Abstract
We have read the article “Effect of routine physiotherapy with and without neuromobilization in the management of internal shoulder impingement syndrome: A randomized controlled trial”1 by Akhtar et al with interest. Considering that the number of randomized clinical trials (RCT) from Pakistan is generally low, this is a good addition to the local biomedical literature. However, an RCT is considered the gold standard of clinical research and must adhere to the highest standards of conducting the trial and reporting. We recently reviewed this article in detail in our class as part of the Evidence based practice module.for the critical appraisal and analysis of the article. While this article scored high in almost all questions, we were able to identify some issues which we feel are important and need some more clarification. Authors stated that the baseline demographic characteristics of both groups were the same at the start of the trial. However, Table-I mentions only two parameters i.e. age and gender. There is a need to add more demographic characteristics in an RCT which can affect the outcomes. These may include duration of the disease, occupational status of the participant and the socioeconomic status. These are important parameters which must be reported. For example, the outcomes for a patient with less than four weeks duration of symptoms Vs. three months duration will likely be different. Similarly, outcomes in a housewife with shoulder impingement who must do household chores daily can differ from shoulder impingement in a banker with a sedentary lifestyle. Therefore, it is important that the base line demographics must include all important parameters which can affect the study outcomes
Rooma Rouf Chughtai, Farooq Azam Rathore. (2021) Comments on Effects of routine physiotherapy with and without neuromobilization in the management of internal shoulder impingement syndrome: A randomized controlled trial, Pakistan Journal of Medical Sciences, Volume-37, Issue-1.
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