연구 목적 : 본 연구는 근골격계 질환에 대한 수기치료가 갖는 경제적 효과를 체계적으로 평가해 보기 위해 시행되었다. 연구 방법 : 2017년 2월 2일까지 국내외 관련 문헌을 체계적으로 검색 하였으며, 연관된 체계적 고찰 논문의 참고문헌을 조사하였다. 두 명의 연구자가 독립적으로 문헌을 선택하고, 비뚤림 위험 평가 및 경제성 평가 질 평가, 자료 추출을 시행하였다. 연구 결과 : 총 3,327개의 논문을 검토하여 최종적으로 18개의 무작위 대조 연구가 포함되었다. 경제성 평가는 수기요법과 다른 치료방법간의 유효성 비교를 통해 시행되었다. 요부 통증, 견관절 통증 및 외측 상과염 치료에 있어 침치료, 견인치료, 주사치료, 일반의 치료, 척추 안정화 기법 및 통증관리 치료보다 비용 효과적인 것으로 나타났다. 또한 또한, 수기치료는 경항통, 흉통, 고관절염 혹은 슬관절염, 경추신경병증 및 수부손상 치료에 있어 일반적 치료, 물리치료, 자가 치료 프로그램, 견인 치료에 비하여 효과적인 치료인 것으로 확인되었다. 결론 : 18개의 논문 중 10개의 논문에서 근골격계 질환 치료에 있어 수기치료가 경제적으로 효과가 있는 것으로 나타났다. 이러한 결과는 다른 치료방법에 비해 수기요법이 근골격계 질환에 있어서 경제적 가치가 있음을 시사하는 내용이다. 하지만, 근골격계 질환 수기치료의 경제성 평가에 대한 선행 연구는 전반적으로 부족한 실정으로, 보다 정확한 결과를 제시하고 정책결정을 위한 효과적인 제안을 위해서는 체계적인 추가 연구가 필요하다 사료되는 바이다.

Objectives : This study was conducted to evaluate the therapeutic effects of Chuna Craniosacral therapy on headaches. Methods : 1. A combination of keywords, such as headache and Chuna Craniosacral therapy, were searched based on studies published in 11 databases (Pubmed, CAJ, EMBASE, Cochrane Library, Web of Science, KMBASE, KISS, KISTI, NDSL, RISS and DBPIA) up to October 31st, 2019. 2. The subjects were randomized controlled clinical studies using Chuna Craniosacral therapy. 3. We used the Cochrane perverse assessment tools for quality assessment. Results : 1. Six randomized controlled clinical studies were selected, and all 404 patients were evaluated. 2. As a result of the meta-analysis, Chuna Craniosacral therapy and scalp acupuncture showed no difference in treatment effect. 3. Chuna Craniosacral therapy showed a significant difference in treatment effect compared to Maitlands mobilization. 4. Chuna Craniosacral therapy showed a partial difference in treatment effect compared to low intensity magnetotherapy. 5. Chuna Craniosacral therapy group showed a significant effect on pain reduction compared to the untreated group. 6. All six papers showed a high degree of bias risk, with no mention of side effects or adverse events. Conclusion : This study provided only a limited assessment of the curative effects of Chuna Craniosacral therapy's headache treatment. However, there was no mention of side effects, and given the therapeutic effects analyzed in individual papers, it is believed that Craniosacral therapy can be used safely to treat headaches.

Objectives : The purpose of this study was to provide a clinical evidence base for the effectiveness of the muscle energy technique (MET) for cervicalgia. Methods : We conducted a search of 10 electronic databases up to April 2019. Randomized controlled trials (RCTs) that performed the MET for cervicalgia were included. The risk of bias was assessed using the Cochrane risk of bias (RoB) tool. Results : Six RCTs met the inclusion criteria. The literature review of these studies showed favorable results for the use of the MET in comparison to other manual medicines. Conclusions : In 6 RCTs, we found that the MET was effective in cervicalgia treatment. However, most of the included studies had an unclear risk of bias. Therefore, well-designed RCTs are necessary to obtain a higher evidence level of the MET use in cervicalgia.

Objectives : This study aimed to evaluate the randomized controlled clinical trials (RCTs) analyzing the effectiveness of Chuna manual therapy (CMT) for benign prostatic hyperplasia (BPH). Methods : Among the literature published until May 2020, a literature search was carried out using 10 electronic databases using related keywords to identify all RCTs that applied CMT for the treatment of BPH. The Cochrane risk of bias tool was used to assess the methodological quality of each RCT. Results : Five RCTs met our inclusion criteria and were included in the analysis. These studies showed that CMT had no positive results compared to herbal medication. However, positive results were shown in terms of an increased efficacy rate, reduced international prostate symptom scores, and increased maximum flow rate when CMT was combined with acupuncture or herbal medication. Conclusions : Based on the analysis, this review has limited evidence of CMT being beneficial in the treatment of BPH. Therefore, further investigation is required using well-designed RCTs to support the effectiveness of CMT and to obtain higher evidence.

Objectives : This study aimed to evaluate the effectiveness of manual therapy for wrist pain. Methods : We searched electronic databases (PubMed, Embase, Cochrane, CAJ, KISS, RISS, NDSL, OASIS, and KMBASE) for randomized controlled trials for manual therapy as a treatment for wrist pain. Results : A total of 9 randomized controlled trials were selected and meta-analysis was conducted on 6 studies. Three studies with different design of the intervention/control group were excluded from the meta-analysis. A high risk of bias was observed for both performance bias and detection bias. Conclusions : Our systematic review verified the clinical effect of manual therapy on wrist pain. Based on the results of this study, it is expected that clinical studies on wrist diseases and high-level follow-up studies will be conducted.

Objectives : This study aimed to verify the clinical effectiveness of Baduanjin for shoulder pain. Methods : We searched 10 electronic databases (PubMed, EMBASE, Cochrane Library, CAJ, KISS, KISTI, KMBASE, RISS, NDSL, and OASIS) up to May 2020. We included randomized controlled trials (RCTs) using Baduanjin for shoulder pain. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : As a result of the search, a total of 6 RCTs were eligible for analysis. Of these 6 studies, one applied Baduanjin alone and 5 cases used Baduanjin in combination with other treatments, such as acupuncture or electroacupuncture. Except for 2 studies, descriptive analysis was performed without meta-analysis due to the high level of heterogeneity between studies. A high risk of bias was observed in all studies. Conclusions : When considering the results of the included papers, there was limited information derived on the therapeutic effect of using Baduanjin as a single intervention, but the results showed significant effectiveness when Baduanjin was combined with other oriental interventions, such as acupuncture and electroacupuncture, in the clinical field. Although all RCTs included in the analysis were biased to CAJ and the number was limited, this study was conducted in accordance with the methodological process of systematic literature reviews and revealed the clinical effects of Baduanjin on shoulder pain.

Objectives : This study aimed to determine the current trends in manual therapy for low back and pelvic girdle pain as regards pregnancy. Methods : Using 7 online databases, we searched for appropriate clinical studies. Results : Eighteen studies were selected from online databases. The included studies consisted of 8 randomized controlled trials, 6 uncontrolled trials, 4 case reports, and 1 non-randomized controlled trial. Four studies were performed in pregnant patients, while others were in postpartum patients. The majority of studies used relaxing or rubbing of soft tissue and some of the studies were manipulated. The visual analog scale (VAS) was the most frequently used outcome, with the effective rate second. Conclusions : This study demonstrates that manual therapy may be a promising therapeutic option low back and pelvic girdle pain for patients as regards pregnancy or postpartum.

Objectives : This study aimed to introduce a new sacral lumbar joint distraction technique in the prone position in Chuna manual therapy for effective lumbar distraction. Methods : The patient was placed in the prone position. Next, clinicians contacted the sacrum and L1, L2, L3, L4 and L5 spinal processes. Then they were pulled in the direction of the head and leg respectively while pressing down with 30% force to maintain the lumbar lordosis. This is a more effective and safer lumbar distraction technique according to the latest knowledge. Conclusions : This technique can be used for lumbar disc herniation in addition to relaxing the existing lumbar muscles, and is suggested to be used as a safe and effective Chuna manual therapy.

Objectives : This case report describes the management of five patients suffering from nonstructural scoliosis with lumbar herniated intervertebral disc all treated with complex Korean medicine treatment. Methods : Five patients were hospitalized and treated with herbal medicine, acupuncture, pharmacopuncture, cupping, and Chuna manual therapy. Patients were assessed for Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-FiveDimensions (EQ-5D), and Cobb's angle. Results : In all patients, NRS, ODI, and Cobb's angle decreased, while the EQ-5D score increased. Conclusions : As seen in these five cases, complex Korean medicine treatment with Chuna manual therapy has effects on the management of nonstructural scoliosis.

Objectives : This study reports the clinical case of a patient diagnosed with ossification of the posterior longitudinal ligament treated with Korean Medicine focusing on Chuna therapy. Methods : The patient was treated by a doctor from July 18th, 2019 to November 28th, 2019. The patient was diagnosed with ossification of the posterior longitudinal ligament based on magnetic resonance imaging results and was recommended to undergo surgery at another hospital. The primary complaint of the patient was left neck pain, left arm sensation, right leg sensation, and right leg loss of strength. The doctor treated the patient with Chuna therapy, acupuncture, cupping, herbal medicine, and pharmacopuncture. The effect of treatment was evaluated using visual analogue scale, neck disability index, pain rating score and Japanese Orthopedic Association score. Spurling, compression, and distraction tests were utilized. Results : Visual analogue scale decreased from 10 at the arm and 10 at the leg to 1 and 2, respectively. Neck disability index decreased from 25 to 11, pain rating score decreased from 66 to 1, and Japanese Orthopedic Association score recovered from 12 to 17 points. In addition, positive spurling test, compression test, and distraction test all improved to negative. Conclusions : Korean medicine treatment can be effective for ossification of the posterior longitudinal ligament patients, even when surgery is recommended. Further clinical studies, such as case series and case-control studies, are required to verify these findings.

Objectives : The aim of this study was to analyze changes in the gait pattern of a unilateral knee pain patient after treatment with Korean Medicine therapy. Methods : We conducted gait analysis 4 times over 11 days to analyze changes in gait parameters using gait analysis systems. Results : Velocity, cadence, step length, and stride length were all increased. On the collateral side, both stance phase and double support (%) decreased. These results are similar to those of hemiplegic patients with improvement patterns. Conclusions : Gait analysis could be used as a good evaluation tool for tracking improvements in knee pain.