Tuina-Focused Integrative Chinese Medical Therapies for Inpatients with Low Back Pain: A Systematic Review and Meta-Analysis

Table 4

Forest plots of the effect of Tuina-focused integrative Chinese medical therapies (TICMT) on functional status of in-patients with low back pain. Box in the line for each study: the mid-point of the box represents the mean effect estimate, which area shows the weight given to the study, and the line represents the confidence intervals of the mean effect estimate. The diamond below these studies represents the overall effect. The vertical line, which corresponds to the value 0 in the plot, is the line of no effect. Note that it says favours TICMT to the right of the vertical line and favours control therapy to the right of the vertical line.

Study or subgroup	TICMT			Control therapy				Std. mean difference	Std. mean difference
	Mean	SD	Total	Mean	SD	Total	Weight	IV, random, 95% CI	IV, random, 95% CI
1.1.1 Tuina plus Chinese herbal medicine
Liang 2005 [13]	12.4	5.79	25	7.1	6.39	24	14.2%	0.86 (0.27, 1.44)
Zhang et al. 2011 [18]	51.2	13.22	87	28.2	13.69	87	15.1%	1.70 (1.35, 2.05)
Subtotal (95% CI)			112			111	29.3%	1.31(0.49,  2.14)
Heterogeneity: Tau^2 = 0.30; Chi^2 = 5.89, df = 1 (P = 0.02); 𝐼^2 = 83%
Test for overall effect: Z = 3.12 (P < 0.002)
1.1.2 Tuina plus acupuncture
Chen et al. 2007 [21]	10.83	3.56	30	8.16	3.96	30	14.5%	0.70 (0.18, 1.22)
Zeng 2012 [26]	12.7	4.77	60	10.6	5.04	40	14.9%	0.43 (0.02, 0.83)
Subtotal (95% CI)			90			70	29.4%	0.53(0.21,  0.85)
Heterogeneity: Tau^2 = 0.00; Chi^2 = 0.65, df = 1 (P = 0.42); 𝐼^2 = 0%
Test for overall effect: Z = 3.24 (P = 0.001)
1.1.3 Tuina plus hot pack
Rong 2010 [27]	11.32	1.77	20	5.23	2.41	20	12.6%	2.82 (1.92, 3.72)
Subtotal (95% CI)			20			20	12.6%	2.82 (1.92,  3.72)
Heterogeneity: not applicable
Test for overall effect: Z = 6.15 (P < 0.00001)
1.1.4 Tuina plus more than one Chinese medical therapy
Chen 2012 [32]	11.1	3.65	51	4	3.28	52	14.6%	2.03 (1.55, 2.51)
Zhou 2009 [30]	19.82	2.91	50	9.46	3.56	50	14.1%	3.16 (2.57, 3.76]
Subtotal (95% CI)			101			102	28.8%	2.58 (1.48,  3.69)
Heterogeneity: Tau^2 = 0.56; Chi^2 = 8.42, df = 1 (P = 0.004); 𝐼^2 = 88%
Test for overall effect: Z = 4.57 (P < 0.00001)
Total (95% CI)			323			303	100.0%	1.64 (0.93,  2.36)
Heterogeneity: Tau^2 = 0.85; Chi^2 = 84.86, df = 6 (P < 0.00001); 𝐼^2 = 93%
Test for overall effect: Z = 4.49 (P < 0.00001)