome will be the standardised mean difference (SMD) in migraine frequency measures, allowing for the inclusion of various frequency metrics (eg, migraine attacks, migraine days, headache days). Secondary outcomes will include response rate (≥50% reduction in frequency), days with acute medication use, the number of migraine days per month, pain intensity (measured using tools such as the Visual Analogue Scale or Numeric Rating Scale), and scores from migraine-specific questionnaires, among others. The Cochrane Risk of Bias tool 2 (RoB 2) will be employed for bias assessment, along with the Confidence in Network Meta-Analysis online tool and the Grading of Recommendations Assessment, Development and Evaluation system. A frequentist NMA will be executed using Stata (V.18.0). The network structure will comprise: acupuncture as a single node (or multiple nodes if heterogeneity warrants), different SA methods as separate nodes, and waiting-list/no-treatment as a single node. In terms of continuous outcomes, the synthesis will be conducted using the SMD with a 95% CI for estimating effects. Heterogeneity, network inconsistency and potential publication bias will be scrutinised. As needed, meta-regression, subgroup analyses and sensitivity analyses will be executed.
Since this research is based on data from published sources, it does not necessitate formal ethical clearance. The results will be shared via articles in scholarly journals and during presentations at academic symposiums.
CRD42024620550.
To examine trends in Chuna manual therapy utilisation for musculoskeletal disorders (MSDs) following its inclusion in the National Health Insurance (NHI) system in Korea in 2019 using claims data from the Health Insurance Review & Assessment Service (HIRA).
Retrospective analysis of NHI claims data.
Nationwide medical institutions, based on HIRA claims data from April 2019 to December 2021.
All patients who received at least one Chuna therapy session during the study period.
Primary outcome: Annual trends in Chuna manual therapy claims. Secondary outcome: Patient demographics, therapy frequency, MSD diagnoses and concurrent therapies.
A total of 12 729 625 Chuna therapy claims were analysed, showing a gradual annual increase in utilisation from 2019 to 2021. The most common age group was 45–54 years (22.3%), with female patients comprising a higher proportion (55.8%) than male patients.
Low back pain (M54.5), lumbar sprain and strain (S33.5) and cervicalgia (M54.2) were the most common diagnoses. Patients receiving Complex Chuna (50% co-payment) had more treatment sessions than those receiving Simple Chuna or Complex Chuna (80% co-payment), with spinal disorders such as spinal stenosis (M48.0) and intervertebral disc disorders (M51.1, M50.1) associated with higher treatment frequency. Acupuncture was the most common concurrent therapy (97.4%).
This study is the first to comprehensively analyse Chuna therapy utilisation using nationwide NHI claims data. The findings confirm that Chuna therapy is widely used for MSDs, particularly among middle-aged and elderly patients with spinal or muscle-related conditions. Patients with severe or chronic spinal diseases were more likely to receive frequent Chuna therapy sessions. These results provide insights into the utilisation patterns of Chuna therapy and highlight the need for further research to refine reimbursement policies based on disease severity and patient characteristics.
Extensive progress has been made in improving pregnancy outcomes for in vitro fertilisation and embryo transfer (IVF-ET) patients through the use of electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS). However, a clear and suitable recommendation for the parameter selection scheme of EA/TEAS remains elusive.
To evaluate evidence-based conclusions of different EA/TEAS parameters on improvement of pregnancy outcomes in patients undergoing IVF-ET and evaluate other factors that may affect pregnancy outcomes.
This meta-analysis systematically searched eight databases from inception to 27 August 2024, focusing on randomised controlled trials (RCTs) that evaluated the effectiveness of EA/TEAS in improving IVF-ET outcomes, with the primary outcome defined as clinical pregnancy rate (CPR), and secondary outcomes including biochemical pregnancy rate (BPR) and live birth rate (LBR). We further explored CPR variations associated with EA/TEAS parameters: waveform (dilatational vs continuous wave), frequency (low vs high) and treatment duration (20, 25, 30, 40, 60 min). Additionally, seven subgroup variables were analysed to identify potential influencing factors: routine treatment, intervention dose, intervention modality, mean participant age, control type, randomisation risk and allocation concealment risk.
A total of 27 RCTs (3786 participants) were included, with the quality of evidence ranging from moderate to very low. Compared with control groups, the use of dilatational waves significantly increased CPR (RR=1.36, 95% CI [1.17 to 1.58], p2=0). Similarly, low-frequency currents demonstrated a significant positive association with CPR (RR=1.38, 95% CI [1.25 to 1.51], p2=0) and a treatment duration of 30 min per session was associated with elevated CPR (RR=1.30, 95% CI [1.19 to 1.42], p2=0). Subgroup analyses revealed that the effect of EA/TEAS on CPRs varied significantly depending on therapeutic dose (p=0.029), with stronger associations observed in studies involving patients receiving high therapeutic dose compared with those receiving low therapeutic dose.
Current evidence suggests that dilatational waves, low-frequency currents and 30-minute treatment duration may improve CPRs, though findings require validation in larger trials. While parameter optimisation shows promise, stronger evidence is needed before standardising protocols. Future research should focus on rigorous RCTs to determine optimal parameters and dose-response relationships.
Chemotherapy-induced peripheral neuropathy (CIPN) is the most prevalent non-haematological, dose-limiting adverse event associated with platinum derivatives and taxanes. Currently, no effective prophylactic interventions for CIPN have been established. However, several studies have shown that acupuncture may alleviate symptoms of peripheral neuropathy, proposing it as a potentially effective strategy for CIPN prevention. This pilot trial will help determine the feasibility and efficacy of acupuncture for preventing CIPN. The results will provide valuable insights for designing a larger clinical trial and conducting power calculations.
This is a randomised sham-controlled trial. A cohort of 60 patients scheduled to receive chemotherapy will be enrolled and randomly assigned to either the electroacupuncture group or the sham acupuncture group. Eligible patients will receive nine treatment sessions administered over the course of three chemotherapy cycles. The primary outcome is the change in CIPN-related quality of life (QOL) measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) CIPN20 from baseline to the end of cycle three. Secondary outcomes include: neurotoxicity symptoms assessed by the Numeric Rating Scale, incidence of CIPN, chemotherapy status, insomnia symptoms measured by the Insomnia Severity Index, depression symptoms evaluated using the Beck Depression Inventory-II, anxiety symptoms assessed with the Generalised Anxiety Disorder-7 and fatigue symptoms measured by the Brief Fatigue Inventory. Adverse events will be meticulously recorded.
The study protocol (V.1.0, 29 July 2024) has been approved by the First Affiliated Hospital of Zhengzhou University (2024-KY-0853–001). All patients will provide oral informed consent and written informed consent before participating in this study. Trial results will be disseminated in peer-reviewed publications.
ITMCTR2024000390 (International Traditional Medicine Clinical Trial Registry, http://itmctr.ccebtcm.org.cn/zh-CN/Home/ProjectView?pid=16387992-8971-4218-9cd0-b623af91f9f3), registered on 3 September 2024.
Chronic low back pain (CLBP) and depressive symptoms (DS) are highly prevalent, burdensome, costly and comorbid health conditions. Osteopathic manipulative treatment (OMT) was shown to improve pain and disability in patients with CLBP; however, the effect on comorbid DS remains less certain. Interestingly, CLBP and DS seem to be associated with changes in interoception, which may be reversed by OMT.
The study protocol proposes a single-blinded, parallel-group, randomised controlled trial to investigate the effect of OMT on clinical symptoms (depression, pain and disability) and interoceptive functions (interoceptive accuracy, sensibility and awareness) in patients with CLBP and comorbid DS. A sample of 60 adult subjects with CLBP and comorbid DS shall be recruited from osteopathic, orthopaedic and physiotherapeutic practices and educational institutes for osteopathy, sports science, psychology and medicine in Hamburg, Germany. Participants will be randomly allocated (1:1 ratio) to receive six 45 min treatment sessions of either OMT (standard-OMT group) or sham treatment imitating OMT (sham-OMT group). Primarily, symptoms of depression, pain and disability will be assessed with the Beck’s Depression Inventory, Second Edition (BDI-II), Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI). Secondarily, interoceptive accuracy, sensibility and awareness will be evaluated using the Heartbeat Tracking Task (HTT), Multidimensional Assessment of Interoceptive Awareness (MAIA-2) and confidence-accuracy correspondence (CAC). Ancillary, the therapeutic alliance will be investigated with the Helping Alliance Questionnaire. Data will be collected at baseline (t0), the first, third and sixth treatment sessions (t1, t3, t6) and at 3 months follow-up (t7). The findings will be analysed for between-group differences using descriptive (mean and SD) and inductive statistics (mixed analysis of variance). It is hypothesised that standard-OMT, compared with sham-OMT, will reduce depression, pain and disability (BDI-II, NRS, ODI) and increase interoceptive accuracy, sensibility and awareness (HTT, MAIA-2, CAC) in patients with CLBP and comorbid DS.
The study was approved by the ethics committee of the Medical School Hamburg (MSH-2023/288). The anonymised dataset will be published in an online repository, and the results will be published in peer-reviewed scientific journals.
DRKS00031694.
Temporomandibular disorders (TMDs) are a group of conditions affecting the temporomandibular joint (TMJ), masticatory muscles and associated structures, often leading to pain, dysfunction and a significant impact on quality of life. Epidemiological studies have estimated that up to 75% of the population in the USA exhibits at least one sign of TMD. Although conservative treatments, such as acupuncture and occlusal splints, have been recommended, evidence for their effectiveness remains inconclusive, and the combined effects of these interventions are not well understood.
This study aims to evaluate the efficacy of an intraoral balance appliance (IBA) combined with standard Korean medicine care, compared to Korean medicine care alone, in patients with chronic, painful TMD with myalgia.
A single-centre, two-arm, parallel, practitioner-blinded and evaluator-blinded, randomised controlled trial with a 1:1 allocation ratio will be designed to test the interventions. 76 patients with TMD with myalgia will be recruited and randomised. The interventions will include manual acupuncture and physical therapy for both groups, with the addition of IBA in the treatment group for 3 weeks. The primary outcomes of the study will be the Numeric Rating Scale (NRS) for pain and discomfort at the final visit at week 4. Secondary outcomes will include overall functional assessment of the TMJ using several scales, as well as evaluations of quality of life, patient satisfaction and
The recruitment started on 18 July 2024, and 37 patients were included as of 8 July 2025.
Ethical approval is obtained from the Kyung Hee University Korean Medicine Hospital Institutional Review Board (IRB number: KOMCIRB 2023-06-001). The result from this study will be actively disseminated through manuscript publications and conference presentations.
The protocol was registered with the Clinical Research Information Service (CRiS), Republic of Korea, on 30 October 2023, CRiS number KCT0008906 prior to the initiation of the study, and was revised on 7 July 2025 (https://cris.nih.go.kr/cris/search/detailSearch.do?seq=30270&search_page=M&search_lang=&class_yn=).
This study aimed to develop a core outcome set (COS) for trials evaluating the effects of complementary therapies in people with multiple sclerosis (pwMS). We sought to identify the outcomes most relevant to pwMS, their relatives and friends, healthcare professionals and researchers and to propose these for inclusion in future trials.
A participatory international research project using a mixed-method approach with qualitative and quantitative methods. The study included a scoping review and a national survey in Switzerland to identify candidate outcomes, followed by an international COS survey to rate the importance of these outcomes. The final phases involved two consensus meetings to refine and finalise the COS.
Data were sourced from the published literature and input from international stakeholders.
pwMS and other relevant stakeholders, including their relatives and friends, healthcare professionals and researchers.
A total of 770 individuals participated in the international COS survey of 39 candidate outcomes (662 pwMS, 27 relatives/friends, 58 healthcare professionals and 23 researchers). According to the survey results, 13 outcomes were added to the COS, 5 were excluded and 21 were classified as ‘no consensus’. 13 individuals (six pwMS, one pwMS’s friend, three healthcare professionals and three researchers) attended the first consensus meeting. Following the voting on the outcomes without consensus, seven outcomes were added to the COS, four were excluded and 10 outcomes were still classified as ‘no consensus’. The six members of the stakeholders advisory board (one pwMS, four healthcare professionals and two researchers) attended the second consensus meeting to define the final COS. Nine additional outcomes were included in the COS. Sexual problems, an outcome previously excluded, were also added. In total, 30 outcomes were included in the final COS.
We have developed the first COS for future trials of complementary therapies for pwMS. The use of this COS will promote that future research in complementary therapies is relevant for pwMS and other stakeholders involved in MS care. Future COS research should integrate diverse geographical regions, where perspectives and access to complementary therapies may vary.
Although caesarean sections (CSs) are essential for the management of obstructed labour and other obstetric complications, postoperative pain, delayed recovery and complication risks continue to be significant challenges in perioperative management. Improvements in traditional medications and surgical techniques have helped, yet issues, including medication side effects and extended recovery times, persist. Therefore, it is particularly important to seek non-pharmacological interventions, such as acupoint stimulation, to optimise the perioperative management of CS. The aim of this systematic review protocol is to synthesise the available evidence and assess the effect of acupoint stimulation in the perioperative period of CS.
We plan to search PubMed, Web of Science, EMBASE, Scopus, the Cochrane Library and China National Knowledge Infrastructure, from their inception to August 2025. Primary outcome indicators will include pain, time to first defecation, time to first bowel movement and time to return of bowel sounds. Secondary outcome indicators will include postoperative complications, such as nausea and vomiting, bloating, anxiety and depression, as well as length of hospital stay and morphine consumption. Subgroup analyses, meta-regression and sensitivity analyses will be used to investigate the potential sources of heterogeneity and to test the stability of the results. Trial sequential analysis will be introduced to enhance the reliability of the evidence.
No ethical approval is required as this study synthesises the existing published data. Results will be disseminated through peer-reviewed publications and conference presentations. Any protocol amendments will be documented in PROSPERO and detailed in the final publication.
CRD42024558572.
Overactive bladder (OAB) is a common condition, affecting approximately one-fifth to one-sixth of the world’s population. The American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Genitourinary Reconstruction guidelines recommend sacral neuromodulation (SNM) as third-line treatment. Although SNM can relieve the symptoms of refractory OAB, several factors, including high cost and the high incidence of adverse effects, limit its large-scale clinical use. Moreover, patient acceptance is low. Acupuncture is an alternative approach for treating OAB that is minimally invasive and has few side effects. Clinical studies have shown that it can reduce the number of episodes of urination and urgent urination within 24 hours and improve the quality of life. However, clinical evidence on the effectiveness of electroacupuncture for treating refractory OAB is limited.
Is to assess the short-term effectiveness of electroacupuncture for improving the symptoms and quality of life of women with refractory OAB and to observe its long-term effects. A secondary objective is to assess whether electroacupuncture is more effective than conventional acupuncture for treating patients with refractory OAB.
The study is designed as a two-arm, parallel, participant-blinded randomised controlled trial (RCT). A total of 60 women between the ages of 18 years and 60 years who are experiencing refractory OAB will be randomly assigned to two groups: one receiving electroacupuncture and the other receiving conventional acupuncture. Each participant will undergo a treatment regimen lasting 4 weeks. During the initial 2 weeks, participants will receive five sessions of either electroacupuncture or conventional acupuncture per week, followed by three sessions per week during the subsequent 2 weeks. In total, each individual will receive 16 treatment sessions throughout the course of the study. The primary outcome measure will be the change in OAB Symptom Score (OABSS) over time between groups. The secondary outcome measures will include the OABSS, the Patient-Perceived Bladder Symptom Grading Scale, the Overactive Bladder Questionnaire, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale during the treatment and follow-up periods. Blinding and safety will also be assessed. Two-sided p values
The study protocol was approved by the Institutional Review Board of Beijing Fengtai Hospital of Integrated Traditional and Western Medicine on 5 February 2024 (Approval No. 2024020101). The results will be disseminated through presentations at scientific conferences and peer-reviewed publications.
ChiCTR2400081448.
Obesity is a growing public health issue worldwide, and anxiety is a major psychological disorder associated with obesity. Electroacupuncture (EA) has been proven to be a feasible treatment modality for obesity and anxiety in clinical practice. However, data on the effectiveness of EA for anxiety patients with obesity are lacking. Therefore, this study aimed to evaluate the effectiveness and safety of EA for anxiety in patients with obesity and to observe the brain functional status of the patients and the intervention effects of EA on brain function by using functional MRI (fMRI).
In this randomised, blinded, sham-controlled clinical trial, 72 patients with obesity from two hospitals with anxiety will be randomly divided into EA and control groups in a 1:1 ratio by using a random number table. Patients in the EA group will receive EA treatment with penetrating needling at specific acupoints for 8 weeks. The control group will receive Park’s acupuncture with non-penetrating needling. Weight, waist, body mass index, Self-rating Anxiety Scale score, State-Trait Anxiety Inventory score and Pittsburgh Sleep Quality Index will be measured before treatment, after 8 weeks of treatment and at the 1-month follow-up evaluation. Objective metabolic parameters such as triglyceride, total cholesterol, fasting blood glucose, ghrelin, leptin, cortisol and adrenocorticotropic hormone levels will also be measured before and after the 8-week intervention. 20 patients will be randomly selected from the EA and control groups before treatment. These randomly selected patients will undergo fMRI scans before and after treatment. Regional homogeneity, amplitude of low-frequency fluctuation and resting-state functional connectivity will be evaluated to compare the dysfunctional brain regions between two groups of patients after treatment.
The study protocol has been approved by the Hospital Ethics Committee of Second Affiliated Hospital of Anhui University of Chinese Medicine (2023-zj-42). Informed consent will be obtained prior to starting study-related procedures. The results will be disseminated in peer-reviewed journals and at scientific conferences.
Chinese Clinical Trial Registry. ChiCTR2400083594, registered 29 April 2024.
To develop a teaching exemplar for optimising the safe and accessible delivery of chair-based yoga to multimorbid older adult populations.
A qualitative process evaluation embedded within the multi-site, randomised controlled Gentle Years Yoga trial for older adults (65+ years) with two or more long-term health conditions (trial status: completed).
Online and face-to-face interviews were conducted with participants and yoga teachers involved in the 12-week chair-based yoga intervention. Interview data were supplemented with observations of in-person and online yoga class delivery.
All yoga teachers delivering the yoga intervention were invited to take part in the interviews, together with a subsample of participants receiving the yoga intervention. Participants were purposively selected to represent the trial cohort demographics of gender, age, ethnicity, index of multiple deprivation, and number and intensity of chronic health conditions.
25 yoga participants and 11 yoga teachers took part in one (N=19) or two (N=17) interviews. Participants were aged 66–91 years (mean age 74 years), with 2–8 long-term health conditions, most commonly osteoarthritis (N=15, 60%), cardiovascular disease (N=14, 56%), sensory conditions (N=9, 36%) and depression or anxiety (N=8, 32%). Yoga teachers were predominantly female (N=10, 91%), with 4–35 years yoga teaching experience across multiple yoga styles. Feedback from yoga teachers and participants was classified into six categories, generating a 21-item teaching exemplar. These covered aspects of delivery including class size and delivery formats, choosing appropriate physical content, enhancing inclusivity of personal beliefs through non-physical content, proactive teaching styles, communication tips and ways to boost visibility.
This 21-item list adds to the current educational base of yoga for older adults. Addressing both face-to-face and online class formats, this exemplar offers pragmatic guidance for yoga teachers to enhance the safe and accessible delivery of chair-based yoga to older adults and multimorbid populations.
Obesity combined with metabolic syndrome is a major global public health problem. This trial aims to investigate the therapeutic effects of low-frequency transcutaneous electrical nerve stimulation (Lo-TENS) in individuals with obesity and coexisting metabolic syndrome. The study will also delve into the underlying mechanisms through which Lo-TENS may mitigate the symptoms of metabolic syndrome, providing insights into its potential as a novel treatment approach.
This randomised controlled trial will enrol 63 individuals with obesity and metabolic syndrome, and randomly assign them to one of the three groups: (1) peripheral stimulation group, (2) central stimulation group and (3) sham stimulation group. Each participant will receive a 30 min daily session of their assigned stimulation, conducted 5 days a week for a duration of 12 weeks. The primary outcomes of interest are body mass index and fasting blood glucose, with secondary outcomes encompassing blood pressure, triglyceride levels and various metabolic biomarkers. Comprehensive assessments will be performed at baseline, immediately post intervention, and followed by a 12-week follow-up evaluation to monitor long-term effects and sustainability of potential benefits.
The trial has been granted ethical approval by the ethics committee of the Second People’s Hospital of Kunming (approval number: 202305001). The study’s findings will be disseminated through peer-reviewed journal publications and international conference presentations.
Chinese Clinical Trial Registry Platform: www.chictr.org.cn (No. ChiCTR2400089104).
Chronic musculoskeletal pain (CMP) is a prevalent and distressing condition. Cupping therapy, one of the most popular complementary and alternative medicines, has been widely used to reduce CMP. But the evidence remains controversial on the effect of cupping therapy on CMP. The objective of this review and meta-analysis is to assess the effectiveness of cupping therapy in patients with CMP.
Systematic review and meta-analysis.
PubMed, Web of Science, EBSCO, Cochrane Library and CNKI (China National Knowledge Infrastructure) were searched through 20 December 2024.
We included randomised control trials that compared cupping therapy for patients with CMP on outcomes (ie, pain intensity, functional disability and mental health).
Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Cochrane Collaboration and Evidence Project tools. Meta-analysis was conducted using random and fixed effects models. Findings were summarised in GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence profiles.
The results showed that cupping therapy (standardised mean difference (SMD)=–1.17; 95% CI=–1.93 to –0.42; p=0.002; I2=94%) had a significant reduction effect on patients with CMP’s pain intensity with moderate quality based on a random-effect model. But cupping therapy had no improvement effects on functional disability (SMD=–0.24; 95% CI=–0.93 to 0.46; p=0.51; I²=93%) and mental health (SMD=0.08; 95% CI=–0.12 to 0.27; p=0.46; I²=0%).
This study indicates that cupping therapy may be efficient in alleviating pain intensity in patients with CMP with immediate effects. But it cannot improve functional disability and mental health significantly.
CRD42023406219.
Labour pain is an unavoidable feature of childbirth and is characterised by extreme intensity. Adequate pain management is thus essential not only from the aspect of physiological pain but also due to the adverse effects of pain on the psychological well-being of parturients. Many studies have shown the benefits of acupoint hot compress. However, to date, little is known about its use for alleviating labour pain. The purpose is to evaluate the effect of acupoint hot compress on relieving pain in primiparous women during the latent phase of the first stage of labour, as well as its effects on key maternal and neonatal outcomes.
This prospective, multicentre, randomised controlled trial will be conducted across 18 institutions in China from January 2024 to August 2025. A total of 1100 primiparous women aged 20–34 years, with singleton pregnancies at 37–41 weeks of gestation, will be enrolled and randomly allocated to two groups using a central stratified block randomisation method. The controls will be treated only with obstetrical care, while those in the intervention group will receive the same obstetrical care as the control group, with the addition of acupoint hot compress therapy at 42±2°C for 4 hours, starting 1 hour after the onset of regular uterine contractions during the latent phase of labour. The primary outcome will be the pain intensity measured at 1, 3 and 5 hours after the onset of regular uterine contractions using a Visual Analog Scale.
The study has been approved by the ethics committee of Women’s Hospital, School of Medicine, Zhejiang University (No. IRB-20230379-R). The results of the main trial will be submitted for publication in a peer-reviewed journal.
This trial is registered at Chinese Clinical Trial Registry, ChiCTR2300079244.
This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.
This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
Three electronic databases—MEDLINE, Scopus and Google Scholar—were searched for all English-language articles published from 2010 until 18 December 2024.
The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.
Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.
Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).
The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.
PROSPERO number: CRD42024560816