Background. Researchers are highly interested in the study of nonspecific low back pain (NSLBP). However, few have attempted to collect global data, analyze the emerging trends, and conduct reviews from the perspectives of visualization and bibliometrics. Purpose. We aimed to evaluate research situation and capture subsequent developmental dynamics regarding NSLBP via CiteSpace. Methods. Publications on NSLBP in recent 19 years were retrieved from the Web of Science Core Collection (WoSCC). We used CiteSpace to analyze publication outputs, document types, countries, institutions, journals, authors, references, and keywords. Knowledge foundation, hot topics, and future direction were then stated. Results. A total of 1099 papers were collected, and the trend of annual publications maintained growth with small fluctuations. Australia (188) and the University of Sydney (76) were the most prolific country and institution, respectively. The Netherlands (0.84) and the University of Sydney (0.47) had the maximum centrality, thus indicating that they have importance in this field. The journal Spine (publication: 87, cocitation counts: 942) ranked first in terms of the volume of publications and cocitation counts. Maher CG (52) who published the most papers and Waddell G (286) who was cited most frequently were the leading authors, thus making strong academic influences. “Motor control exercise” was the largest cluster, which contained most related research articles. 14 references with the strongest citation counts were cited until 2018, thus implying the future development trend. Current hotspots were treatment, meta-analysis, method, and risk factors. Spine, efficacy, adult, and meta-analysis can be regarded as research frontiers. Conclusion. This study offers insights into the trend of NSLBP to determine major research countries and institutions, core journals, pivotal authors, overall development tendency, hot topics, and research frontiers. Moreover, it will help researchers extract hidden valuable information for further study.

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Background Comorbid pain and depression occur with high prevalence in clinical observations, and published academic journals about them have been increasing in number over time. However, few studies used the bibliometric method to analyze the general aspects of scientific researches on the comorbidity of pain and depression. The aim of this study is to systematically provide global scientific research in the comorbidity of pain and depression from 1980 to 2018. Methods The published papers were searched between 1980 and 2018 in Web of Science. Publications related to comorbid pain and depression research were included. The language was restricted to English, and no species limitations were specified. Results A total of 2,519 papers met the inclusion criteria in our study. The results revealed that the publications had a significant growth over time in the comorbidity of pain and depression research (P < 0.001) by linear regression analyses. The United States had the largest number of publications and citations and the highest value of H-index. According to subject categories of Web of Science, research areas of the 2,519 papers mainly focused on clinical neurology (28.78%), neurosciences (22.9%), and psychiatry (22.23%). In accordance with types of pain, headache (19.09%) was the most popular topic in the included papers on comorbid pain and depression research. Conclusions The findings provide useful information for pain and depression researchers to detect new areas related to collaborators, cooperative institutions, popular topics, and research frontiers.

IMPORTANCE Therapeutic aquatic exercise is frequently offered to patients with chronic low back pain, but its long-term benefits are unclear.OBJECTIVE To assess the long-term effects of therapeutic aquatic exercise on people with chronic low back pain. DESIGN, SETTING, AND PARTICIPANTSThis 3-month, single-blind randomized clinical trial with a 12-month follow-up period was performed from September 10, 2018, to March 12, 2019, and the trial follow-up was completed March 17, 2020. A total of 113 people with chronic low back pain were included in the experiment. INTERVENTIONS Participants were randomized to either the therapeutic aquatic exercise or the physical therapy modalities group. The therapeutic aquatic exercise group received aquatic exercise, whereas the physical therapy modalities group received transcutaneous electrical nerve stimulation and infrared ray thermal therapy. Both interventions were performed for 60 minutes twice a week for 3 months. MAIN OUTCOMES AND MEASURESThe primary outcome was disability level, which was measured using the Roland-Morris Disability Questionnaire; scores range from 0 to 24, with higher scores indicating more severe disability. Secondary outcomes included pain intensity, quality of life, sleep quality, recommendation of intervention, and minimal clinically important difference. Intention-totreat and per-protocol analyses were performed. RESULTSOf the 113 participants, 59 were women (52.2%) (mean [SD] age, 31.0 [11.5] years).Participants were randomly allocated into the therapeutic aquatic exercise group (n = 56) or the physical therapy modalities group (n = 57), and 98 patients (86.7%) completed the 12-month follow-up. Compared with the physical therapy modalities group, the therapeutic aquatic exercise group showed greater alleviation of disability, with adjusted mean group differences of −1.77 (95% CI, −3.02 to −0.51; P = .006) after the 3-month intervention, −2.42 (95% CI, −4.13 to −0.70; P = .006) at the 6-month follow-up, and −3.61 (95% CI, −5.63 to −1.58; P = .001) at the 12-month follow-up (P < .001 for overall group × time interaction). At the 12-month follow-up point, improvements were significantly greater in the therapeutic aquatic exercise group vs the physical therapy modalities group in the number of participants who met the minimal clinically important difference in pain (at least a 2-point improvement on the numeric rating scale) (most severe pain, 30 [53.57%] vs 12 [21.05%]; average pain, 14 [25%] vs 11 [19.30%]; and current pain, 22 [39.29%] vs 10 [17.54%]) and disability (at least a 5-point improvement on the Roland-Morris Disability Questionnaire) (26 (continued) Key Points Question Is therapeutic aquatic exercise as effective as physical therapy modalities in the management of adults with chronic low back pain? Findings In this randomized clinical trial of 113 individuals with chronic low back pain, therapeutic aquatic exercise had a greater influence on pain, function, quality of life, sleep quality, and mental state than physical therapy modalities a...