Table 2.

Tuina therapy for knee OA

Sequence number	Tuina manipulation
1	The therapist using grasping or rolling applies to the back of the thigh and the crus for 2 minutes.
2	Pushing, kneading or pushing with one-finger meditation on popliteal fossa for 2 minutes.
3	Rolling applies to tensor fascia lata, quadriceps and adductors in the limb for 3 minutes.
4	Rubbing, kneading or pushing with one-finger meditation applies to the Dubi(ST35), Neixiyan(EX-LE5), Ashi points, and each acupoint is about 40 seconds.
5	Gently Pushing the patella to the upward, downward, inward and outward directions for several times, then to the extreme limit of patella and maintaining for 2 and 3 seconds. Repeat 3 times.
6	Pulling the knee. The assistant helps fix the distal thigh, and the therapist uses hands to hold the distal leg and pull for 2 seconds. Repeat 5 times.
7	Passive flexion and extension, adduction and abduction of hip and knee joint to the utmost degree that patient can stand. Repeat 3 times.

Description: The power of tuina manipulation requires evenly and gently application to the degree that patients feel comfort and tolerance. In operations 1 and 2, the patient remains in the prone position. In operations 3 through 7, the patient assumes the supine position.

Dose: about 20 minutes each time and 2 times per week.