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Practice Guideline
. 2010 Feb;89(2):160-72.
doi: 10.1097/PHM.0b013e3181bc0bbd.

Challenges and Recommendations for Placebo Controls in Randomized Trials in Physical and Rehabilitation Medicine: A Report of the International Placebo Symposium Working Group

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Practice Guideline

Challenges and Recommendations for Placebo Controls in Randomized Trials in Physical and Rehabilitation Medicine: A Report of the International Placebo Symposium Working Group

Felipe Fregni et al. Am J Phys Med Rehabil. .
Free PMC article

Abstract

Compared with other specialties, the field of physical and rehabilitation medicine has not received the deserved recognition from clinicians and researchers in the scientific community. One of the reasons is the lack of sound evidence to support the traditional physical and rehabilitation medicine treatments. The best way to change this disadvantage is through a well conducted clinical research, such as standard placebo- or sham-controlled randomized clinical trials. Therefore, having placebo groups in clinical trials is essential to improve the level of evidence-based practice in physical and rehabilitation medicine that ultimately translates to better clinical care. To address the challenges for the use of placebo in physical and rehabilitation medicine and randomized clinical trials and to create useful recommendations, we convened a working group during the inaugural International Symposium in Placebo (February 2009, in Sao Paulo, Brazil) in which the following topics were discussed: (1) current status of randomized clinical trials in physical and rehabilitation medicine, (2) challenges for the use of placebo in physical and rehabilitation medicine, (3) bioethics, (4) use of placebo in acupuncture trials and for the treatment of low-back pain, (5) mechanisms of placebo, and (6) insights from other specialties. The current article represents the consensus report from the working group.

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Figure 1
Figure 1
Number of articles when using the following search strategy in Pubmed:- Search with the following limits: (1) Period (e.g.: 2000–2009); (2) We searched in the 5 main clinical journals in PRM: (“Archives of physical medicine and rehabilitation”, “American journal of physical medicine & rehabilitation/Association of Academic Physiatrists”, “Physical therapy”, “Restorative neurology and neuroscience” and “Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine”). This search yielded the total number of articles in each respective period in these 5 journals. We then added the word “placebo” for the total number of articles including placebo as a keyword.

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