청소년 특발성 척추측만증에 대한 추나 치료의 임상적 효능 : 체계적 문헌 고찰 및 메타분석

Clinical Efficacy of Chuna Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

Objectives This study aimed to systematically evaluate the clinical efficacy of Chuna manual therapy (CMT) for adolescent idiopathic scoliosis (AIS). The primary focus was on assessing improvements in Cobb angle correction, muscle function, and pulmo- nary health outcomes while addressing limitations in previous studies, such as incon- sistent definitions of interventions and protocol heterogeneity. Methods A comprehensive literature search was conducted across 10 electronic databases, including PubMed, Ovid-MEDLINE, EMBASE, Cochrane Library, CNKI, ScienceON, KMCRIC, OASIS, RISS, and KISS. Studies were selected based on pre- defined inclusion criteria (PICOS framework). Only randomized controlled trials (RCTs) explicitly referring to “Chuna,” “Tuina,” or “推拿” were included. The risk of bias for all included RCTs was assessed using the Cochrane risk of bias tool, and a meta-analysis was performed to synthesize outcomes. Results Eight RCTs involving 464 patients met the inclusion criteria. CMT, either alone or as part of combination therapies, demonstrated statistically significant im- provements in Cobb angle correction (mean difference [MD] = -3.29; 95% confidence interval [CI]: -6.36, -0.22; p = 0.04) and clinical efficacy (risk ratio [RR] = 1.22; 95% CI: 1.13, 1.32; p < 0.00001). Improvements were also observed in muscle function (AEMG ratio) and pulmonary health indicators (VC, FEV1/FVC, MVV). However, sig- nificant heterogeneity (I² = 95%) was noted for Cobb angle correction due to variations in intervention protocols and evaluation periods. Conclusions CMT appears to be a promising non-surgical treatment option for AIS, offering benefits in spinal alignment, muscle function, and pulmonary health. Despite these positive findings, the evidence is limited by protocol heterogeneity, incon- sistent comparator groups, and a lack of geographic diversity in the included studies. Future research should focus on standardized protocols, long-term outcomes, and CMT's independent effects to establish evidence-based guidelines for its clinical use in AIS management.