{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T21:52:30Z","timestamp":1757541150236,"version":"3.37.3"},"reference-count":57,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Despite the widespread recommendation to engage in therapeutic exercise for the treatment of low back pain (LBP), there is conflicting evidence regarding clinical outcomes and effectiveness. Poor methodological quality may be to blame for reducing the overall strength of evidence for this intervention, yet little is known about the difficulties researchers encounter when designing and implementing their study methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>The aim of this study was to characterize the extent and type of self\u2010acknowledged limitations (SALs) in exercise therapy trials for LBP to gain a better understanding of challenges encountered when conducting this research.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a methodological review of clinical trials in which SALs were extracted, categorized by theme and subcategorized within each theme. Counts and prevalence rates were tabulated for the number of SALs in each category and subcategory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 914 SALs among the 312 included trials, with a mean of 2.93 (95% confidence interval [CI], 2.77\u20133.09) per trial. Analysis of the data resulted in the development of 13 distinct categories of limitations, among which were 37 subcategories. The top three categories pertained to statistical power (14.3% of total SALs), study length and\/or follow\u2010up (14.3%) and inclusion criteria (14.2%). The top three subcategories were lack of long\u2010term follow\u2010up (13.8% of total SALs), inadequate sample size (13.3%) and inclusion of specific populations (12.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Statistical power, study length and\/or follow\u2010up, and inclusion criteria were the three most commonly reported categories of SALs in exercise trials for LBP. Lack of long\u2010term follow\u2010up, inadequate sample size and inclusion of specific populations were the most common subcategories. Research protocols recognizing and avoiding these limitations will enhance the overall quality of evidence of exercise therapy trials for LBP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14033","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T17:03:01Z","timestamp":1717520581000},"page":"1251-1260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Self\u2010acknowledged limitations in exercise therapy trials for low back pain"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8571-6124","authenticated-orcid":false,"given":"Laura M.","family":"Siviter","sequence":"first","affiliation":[{"name":"Bellin College Physical Therapy Department Green Bay Wisconsin USA"},{"name":"University of St. Augustine for Health Sciences Physical Therapy Department San Marcos California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7803-3899","authenticated-orcid":false,"given":"Matthew","family":"Morretta","sequence":"additional","affiliation":[{"name":"Bellin College Physical Therapy Department Green Bay Wisconsin USA"},{"name":"University of St. Augustine for Health Sciences Physical Therapy Department San Marcos California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3304-3808","authenticated-orcid":false,"given":"Teressa","family":"Petosky","sequence":"additional","affiliation":[{"name":"Bellin College Physical Therapy Department Green Bay Wisconsin USA"},{"name":"Faulkner University Physical Therapy Department Montgomery Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2107-735X","authenticated-orcid":false,"given":"Mareli","family":"Klopper","sequence":"additional","affiliation":[{"name":"Bellin College Physical Therapy Department Green Bay Wisconsin USA"},{"name":"Graceland University Physical Therapy Department Lamoni Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-990X","authenticated-orcid":false,"given":"Daniel I.","family":"Rhon","sequence":"additional","affiliation":[{"name":"Uniformed Services University Rehabilitation Medicine Department Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9309-4063","authenticated-orcid":false,"given":"Jodi L.","family":"Young","sequence":"additional","affiliation":[{"name":"Bellin College Physical Therapy Department Green Bay Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2021.0304"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2367"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.04.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2015.10.006"},{"key":"e_1_2_10_6_1","unstructured":"Low Back Pain and Sciatica in over 16s: Assessment and Management. National Institute for Health and Care Excellence (NICE). December 11 2020. Accessed September 6 2023.https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/33090750"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5099-2"},{"key":"e_1_2_10_8_1","unstructured":"U.S. Department of Veterans Affairs.VA\/DoD Clinical Practice Guidelines. February 2022. Accessed September 24 2023.https:\/\/www.healthquality.va.gov\/guidelines\/Pain\/lbp\/"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-020-01412-8"},{"issue":"9","key":"e_1_2_10_10_1","article-title":"Exercise therapy for chronic low back pain","volume":"9","author":"Hayden JA","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000335.pub2"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7205.279"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200011010-00011"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20080103"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000146464.23007.2a"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2003.10.017"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2008.03.003"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2010.01.002"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-9-200505030-00014"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-9-200505030-00013"},{"key":"e_1_2_10_21_1","article-title":"Exercise therapy for low back pain","volume":"2","author":"Tulder MW","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(03)00174-8"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05722-x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-7"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.06.025"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-11-201006010-00232"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1054\/math.2000.0372"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3755"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-014-0565-6"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817b8fd6"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.10.018"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.68390"},{"key":"e_1_2_10_34_1","unstructured":"Clinical trial requirements for grants and contracts. NIH Grants & Funding. Updated July 26 2017. Accessed October 4 2023.https:\/\/grants.nih.gov\/policy\/clinical-trials.htm"},{"volume-title":"Medical Statistics: A Guide to SPSS, Data Analysis and Critical Appraisal","year":"2014","author":"Barton J","key":"e_1_2_10_35_1"},{"volume-title":"Type I and Type II Errors and Statistical PowerType","year":"2023","author":"Shreffler J","key":"e_1_2_10_36_1"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2020.1776002"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001953"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-099878"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.0301"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-015-0610-7"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2017.7415"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2019.04.010"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.11.014"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.184820"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000368"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-044702"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2034-6"},{"issue":"2","key":"e_1_2_10_49_1","first-page":"25","article-title":"A comparison of change in visual analogue pain rating of acute low back pain patients following deep water walking or deep water hanging","volume":"8","author":"Schrepfer RW","year":"2000","journal-title":"J Aquat Phys Ther"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.251.193"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2012.04.012"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2021-0042"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.07.014"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-285"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20120414"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000232787.71938.5d"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.09.397"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.14033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T06:01:57Z","timestamp":1727935317000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.14033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,4]]},"references-count":57,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/jep.14033"],"URL":"https:\/\/doi.org\/10.1111\/jep.14033","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"type":"print","value":"1356-1294"},{"type":"electronic","value":"1365-2753"}],"subject":[],"published":{"date-parts":[[2024,6,4]]},"assertion":[{"value":"2024-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}