Highlights
- •Abstract reporting quality in low back pain trials was poor.
- •Ninety-eight percent of abstracts contained spin of information.
- •Several inconsistencies were found between abstracts and full texts.
- •Actions should be taken to change journals’ editorial policies.
Abstract
Objective
To investigate trials abstracts evaluating treatments for low back pain with regard
to completeness of reporting, spin (ie, interpretation of study results that overemphasizes
the beneficial effects of the intervention), and inconsistencies in the data with
the full text.
Data Sources
The search was performed on the Physiotherapy Evidence Database (PEDro) in February 2016.
Study Selection
This is an overview study of a random sample of 200 low back pain trials published
between 2010 and 2015. The languages of publication were restricted to English, Spanish,
and Portuguese.
Data Extraction
Completeness of reporting was assessed using the Consolidated Standards of Reporting
Trials (CONSORT) for abstracts checklist (CONSORT-A). Spin was assessed using a spin
checklist. Consistency between abstract and full text was assessed by applying the
assessment tools to both the abstract and full text of each trial and calculating
inconsistencies in the summary score (paired t test) and agreement in the classification of each item (kappa statistics). Methodologic
quality was analyzed using the total PEDro score.
Data Synthesis
The mean number of fully reported items ± SD for abstracts using the CONSORT-A was
5.1±2.4 out of 15 points. The mean number of items ± SD with spin was 4.9±2.6 out
of 7 points. Abstract and full text scores were statistically inconsistent (P=.01). There was slight to moderate agreement between items of the CONSORT-A in the
abstracts and full text (mean kappa ± SD, 0.20±0.13) and fair to moderate agreement
for items of the spin checklist (mean kappa ± SD, 0.47±0.09).
Conclusions
The abstracts were incomplete, with evidence of spin and inconsistent with the full
text. We advise health care professionals to avoid making clinical decisions based
solely upon abstracts. Journal editors, reviewers, and authors are jointly responsible
for improving abstracts, which could be guided by amended editorial policies.
Keywords
List of abbreviations:
CONSORT (Consolidated Standards of Reporting Trials), CONSORT-A (Consolidated Standards of Reporting Trials for abstracts), PEDro (Physiotherapy Evidence Database)To read this article in full you will need to make a payment
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Supplemental Appendix S2
Included Trials
- Cost-effectiveness of early interventions for non-specific low back pain: a randomized controlled study investigating medical yoga, exercise therapy and self-care advice.J Rehabil Med. 2015 Feb; 47: 167-173
- Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial.Lasers Med Sci. 2014 May; 29: 1065-1073
- The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.Spine (Phila Pa 1976). 2010 Mar 1; 35: 483-496
- The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial.Spine (Phila Pa 1976). 2012 Apr 1; 37: 531-542
- Ten-year follow-up of strengthening versus flexibility exercises with or without abdominal bracing in recurrent low back pain.Spine (Phila Pa 1976). 2014 Jun 01; 39: 997-1003
- Efficacy of core-stabilization exercise and its comparison with home-based conventional exercise in low back pain patients.Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi [Turkish Journal of Physical Medicine and Rehabilitation]. 2014; 60: S36-S42
- The effect of core stability exercises on variations in acceleration of trunk movement, pain, and disability during an episode of acute nonspecific low back pain: a pilot clinical trial.J Manipulative Physiol Ther. 2013 Oct; 36: 497-504 e1-3
- Cost-effectiveness of a classification-based system for sub-acute and chronic low back pain.Eur Spine J. 2012 Jul; 21: 1290-1300
- A randomized controlled trial on the effectiveness of a classification-based system for subacute and chronic low back pain.Spine (Phila Pa 1976). 2012 Jul 15; 37: 1347-1356
- Comparison of real-time ultrasound imaging and pressure biofeedback training for performing abdominal drawing-in maneuver in low back pain.Indian J Physiother Occup Ther. 2010; 4: 61-65
- Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis.Spine (Phila Pa 1976). 2012 Apr 15; 37: 701-710
- Hydrotherapy versus land-based exercises in the management of chronic low back pain: a comparative study.J Musculoskelet Res. 2010; 13
- Pelvic floor muscle exercise for chronic low back pain.J Int Med Res. 2013 Feb; 41: 146-152
- Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation.Ann Intern Med. 2014 Sep 16; 161: 381-391
- Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial.Spine J. 2011 Jul; 11: 585-598
- One lumbar extension training session per week is sufficient for strength gains and reductions in pain in patients with chronic low back pain ergonomics.Ergonomics. 2012; 55: 500-507
- A pilot randomized controlled trial of flexion-distraction dosage for chiropractic treatment of lumbar spinal stenosis.J Manipulative Physiol Ther. 2014 Jul-Aug; 37: 396-406
- Implementation of a multidisciplinary program for active duty personnel seeking care for low back pain in a U.S. Navy Medical Center: a feasibility study.Mil Med. 2012 Sep; 177: 1075-1080
- Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation.Eur J Phys Rehabil Med. 2012 Sep; 48: 371-378
- Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain: a randomized controlled trial.Arch Phys Med Rehabil. 2011 Oct; 92: 1681-1685
- Is rehabilitation intervention during hospitalization enough for functional improvements in patients undergoing lumbar decompression surgery? A prospective randomized controlled study.Clin Neurol Neurosurg. 2015 Feb; 129: S41-S46
- Evaluation of different moxibustion doses for lumbar disc herniation: multicentre randomised controlled trial of heat-sensitive moxibustion therapy.Acupunct Med. 2012 Dec; 30: 266-272
- painACTION-back pain: a self-management website for people with chronic back pain.Pain Med. 2010 Jul; 11: 1044-1058
- Synergistic effect of a rehabilitation program and treadmill exercise on pain and dysfunction in patients with chronic low back pain.J Phys Ther Sci. 2015 Apr; 27: 1187-1190
- A short goal-pursuit intervention to improve physical capacity: a randomized clinical trial in chronic back pain patients.Pain. 2010 Jun; 149: 444-452
- A pragmatic multicentered randomized controlled trial of yoga for chronic low back pain: economic evaluation.Spine (Phila Pa 1976). 2012 Aug 15; 37: 1593-1601
- Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding.J Manipulative Physiol Ther. 2013 May; 36: 203-217
- Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial.Disabil Rehabil. 2016; 38: 1300-1308
- Efeito do isostretching na resistência muscular de abdominais, glúteo máximo e extensores de tronco, incapacidade e dor em pacientes com lombalgia (The Isostretching effect in the muscle strength of gluteus maximus, abdominal and the trunk extensor, incapacity and pain in patients with low back pain).Fisioterapia em Movimento. 2010; 23
- Deep water running and general practice in primary care for non-specific low back pain versus general practice alone: randomized controlled trial.Clin Rheumatol. 2012 Jul; 31: 1073-1078
- Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: a pragmatic randomized controlled trial.Am J Phys Med Rehabil. 2011 Jul; 90 (quiz 35-8): 526-534
- Immediate effects of region-specific and non-region-specific spinal manipulative therapy in patients with chronic low back pain: a randomized controlled trial.Phys Ther. 2013 Jun; 93: 748-756
- Reanalysis of a tailored web-based exercise programme for office workers with sub-acute low back pain: assessing the stage of change in behaviour.Psychol Health Med. 2013; 18: 687-697
- Clinical effects of a nine-month web-based intervention in subacute non-specific low back pain patients: a randomized controlled trial.Clin Rehabil. 2013 Jan; 27: 28-39
- Effects of whole body vibration therapy on main outcome measures for chronic non-specific low back pain: a single-blind randomized controlled trial.J Rehabil Med. 2011 Jul; 43: 689-694
- An occupational, internet-based intervention to prevent chronicity in subacute lower back pain: a randomised controlled trial.J Rehabil Med. 2012 Jun; 44: 581-587
- Effects of dynamic lumbar stabilization exercises following lumbar microdiscectomy on pain, mobility and return to work. Randomized controlled trial.Eur J Phys Rehabil Med. 2014 Dec; 50: 627-640
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- Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial.Geriatr Orthop Surg Rehabil. 2014 Dec; 5: 154-164
- Physiotherapy for sleep disturbance in people with chronic low back pain: results of a feasibility randomized controlled trial.Arch Phys Med Rehabil. 2013 Nov; 94: 2083-2092
- The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial.BMC Musculoskelet Disord. 2012; 13: 192
- Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial.Sao Paulo Med J. 2011; 129: 206-216
- Effects of William training on lumbosacral muscles function, lumbar curve and pain.J Back Musculoskelet Rehabil. 2015; 28: 591-597
- Effect of a pain diary use on recovery from acute low back (lumbar) sprain.Rheumatol Int. 2015 Jan; 35: 55-59
- Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial.Eur J Phys Rehabil Med. 2011 Sep; 47: 367-373
- Adherence, tolerance and effectiveness of two different pelvic support belts as a treatment for pregnancy-related symphyseal pain - a pilot randomized trial.BMC Pregnancy Childbirth. 2015 Feb 15; 15: 36
- Individualised physiotherapy as an adjunct to guideline-based advice for low back disorders in primary care: a randomised controlled trial.Br J Sports Med. 2016 Feb; 50: 237-245
- Effects of muscular stretching and segmental stabilization on functional disability and pain in patients with chronic low back pain: a randomized, controlled trial.J Manipulative Physiol Ther. 2012 May; 35: 279-285
- Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study.Clinics (Sao Paulo). 2010; 65: 1013-1017
- Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial.JAMA. 2015 Oct 13; 314: 1459-1467
- No difference in long-term trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain 7 to 11 years after lumbar fusion versus cognitive intervention and exercises.Spine J. 2011 Aug; 11: 718-725
- Effect of trunk muscles training using a star excursion balance test grid on strength, endurance and disability in persons with chronic low back pain.J Back Musculoskelet Rehabil. 2015; 28: 521-530
- Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial.Phys Ther. 2013 Jun; 93: 729-747
- Identifying Patients With Chronic Low Back Pain Who Respond Best to Mechanical Diagnosis and Therapy: Secondary Analysis of a Randomized Controlled Trial.Phys Ther. 2016 May; 96: 623-630
- Brief psychosocial education, not core stabilization, reduced incidence of low back pain: results from the Prevention of Low Back Pain in the Military (POLM) cluster randomized trial.BMC Med. 2011; 9: 128
- A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to ‘stay active’ care on health-related quality of life in acute or subacute low back pain.Clin Rehabil. 2011 Nov; 25: 999-1010
- The effect of the muscle endurance training on the chronic low back pain.Turk Fizyoterapi ve Rehabilitasyon Dergisi [Turkish Journal of Physiotherapy and Rehabilitation]. 2014; 25: 28-34
- Effectiveness of nerve mobilization in the management of sciatica.Indian J Physiother Occup Ther. 2012; 6: 79-81
- The effect of traditional bridging or suspension-exercise bridging on lateral abdominal thickness in individuals with low back pain.J Sport Rehabil. 2012 May; 21: 151-160
- Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: a randomized, controlled clinical trial.J Rehabil Med. 2010 Nov; 42: 929-935
- Effect of a regular exercise programme on pelvic girdle and low back pain in previously inactive pregnant women: A randomized controlled trial.J Rehabil Med. 2015 Mar; 47: 229-234
- Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial.Spine J. 2014 Jul 01; 14: 1106-1116
- The effects on muscle strength and visual analog scale pain of aquatic therapy for individuals with low back pain.Journal of Physical Therapy Science. 2011; 23: 57-60
- Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial.BMC Musculoskelet Disord. 2010; 11: 30
- Acupuncture for acute non-specific low back pain: a randomised, controlled, double-blind, placebo trial.Acupunct Med. 2014 Apr; 32: 109-115
- Surgery with disc prosthesis versus rehabilitation in patients with low back pain and degenerative disc: two year follow-up of randomised study.BMJ. 2011 May 19; 342: d2786
- Role of physical exercise in low back pain rehabilitation: a randomized controlled trial of a three-month exercise program in patients who have completed multidisciplinary rehabilitation.Spine (Phila Pa 1976). 2010 May 20; 35: 1192-1199
- Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial.Swiss Med Wkly. 2010; 140: w13133
- Outcomes are not different for patient-matched versus nonmatched treatment in subjects with chronic recurrent low back pain: a randomized clinical trial.Spine J. 2014 Dec 01; 14: 2799-2810
- Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial.J Manipulative Physiol Ther. 2015 Jul-Aug; 38: 365-374
- Daily exercises and education for preventing low back pain in children: cluster randomized controlled trial.Phys Ther. 2015 Apr; 95: 507-516
- Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain.Man Ther. 2011 Aug; 16: 344-350
- Comparison of the effect of aquatic physical therapy and conventional physical therapy in patients with lumbar spinal stenosis (a randomized controlled trial).Journal of Musculoskeletal Research. 2015; 18: 1550002
- Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: a double-blind randomized placebo-controlled study.Lasers Med Sci. 2014 Mar; 29: 671-679
- The effect of early isometric exercises on clinical and neurophysiological parameters in patients with sciatica: an interventional randomized single-blinded study.Isokinet and Exerc Sci. 2011; 19: 207-214
- Adherence to home exercises in non-specific low back pain. A randomised controlled pilot trial.J Bodyw Mov Ther. 2015 Jan; 19: 177-185
- Supervised walking in comparison with fitness training for chronic back pain in physiotherapy: results of the SWIFT single-blinded randomized controlled trial (ISRCTN17592092).Pain. 2015 Jan; 156: 131-147
- The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients.J Phys Ther Sci. 2013 Sep; 25: 1189-1192
- Structural integration as an adjunct to outpatient rehabilitation for chronic nonspecific low back pain: a randomized pilot clinical trial.Evid Based Complement Alternat Med. 2015; 2015: 813418
- Effectiveness of slump stretching in comparison to conventional physiotherapy in treatment of subacute non-radicular low back pain.Indian J Physiother Occup Ther. 2012; 6: 123-126
- Treatment and ergonomics training of work-related lower back pain and body posture problems for nurses.J Clin Nurs. 2012 Jun; 21: 1776-1784
- Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial.Caspian J Intern Med. 2015 Spring; 6: 98-102
- The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability.J Back Musculoskelet Rehabil. 2012; 25: 149-155
- Sustainability of return to work in sick-listed employees with low-back pain. Two-year follow-up in a randomized clinical trial comparing multidisciplinary and brief intervention.BMC Musculoskelet Disord. 2012; 13: 156
- Do MRI findings identify patients with chronic low back pain and Modic changes who respond best to rest or exercise: a subgroup analysis of a randomised controlled trial.Chiropr Man Therap. 2015; 23: 26
- Rest versus exercise as treatment for patients with low back pain and Modic changes. A randomized controlled clinical trial.BMC Med. 2012; 10: 22
- Cost-effectiveness of total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain: a Norwegian multicenter RCT.Spine (Phila Pa 1976). 2014 Jan 01; 39: 23-32
- The effect of two manipulative therapy techniques and their outcome in patients with sacroiliac joint syndrome.J Bodyw Mov Ther. 2012 Jan; 16: 29-35
- Facet joints infiltration: a viable alternative treatment to physiotherapy in patients with low back pain due to facet joint arthropathy.Niger J Clin Pract. 2011 Apr-Jun; 14: 219-222
- The effect of the addition of hip strengthening exercises to a lumbopelvic exercise programme for the treatment of non-specific low back pain: A randomized controlled trial.J Sci Med Sport. 2015 Nov; 18: 626-631
- Effectiveness of coccygeal manipulation in coccydynia: a randomized control trial.Indian Journal of Physiotherapy and Occupational Therapy. 2010; 4: 93-95
- Rehabilitation with osteopathic manipulative treatment after lumbar disc surgery: a randomised, controlled pilot study.International Journal of Osteopathic Medicine. 2015; 18: 181-188
- Specific exercises to treat pregnancy-related low back pain in a South African population.Int J Gynaecol Obstet. 2011 Jun; 113: 187-191
- Comparison between the effect of lumbopelvic belt and home based pelvic stabilizing exercise on pregnant women with pelvic girdle pain; a randomized controlled trial.J Back Musculoskelet Rehabil. 2013; 26: 133-139
- Pulsed electromagnetic energy as an adjunct to physiotherapy for the treatment of acute low back pain: a randomised controlled trial.New Zealand Journal of Physiotherapy. 2015; 43: 16-22
- Efficacy of spinal mobilization in the treatment of patients with lumbar radiculopathy due to disc herniation: a randomized clinical trial.Int J Neurol. 2011; 3: 65-76
- A multicentred randomised controlled trial of a primary care-based cognitive behavioural programme for low back pain. The Back Skills Training (BeST) trial.Health Technol Assess. 2010 Aug; 14 (iii-iv): 1-253
- Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: a randomized controlled trial.Clin Rehabil. 2013 May; 27: 439-449
- Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain: A randomized controlled trial.Joint Bone Spine. 2015 Jul; 82: 272-277
- Thrust and nonthrust manipulation for older adults with low back pain: an evaluation of pain and disability.J Manipulative Physiol Ther. 2013 Jun; 36: 284-291
- The effect of abdominal bracing in combination with low extremity movements on changes in thickness of abdominal muscles and lumbar strength for low back pain.J Phys Ther Sci. 2014 Jan; 26: 157-160
- Effects of hip exercises for chronic low-back pain patients with lumbar instability.J Phys Ther Sci. 2015 Feb; 27: 345-348
- Strain-Counterstrain therapy combined with exercise is not more effective than exercise alone on pain and disability in people with acute low back pain: a randomised trial.J Physiother. 2011; 57: 91-98
- Prevention of progressive back-specific dysfunction during pregnancy: an assessment of osteopathic manual treatment based on Cochrane Back Review Group criteria.J Am Osteopath Assoc. 2013 Oct; 113: 728-736
- Associations of cytokine concentrations with key osteopathic lesions and clinical outcomes in patients with nonspecific chronic low back pain: results from the OSTEOPATHIC Trial.J Am Osteopath Assoc. 2012 Sep; 112: 596-605
- Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.Ann Fam Med. 2013 Mar-Apr; 11: 122-129
- The Effects of Extracorporeal Shock Wave Therapy in Patients with Coccydynia: A Randomized Controlled Trial.PLoS One. 2015; 10e0142475
- Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain.Man Ther. 2014 Oct; 19: 425-432
- Effect of Tai Chi exercise in combination with auricular plaster on patients with lumbar muscle strain.Int J Clin Exp Med. 2015; 8: 2949-2953
- Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial.Spine (Phila Pa 1976). 2014 Jan 01; 39: 3-16
- Effect of motor control exercises versus graded activity in patients with chronic nonspecific low back pain: a randomized controlled trial.Phys Ther. 2012 Mar; 92: 363-377
- The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial.BMC Med. 2010; 8: 10
- Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials.Spine J. 2013 Nov; 13: 1438-1448
- Peripheral neurostimulation and specific motor training of deep abdominal muscles improve posturomotor control in chronic low back pain.Clin J Pain. 2013 Sep; 29: 814-823
- Orthotic insoles do not prevent physical stress-induced low back pain.Eur Spine J. 2011 Jan; 20: 100-104
- An evaluation of a postoperative rehabilitation program after spinal surgery and its impact on outcome.Spine (Phila Pa 1976). 2012 Apr 1; 37: E417-E422
- Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study.J Manipulative Physiol Ther. 2010 Oct; 33: 576-584
- Intermediate and long-term effects of a standardized back school for inpatient orthopedic rehabilitation on illness knowledge and self-management behaviors: a randomized controlled trial.Clin J Pain. 2011 Mar-Apr; 27: 248-257
- Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial.Phys Ther. 2013 Mar; 93: 310-320
- Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment.J Back Musculoskelet Rehabil. 2015; 28: 383-392
- Group-based task-oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain.Eur J Pain. 2016 Apr; 20: 541-551
- Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain.Ann Rehabil Med. 2013 Feb; 37: 110-117
- Effects of exercise therapy on muscular strength in firefighters with back pain.J Phys Ther Sci. 2015 Mar; 27: 581-583
- Prevention of low back pain in sedentary healthy workers: a pilot study.Am J Med Sci. 2012 Aug; 344: 90-95
- Quality of life improved by multidisciplinary back school program in patients with chronic non-specific low back pain: a single blind randomized controlled trial.Eur J Phys Rehabil Med. 2011 Dec; 47: 533-541
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Article info
Publication history
Published online: June 14, 2019
Footnotes
Supported by the Sao Paulo Research Foundation (grant no. 2015/16953-2), which was conducted as part of a PhD undertaken by D.P.N.
Disclosures: The authors declare that, even though 7 out of the 200 articles analyzed involved authors from our research groups, all articles were evaluated with the same criteria and rigor.
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© 2019 by the American Congress of Rehabilitation Medicine
