#0040 Letter to the Editor: A randomized clinical trial for neck pain among adults
Critical Review of a Study Recommending Tasukis for Neck Pain
A 2010 Global Burden of Disease Study ranked neck pain as the fourth highest disability that people lived with in terms of number of years, indicating that people generally live with chronic neck pain without addressing it.
A recent study published in the Journal of Occupational Health endorses the effectiveness of wearing a tasuki as a simple, affordable, and non-invasive technique to alleviate chronic neck pain. A tasuki is a sash that is generally worn with a kimono (traditional Japanese clothes) as it helps in holding up the sleeves of the kimono. It also improves the wearer’s posture and reduces slouching by retracting the shoulders and keeping the head straight up.
We have critically reviewed the study in a letter to the editor published in the Journal of Occupational Health. In the letter, we discuss a couple of factors that were perhaps overlooked in the study. A clinical trial with such a small number of total participants (50) needs to account for factors like medication, physiotherapy, physical activity (frequency, type, and duration) and the duration for which the tasuki was worn.
These factors are generally addressed in larger randomized clinical trials that employ strict protocols for randomization and allocation of individuals to different study groups. Additionally, the control group in this study comprised individuals who were wait-listed for the trial. So, essentially, individuals in both the intervention and the control groups knew the group to which they were assigned, based on whether they were given the tasuki or not.
Although the author acknowledges that the results were possibly affected by the placebo effect, we speculate that the results might actually be affected by the Hawthorne Effect. In this scenario, the phenomenon translates to the trial participants’ responses being influenced by their knowledge of which group they belonged to.
We hope that future studies with small sample sizes employ alternate randomization methods to decrease the selection bias caused by a lack of allocation concealment. In addition, robust statistical analyses should be employed in instances where randomization or allocation concealment are not possible.
Link to the original journal article:
https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12119
Title of the paper:
A randomized clinical trial for neck pain among adults
Authors:
Maryam M. K. Bashir and Elpidoforos S. Soteriades
