Tuina on knee pain and physical function for patients with mild-moderate knee osteoarthritis in Shanghai: protocol for a multicenter, assessor-blinded, randomized controlled trial
Bibliographic record
Abstract
Abstract Background Knee osteoarthritis (KOA) is one of the most common osteoarthritis, imposing substantial economic and medical burdens on both individuals and society. In China, Tuina has been chosen as a complementary and alternative therapy to relieve symptoms of knee pain and dysfunction. However, current evidence is insufficient to support the efficacy of Tuina therapy in addressing knee pain and improving physical function. The purpose of this trial was to investigate the efficacy of Tuina compared to celecoxib, by observing changes in outcome measures and assessing its level of effectiveness as an alternative treatment. Methods and analysis A total of 360 patients with KOA aged between 40 and 70 years and classified as Kellgren and Lawrence Grade I-II will be recruited from eight sub-central hospitals. The participants will be randomly assigned to either the treatment group (Tuina, Biw) or the control group (Celecoxib, Qd), with both groups undergoing a 4-week intervention phase followed by an 8-week follow-up phase. The primary outcome is the change of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at week 4 compared with baseline. Secondary outcomes including WOMAC stiffness and function subscales, WOMAC total score, 36-item short form health survey (SF-36), timed up and go test (TUG), short physical performance battery (SPPB), gait analysis parameters, and pain medication records will be assessed at weeks 4, 8, and 12. Any adverse events occurring during the trial will be promptly recorded. Discussion This multicenter randomized trial aims to evaluate the effectiveness of Tuina on relieving pain and increasing physical function of KOA patients. This protocol, if proven effective, will present more compelling evidence supporting the value of Tuina and contribute to providing a promising alternative therapy for patients with mild-moderate KOA. Trial registration number: This trial has been registered in the China Clinical Trials Registry (registration number: ChiCTR2300069416).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.030 | 0.020 |
| Meta-epidemiology (narrow) | 0.005 | 0.002 |
| Meta-epidemiology (broad) | 0.011 | 0.006 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.034 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".