3. Discussion
muscle contraction, muscle stiffness, pain
DISEASES, HERNIATED DISC
Previous studies on Korean medicine have predominantly relied on subjective measures for assessing treatment efficacy, limiting their ability to provide objective information on changes before and after treatment.In this study, we outlined a protocol for an RCT aimed at evaluating the efficacy and safety of moving cupping combined with SWE for CLBP management. The use of objective measures to assess complementary therapies is a significant challenge in the field, and this study aimed to address this issue by using SWE to assess muscle stiffness and relaxation as a quantitative measure of the therapeutic benefits of moving cupping.As previously suggested, the degree of muscle contraction in the lower spine may vary depending on the underlying condition causing the low back pain, such as a herniated disc.The use of this RCT protocol has the potential to significantly improve our understanding of the efficacy of moving cupping as a complementary therapy for managing CLBP and other musculoskeletal conditions. The findings may provide valuable insights for clinicians and researchers to optimize the clinical application of moving cupping and SWE in managing CLBP, potentially improving patient outcomes and quality of life.This RCT protocol has several limitations. First, it is not double-blinded, which may introduce researcher bias. However, the protocol minimizes bias by taking the mean of 10 out of the 12 quantitative values recorded in ultrasound images and excluding the maximum/minimum values. Second, it is not an absolute comparison study, and variance may be high owing to individual differences in values. However, it evaluates the effectiveness of recovery through a relative value comparison before and after treatment, and explores the significance of value changes with qualitative evaluations such as the NRS. Third, it is a placebo-controlled study, and information bias may be introduced if the patient understands the difference in treatment. However, it controls for participants’ expectations by excluding those who have experienced moving cupping, omitting treatment information, or offering a sham treatment similar to the actual procedure.There are several areas that warrant further research to determine the full scope and implications of this treatment. Long-term research on the efficacy of moving cupping and SWE in treating CLBP may provide additional insight into the potential for relieving and preventing symptoms. Additionally, exploring the therapeutic efficacy of this combined therapy for other conditions may open up new avenues for treating other diseases. Moreover, studying the combined therapy of moving cupping and SWE with other treatments may help identify the most effective approach to managing pain and improving function. Finally, providing clinical guidelines for the application of the RCT results may help healthcare professionals use this therapy more effectively to benefit their patients.In conclusion, we present a RCT protocol for investigating the efficacy and safety of moving cupping combined with SWE for patients with CLBP. This therapy may have a significant effect on pain reduction and functional improvement. Such research avenues can expand our understanding of the potential benefits of moving cupping and SWE, and help optimize their clinical application.