Reply to Kudus, A.L. Comment on “Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845”
- They studied only adolescent subjects (mean age 13 ± 2 years) with and without scoliotic curvatures (80% versus 20%). The sample included 24% with severe scoliosis and a Cobb angle greater than 40°. This makes the sample inhomogeneous and not comparable to our study population with a mean age of 43.8 ± 10.5 years and aLBP.
- Bassani et al. examined their subjects during an orthopedic visit over three years and calculated the Pearson or Spearman correlation (r) in 192 participants. In this context, r is not a reliable indication of causality, as other variables may influence the correlation [5]. Therefore, Koo et al. [6] strongly recommend the use of the intraclass correlation coefficient (ICC) and point out that r is not an ideal measure of reliability.
- Although the authors included 192 participants, they only used a small group of 30 subjects for follow-up. For this group, they calculated the measurement difference for the Cobb angle between baseline and 6 months later to infer the within-subjects correlation [7]. Both RAD and VRS showed equal mean differences (0° ± 7° versus 1° ± 9°) and were not statistically significantly different from zero. The correlation plot shows a wide scatter of data, with 16 of 30 data points falling outside the 95% confidence interval. The Bland–Altman method of calculating correlation coefficients for repeated observations is based on the General Linear Model and the Analysis of Covariance. Standard assumptions for using these statistical methods are normally distributed data, homogeneity of variance and a relationship between the dependent variable and the covariate. The model is also very sensitive to outliers. Bassani et al. did not specify any of these assumptions. From the graphs presented, it appears that there is an outlier and the data is apparently not normally distributed, which implies a high risk of bias in the calculation.
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References
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Brandl, A.; Egner, C.; Schleip, R. Reply to Kudus, A.L. Comment on “Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845”. Life 2022, 12, 868. https://doi.org/10.3390/life12060868
Brandl A, Egner C, Schleip R. Reply to Kudus, A.L. Comment on “Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845”. Life. 2022; 12(6):868. https://doi.org/10.3390/life12060868
Chicago/Turabian StyleBrandl, Andreas, Christoph Egner, and Robert Schleip. 2022. "Reply to Kudus, A.L. Comment on “Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845”" Life 12, no. 6: 868. https://doi.org/10.3390/life12060868