Bias control in trials of bodywork: a review of methodological issues.
ABSTRACT To review and summarize the methodological challenges in clinical trials of bodywork or handson mind-body therapies such as Feldenkrais Method, Alexander Technique, Trager Work, Eutony, Body Awareness Therapy, Breath Therapy, and Rolfing, and to discuss ways these challenges can be addressed.
Review and commentary.
Search of databases PubMed and EMBASE and screening of bibliographies. Published clinical studies were included if they used individual hands-on approaches and a focus on body awareness, and were not based on technical devices.
Of the 53 studies identified, 20 fulfilled inclusion criteria. No studies blinded subject to the treatment being given, but 5 used an alternative treatment and blinded participants to differential investigator expectations of efficacy. No study used a credible placebo intervention. No studies reported measures of patient expectations. Patient expectations have been measured in studies of other modalities but not of hands-on mind-body therapies. Options are presented for minimizing investigator and therapist bias and bias from differential patient expectations, and for maintaining some control for nonspecific treatment effects. Practical issues with recruitment and attrition resulting from volunteer bias are addressed.
Rigorous clinical trials of hands-on complementary and alternative therapy interventions are scarce, needed, and feasible. Difficulties with blinding, placebo, and recruitment can be systematically addressed by various methods that minimize the respective biases. The methods suggested here may enhance the rigor of further explanatory trials.
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ABSTRACT: Somatic education offers the promise of freer and easier movement and enhanced body awareness through gentle exercises and/or body manipulation. This column explores Web resources that offer useful information for learning more about somatic education practices including the Alexander Technique, the Feldenkrais Method, and a few other key practices.Journal of Consumer Health on the Internet 05/2009; 13(2):188-197. DOI:10.1080/15398280902897160
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ABSTRACT: Background: In the last 2 decades there has been a large increase in publications on complementary and alterna-tive medicine (CAM). However, CAM research methodol-ogy was heterogeneous and often of low quality. The aim of this systematic review was to investigate scien-tific publications with regards to general issues, con-cepts and strategies. We also looked at research priori-ties and methods employed to evaluate the clinical and epidemiological research of CAM in the past to identify the basis for consensus-based research strategies. Meth-ods: We performed a systematic literature search for papers published between 1990 and 2010 in 7 electronic databases (Medline, Web of Science, PsychArticles, Psy-cInfo, CINAHL, EMBASE and Cochrane Library) on De-cember 16 and 17, 2010. In addition, experts were asked to nominate relevant papers. Inclusion criteria were pub-lications dealing with research methodology, priorities or complexities in the scientific evaluation of CAM. All references were assessed in a multistage process to identify relevant papers. Results: From the 3,279 refer-ences derived from the search and 98 references contri-buted by CAM experts, 170 papers fulfilled the criteria and were included in the analysis. The following key is-sues were identified: difficulties in past CAM research (e.g., randomisation, blinding), utility of quantitative and qualitative research methods in CAM, priority setting in CAM research and specific issues regarding various CAM modalities. Conclusions: Most authors vote for the use of commonly accepted research methods to evaluate CAM. There was broad consensus that a mixed methods approach is the most suitable for gathering conclusive knowledge about CAM.Forschende Komplementarmedizin 11/2012; DOI:10.1159/000343126 · 1.05 Impact Factor
Journal of Bodywork and Movement Therapies 04/2006; 10(2):96-98. DOI:10.1016/j.jbmt.2005.09.003