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Clinical trials in sports physiotherapy. Building on five decades of research to produce even better trials: a critical review and tips for improvements
  1. Steven J Kamper1,2,
  2. Anne M Moseley1,
  3. Mark R Elkins3
  1. 1Musculoskeletal Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2Department of Musculoskeletal Health, The EMGO+ Institute, VU University Medical Centre, Amsterdam, The Netherlands
  3. 3Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia
  1. Correspondence to Dr Steven J Kamper, Musculoskeletal Division, The George Institute for Global Health, University of Sydney, PO Box M201 Missenden Road, Camperdown NSW 2050, Australia; skamper{at}

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The last decades have seen an enormous shift in the practice of healthcare with widespread acceptance of the evidence-based practice paradigm.1 This change has been accompanied by an increase in the volume of clinical research2 and refinement of our understanding of how research should be conducted and reported.3 Concurrent with these changes, longitudinal analyses have identified improvements in the conduct and reporting of various types of research in many disciplines of healthcare.3–7 However, not all such analyses have identified improvements.8

A recent assessment of reports of randomised trials of physiotherapy interventions9 allows trial reports in sports physiotherapy to be compared to other clinical subdisciplines of physiotherapy, such as musculoskeletal, neurology or cardiorespiratory. Compared to all other physiotherapy trial reports, trials that enrolled sporting participants reported fewer key design features that reflect rigorous methods and allow readers to interpret the research fully. Therefore, the purpose of this article is to highlight the methodological features that are often lacking in sports physiotherapy trial reports, explain their significance and offer suggestions for improving the conduct and reporting of future trials.

Issues in sports physiotherapy trials

Moseley et al9 examined the conduct and reporting of almost 15 000 trial reports that were fully indexed on the Physiotherapy Evidence Database (PEDro; When the trial reports were evaluated using items on the PEDro Scale,10 sports physiotherapy trials performed less well on several items in comparison to other subdisciplines. The results are summarised in table 1 along with those for musculoskeletal trials and all trials, for the purposes of comparison.

View this table:
Table 1

Studies meeting Physiotherapy Evidence Database (PEDro) criteria by subdiscipline of physiotherapy

In the following items, sports physiotherapy trial reports rated substantially lower than trial reports from other subdisciplines. For each item, we provided a short explanation and recommendations for improvement.

Eligibility criteria and source of participants

This item concerns a …

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  • Contributors SJK wrote the first draft of the manuscript. AMM and MRE provided comments and contributed to successive revisions of the manuscript. All the authors are guarantors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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