Physiotherapy: A potential and novel treatment approach for phantom limb pain in post-amputee patients - A systematic review.

Objective: To evaluate the efficacy of conventional and novel non-pharmacologic, non-invasive therapeutic interventions in physiotherapy for the treatment of phantom limb pain (PLP) in post-amputee patients. Methods: A systematic search for the articles was conducted in multiple electronic databases such as PUBMED, Google Scholar, EMBASE, Cochrane library and Physiotherapy Evidence Database (PEDro), following the PRISMA method and only published articles from the last 12 years (2010-2022) evaluating the efficacy of different physiotherapy interventions for the treatment of PLP in post-amputee patients were included. The methodological quality and risk of bias of the articles were assessed and evaluated by two independent reviewers using the PEDro scale, Methodological index for non-randomized studies scale (MINORS), and Cochrane collaboration's assessment tool. Result: A total of 1840 articles were identified, out of which 17 articles (11 RCTs and 6 pilot studies) were ultimately chosen after the full-text screening. After reviewing the articles, evidence identified in RCTs and pilot studies indicates towards significant improvement in reducing the severity of PLP in post-amputee patients by using different physiotherapy interventions. Conclusion and discussion: Physiotherapy interventions with advance modalities and exercises can be used to increase the overall effectiveness of the treatment and to reduce the severity of phantom limb pain in post-amputee patients. However, due to the lack of consistent evidence for a given intervention, it becomes even more difficult to reach a majority consensus as to which intervention better assess all the mechanism of PLP thereby alleviating the problem of PLP in post-amputee patients. Therefore, more rigorous randomized controlled trials will be required in the future to reach a conclusion.

Combined effect of Brunnstrom's hand rehabilitation and functional electrical stimulation for improving hand function in patients with chronic stroke: A randomized controlled trial.

BACKGROUND: Motor recovery of the upper extremity is one of the most common challenging outcomes after stroke. OBJECTIVE: To find out the combined effects of Brunnstrom hand rehabilitation (BHR) and functional electrical stimulation for improving hand functions in patients with chronic stroke. STUDY DESIGN: Randomized controlled trial. METHOD: 25 participants, both male (n = 11) and female (n = 14), age group between 40 and 70 years were randomly divided into control group (n = 12) and experimental group (n = 13). The treatment protocol was continued 5 days per week, for 4 weeks. The experimental group received Brunnstrom hand training and functional electrical stimulation (FES) along with conventional physiotherapy. The control group received only conventional physiotherapy. Participants were evaluated at baseline and after 4 weeks of intervention. OUTCOME MEASURES: Fugl Meyer Assessment scale-upper extremity, Modified Ashworth scale, Handheld Dynamometer, and Jabsen Taylor Hand Function Test. Paired t-test was used to compare within-group variables and an independent t-test was used for between-group comparisons. P-value was set as 0.05 to minimize type-1 error. RESULTS: Statistically significant difference was obtained in favor of the experimental group undergoing FMA (p < .001), MAS (p = .004), JTHF (p = .018), and HHD (p < .001) in between-group analysis. However, both groups showed significant improvement [experimental group; FMA-UE (p < .001), MAS (p < .001); JTHF (p < .001), and HHD (p < .001), and control group; FMA-UE (p < .001), MAS (p < .001), JTHF (p < .001) and HHD (p < .001)] in within-group analysis at post-intervention. CONCLUSION: Brunnstrom hand rehabilitation and FES in combination were found to be more effective in improving hand function than conventional physiotherapy treatment. CLINICAL TRIAL REGISTRATION: URL: http://www.ctri.nic.in. No: CTRI/2019/06/019,905.

Terapia a laser de alta intensidade para rigidez muscular dos isquiotibiais: fundamentação e desenho do estudo para estudo controlado randomizado simples-cego / High-intensity laser therapy for hamstring muscle tightness: rationale and study design for a single-blinded randomized controlled trial

CONTEXTO: Sentar-se por muito tempo e um estilo de vida sedentário podem resultar em encurtamento dos isquiotibiais. Um declínio na atividade física regular pode levar a uma diminuição da flexibilidade do músculo em um adulto mais jovem. Aumentar a flexibilidade dos músculos isquiotibiais pode diminuir as possibilidades de lesões e prevenir a dor lombar. A aplicação da terapia a laser de alta intensidade (TLAI) tem demonstrado inúmeros benefícios para diversas condições. No entanto, até o momento, não hápesquisas publicadassobre a eficácia dessaterapia para melhorar o comprimento dos músculos isquiotibiais em adultos jovens saudáveis. Este artigo descreve o protocolo de estudo para investigar os benefícios do TLAI no tratamento da rigidez muscular dos isquiotibiais em adultos jovens. MÉTODOS: 136 indivíduos jovens saudáveis serão recrutados, pelo método de amostragem intencional, para participar de um estudo randomizado, simplescego e controlado por simulação. Os participantes recrutados serão divididos aleatoriamente em dois grupos, o grupo TLAIativo e o grupo TLAI placebo. A duração do tratamento será de 8 a 10 minutos por sessão em ambos os membros inferiores, em dias alternados, durante duas semanas. O teste de extensão ativa do joelho e o teste de sentar e tocar são as medidas de resultado que serão registradas na linha de base, no final do período pós-intervenção de 2 semanas. O valor de p ≤0,05 será considerado estatisticamente significativo. DISCUSSÃO: Os resultados do estudo fornecerão os dados para determinar se aTLAI seria uma futura intervenção não farmacológica não invasiva para reduzir a tensão muscular dos isquiotibiais em adultos jovens. REGISTRO DE ENSAIO: Registro de Ensaios Clínicos NCT05077761.

BACKGROUND: Prolonged sitting and a sedentary lifestyle may result in hamstring shortness. A decline in regular physical activity could lead to a decrease in the flexibility of the muscle in a younger adult. Increasing hamstring muscle flexibility could decrease the possibility of injuries and prevent low back pain. The application of high-intensity laser therapy (HILT) has proved to be innumerable benefits for many conditions. However, to date, no published research is available on the effectiveness of this therapy in improving hamstring muscle length in healthy young adults. This article describes the study protocol for investigating the benefits of HILT in treating hamstring muscle tightness among young adults. METHODS: 136 healthy young individuals will be recruited, by purposive sampling method, to participate in a randomized, single-blinded, sham-controlled study. Recruited participants will be randomly divided into two groups, the active HILT group, and the sham HILT group. The treatment duration will be 8-10 minutes per session, on both lower limbs, for alternate days a week, for two weeks. The active knee extension test and sit-toe and touch test are the outcome measures that will be recorded at baseline, end of the 2-week post-intervention period. The p-value ≤0.05 will be considered statistically significant. DISCUSSION: The study findings will provide the data to determine whether HILT would be a future non-pharmacological non-invasive intervention to reduce hamstring muscle tightness among young adults. TRIAL REGISTRY: Clinical Trials Registry NCT05077761.

Effectiveness of immersive virtual reality training to improve sitting balance control among individuals with acute and sub-acute paraplegia: A randomized clinical trial.

OBJECTIVES: Spinal cord injury (SCI) is a disabling condition with physical, psychological, and financial consequences. The study's goal is to compare the effectiveness of immersive virtual reality (VR) training in balance among individuals with incomplete paraplegia to that of functional electrical stimulation (FES). DESIGN: Two groups, randomized clinical trial. SETTING: Neurological Physiotherapy Out Patient Department, Tertiary Care Hospital. PARTICIPANTS: Eighteen people aged 18-60 years with incomplete SCI. INTERVENTIONS: VR training along with conventional physical therapy (CPT) and FES for Rectus Abdominis and Erector Spinae with CPT five times a week for 4 weeks. OUTCOME MEASURES: The outcome measures were Modified Functional Reach Test (mFRT) and Function in Sitting Test (FIST) to assess sitting balance and Spinal Cord Independence Measure III (SCIM III) for the level of independence. Assessments were taken before initiating treatment and at the end of the 2 and 4 weeks after treatment. Within-group analyses for the mFRT values were performed using Repeated Measures ANOVA test, and between-group analyses were performed using the independent t-test test. Friedman and Mann-Whitney U-tests were used for analyzing FIST and SCIM III. RESULTS: All variables (mFRT and FIST) improved significantly in both groups (P < 0.05), with the VR + CPT group showing a more significant result than the FES + CPT group (P value < 0.05), except for SCIM III. CONCLUSION: VR as an adjunct to CPT demonstrated proved to be an effective treatment to improve balance among individuals with incomplete paraplegia.Trial registration: Clinical Trials Registry India identifier: CTRI/2020/03/024080.

Terapia a laser de alta intensidade (Class IV) e fonoforese em gel de ibuprofeno para o tratamento de osteoartrite de joelho entre pessoas que vivem em terreno montanhoso: um protocolo de ensaio multicêntrico, duplo-cego randomizado / High-intensity laser therapy (Class IV) and ibuprofen gel phonophoresis for treating knee osteoarthritis among people living in hilly terrain: A randomized, double blind, multi-centre trial protocol

INTRODUÇÃO: Pessoas que vivem em terrenos íngremes com carga cíclica anormal podem levar à degeneração da cartilagem óssea. A terapia a laser de alta intensidade (TLAI) e a fonoforese trazem inúmeros benefícios aos pacientes com osteoartrite de joelho (OAJ). No entanto, ainda não está claro qual tratamento é eficaz entre eles na reabilitação de pacientes com OAJ. OBJETIVO: Verificar se a TLAI de 8 semanas não é pior que a fonoforese em gel de ibuprofeno (FGI) no tratamento de pacientes com osteoartrite de joelho que vivem em terreno montanhoso. MATERIAIS E MÉTODOS: Um total de 108 indivíduos com OAJ serão recrutados por amostragem aleatória simples para participar de um estudo randomizado, duplo-cego e controlado. Os indivíduos recrutados com OAJ serão divididos aleatoriamente em dois grupos, grupo TLAI (grupo experimental) e grupo FGI (grupo controle). A duração do tratamento de TLAI e FGI será de 8 minutos em uma sessão/articulação do joelho para cada dia, por 3 dias/semana até 8 semanas, além de seus exercícios convencionais por 30 minutos. O Western Ontario and Mc Master Universities Osteoarthritis Index, o algômetro digitalizado de pressão de dor e o questionário de 36 itens Short-Form Health Survey são as medidas de resultado que serão registradas ao término, no final do período pós-intervenção de 8 semanas. PERSPECTIVAS: Os resultados deste ensaio contribuirão para recomendações baseadas em evidências para a implicação clínica de que o TLAI não é pior que o FGI juntamente com a intervenção de exercício para tratar indivíduos com OAJ que vivem em terreno íngreme.

INTRODUCTION: People living in hilly terrain with abnormal cyclic loading could lead to bone cartilage degeneration. High-intensity laser therapy (HILT) and Ibuprofen gel phonophoresis (IGP) have innumerable benefits for patients with knee osteoarthritis (KOA). However, it is still unclear which treatment is effective among them in rehabilitating patients with KOA. OBJECTIVE: To verify whether 8-week HILT is no worse than the IGP in treating patients with knee osteoarthritis living in hilly terrain. MATERIALS AND METHODS: A total of 108 individuals with KOA will be recruited by simple random sampling to participate in a randomized, double-blind, controlled study. Recruited individuals with KOA will be randomly divided into two groups, the HILT group (experimental group) and the IGP group (active control group). The treatment duration of HILT and IGP will be 8 minutes in one session/knee joint for each day for 3 days/week up to 8 weeks in addition to their conventional exercises for 30 minutes. The Western Ontario and McMaster Universities Osteoarthritis Index, Digitalized pain pressure algometer, and 36-Item Short-Form Health Survey questionnaire are the outcome measures that will be recorded at baseline, end of the 8-week post-intervention period. PERSPECTIVES: The results from this trial will contribute to evidencebased recommendations for the clinical implication of whether HILT is no worse than IGP, along with exercise intervention for treating individuals with KOA living in hilly terrain.

Safeguarding from COVID-19: educating healthcare workers about the available protective equipment.

Aim: Coronavirus disease 2019 (COVID-19) is a viral illness which is transmitted through droplet spread and possibily the aerosol method. Older individuals are at higher risk compared with younger adults and children due to the presence of weaker immune functions. Healthcare workers are also at higher risk due to close proximity with the infected cases. Proper precautions and hand hygiene techniques can prevent the transmission of the disease. There is a dearth of evidence on how to manage the disease; therefore, protective measures might help to reduce the spread of infection. This article aimed to evaluate the preventive measure and use of protective equipment among healthcare workers and community settings. Subjects and methods: Various recent literature searched in the following databases-Medline/PubMed, CINAHL, Scopus-recommendations from centre for disease control and prevention (CDC) and World Health Organization (WHO) reports on preventive measures of COVID-19 were included. Results: After reviewing the previous literature, we summarized proper precautions and hygiene techniques, use of PPE and applicability of surgical and N95 (can block 95% small particles but not resistant to oil) masks to prevent the transmission of disease. Conclusion: This viewpoint can be considered as a unique example of information on infection control and protective measures. However, due to the lack of evidence, further research is required to compare the effectiveness of medical masks and N95 masks.

Reabilitação funcional em unidades de terapia intensiva para pacientes pós-craniotomia: protocolo de estudo / Functional rehabilitation in intensive care units for post craniotomy patients: study protocol

INTRODUÇÃO: A craniotomia torna mais fácil a compreensão e abordagem do cérebro, mas acompanha as doenças. As unidades de terapia intensiva são equipadas com fisioterapeutas profissionais treinados para lidar com esses efeitos deletérios após este programa cirúrgico, mas falta um protocolo progressivo, definido e apoiado por evidências para esses pacientes. OBJETIVO: Avaliar a viabilidade do protocolo de neuro-reabilitação elaborado para pacientes pós-craniotomia durante sua internação em Unidade de Terapia Intensiva (UTI) para melhorar seus resultados funcionais e reduzir seu tempo de internação (LOS). MATERIAIS E MÉTODOS: Será um ensaio de quase viabilidade pós-teste de pré-teste de grupo único. Quinze pacientes submetidos à craniotomia serão recrutados para o estudo e serão processados com protocolo de Neuro-reabilitação por 60 minutos do primeiro dia da cirurgia até o 15º dia da cirurgia. O resultado primário será a Escala de Habilidades Funcionais Precoces (EFA) para medição de resultados funcionais como nível de consciência, habilidades sensório-motoras, habilidades cognitivo-perceptuais e habilidades oromotoras de pacientes que serão avaliadas no primeiro dia após a craniotomia. Os resultados secundários incluirão Escala de Coma de Glasgow (GCS), Escala de Recuperação de Coma - Revisada (CRS-R), Técnica de Reabilitação de Avaliação de Modalidade Sensorial (SMART), Escala de Ashworth modificada modificada (mMAS), Pontuação de Avaliação Cognitiva de Montreal (MoCA) e Conselho de Pesquisa Médica Escala (MRC). As avaliações serão feitas no primeiro e no décimo quinto dia pós-operatório. PERSPECTIVAS: Espera-se que este protocolo melhore os resultados funcionais e reduza a incidência de ocorrência de comorbidades em pacientes após craniotomia em UTI.

INTRODUCTION: Craniotomy makes insight and approach towards the brain easier but accompanies ailments. Intensive care units are equipped with trained professional physical therapists working over these deleterious after-effects of this surgical program, but a progressive, defined, and evidence-supported protocol for such patients is lacking. OBJECTIVE: To assess the feasibility of a Neurorehabilitation protocol devised for post-craniotomy patients within their stay in the Intensive Care Unit (ICU) to improve their functional outcomes and reduce their length of stay (LOS). MATERIALS AND METHODS: It will be a single group pre-test post-test quasi feasibility trial. Fifteen patients undergoing craniotomy will be recruited for the trial and will be rendered with Neuro-rehabilitation protocol for 60 minutes from the first day of surgery up to 15 days of surgery. The primary outcome will be the Early Functional Abilities (EFA) Scale to measure functional outcomes like conscious level, sensorimotor abilities, cognitive-perceptual abilities, and oro-motor abilities of patients, which will be assessed first-day post craniotomy. Secondary outcomes will include Glasgow Coma Scale (GCS), Coma Recovery Scale-Revised (CRS-R), Sensory Modality Assessment Rehabilitation Technique (SMART), Modified Ashworth Scale (mMAS), Montreal Cognitive Assessment Score (MoCA), and Medical Research Council Scale (MRC). Assessments will be taken on the first and fifteenth days post-surgery. PERSPECTIVES: It is expected that this protocol might improve functional outcomes and may reduce the occurrence of comorbidities in patients after Craniotomy in ICUs.

Mobile-Based Health Apps to Promote Physical Activity During COVID-19 Lockdowns.

OBJECTIVE: Periods of lockdown due to coronavirus disease 2019 (COVID-19) have a negative effect on individuals' physical health and quality of life, and may result in a weakened immune response, leading to enhanced risk of infection. Due to lack of access to public resources during periods of lockdown many individuals cannot perform their usual daily physical activities. The aim of this short report is to discuss the use of mobile-based health applications and virtual reality systems for promoting physical activity at home through an interactive and motivating digital environment. METHODS AND RESULTS: Information on tele-health, available from the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), and data on physical activity during lockdowns were reviewed. A list of mobile-based health applications suitable for use in promoting physical activity at home was compiled. CONCLUSION: This report makes recommendations for mobile-based health applications to promote physical health, which can be used at home during periods of lockdown.

Impact of Coronavirus disease-19 (COVID-19) lockdown on physical activity and energy expenditure among physiotherapy professionals and students using web-based open E-survey sent through WhatsApp, Facebook and Instagram messengers.

BACKGROUND: Coronavirus disease - 19 (COVID-19) spread throughout the world and become pandemic. To stop and control the rapid infection of COVID-19 lockdown is the best option. Sudden lockdown implies change in entire lifestyle of the population. Social isolation affects individual's lives by greater reduction in their physical activity, which might increase the chance of infection by reducing immunity. To what extent, the physical activity is reduced during this lockdown period among physiotherapy professionals, and students who propagate physical activity is not known. Hence, we aimed to evaluate the impact of the COVID-19 lockdown on physical activity level and energy expenditure among physiotherapy professionals and students. MATERIAL AND METHODS: One hundred and forty three volunteered physiotherapy professionals and students participated in web-based open E-survey. The survey was carried out by sending the Google Forms link for International Physical activity questionnaire-short form (IPAQ-SF) through social networking sites using Google Forms to gather the amount of PA before and during COVID-19 lockdown period and analysed using Wilcoxon signed rank test. RESULTS: Among identified 261 potential survey participants, 143 responded, reaching a response rate of 54.8%. Total physical activity before and during COVID-19 lockdown period were 7809.7 (3849.7-11769.8) MET-min/week and 4135.7 (867.2-7404.1) MET-min/week; p < 0.0001. While energy expenditure before and during COVID-19 lockdown period were 8189.8 (4242.1-12137.6) kcal/wk and 4221.7 (1004.6-7438.8) kcal/wk; p < 0.0001. CONCLUSION: A significant reduction in self-report physical activity and energy expenditure levels were observed among physiotherapy professionals and students during the COVID-19 lockdown period.

Níveis de conscientização da comunidade rural, desafios e estratégias adotadas para combater o COVID-19: uma e-survey transversal / Rural community awareness levels, challenges and strategies adopted to combat COVID-19: A cross-sectional E-survey

COVID-19 tem um efeito generalizado nas economias rurais em todo o mundo. Tem afetado a renda familiar e os negócios em todos os setores das economias rurais. O lockdown devido ao surto de COVID-19 limita a atividade física regular e ao ar livre, e ainda pode levar a um risco aumentado de condições crônicas de saúde. A atividade física e a ioga desempenham papel vital para quebrar o tédio causado pelo lockdown e, assim, podem melhorar a qualidade de vida. OBJETIVO: Identificar o nível de consciência e desafios enfrentados pelas pessoas de comunidades rurais devido ao surto COVID-19. MATERIAIS E MÉTODOS: Um total de 36 participantes foram recrutados pelo método de amostragem de conveniencia de cinco aldeias diferentes no Distrito, Ambala, Haryana, Índia. Os questionários da pesquisa eletrônica foram distribuídos por meio do aplicativo móvel de mensagens WhatsApp. O questionário foi elaborado incorporando a escala Likert de três pontos com três domínios, 1) Conscientização, 2) Desafios e, 3) Estratégias e 12 itens. A validação do questionário foi realizada pelos juízes por meio do método Delphi survey até S-CVI / Ave > 0,8. A tendência central e a dispersão da variável contínua idade foram expressas em média com intervalo de confiança (IC) de 95%. Os dados categóricos foram relatados em frequências, porcentagem (%) e tamanho da amostra (n). Os níveis de significância foram estabelecidos em 0,05 para minimizar o erro Tipo 1. RESULTADOS: Índice de validade de conteúdo do questionário, S-CVI / Ave = 0,90. Ao entrar em contato com 36 participantes em potencial, um total de 27 respostas da pesquisa foram registradas. Consequentemente, a taxa de resposta (RR) foi encontrada em 75%. A média com IC de 95% de idade foi de 30,8 (27,3; 34,3) anos. Um total de 94% (n = 25) dos moradores estavam cientes do COVID-19, 88% (n = 24) estavam enfrentando desafios e 86% (n = 23) dos participantes estavam adotando as melhores estratégias que incluem, de zona de contenção, uso de máscara artesanal composta de roupas, consumo de fitoterápicos tradicionais como potenciadores de imunidade para profilaxia e envolvimento em atividade física regular e ioga . CONCLUSÃO: As populações rurais que está ciente de COVID-19 e ter conhecimento adequado sobre COVID-19. Eles estavam enfrentando desafios devido ao COVID-19 e preparados com as melhores estratégias / métodos de combate ao COVID-19.

COVID-19 has a widespread effect on rural economies all over the world. It has affecting household incomes, and businesses in every sector of rural economies. Lockdown due to COVID-19 outbreak limiting the outdoor and regular physical activity, and further can leads to increased risk of chronic health conditions. Physical activity and yoga play a vital role in breaking the boredom due to COVID-19 lockdown and thereby, improves the quality of life. OBJECTIVE: To identifying the level of awareness and challenges faced by the people of rural communities due to the COVID-19 outbreak. MATERIALS AND METHODS: A total of 36 participants were recruited by convenient sampling method from five different villages in District, Ambala, Haryana, India. E-survey questionnaires were circulated through WhatsApp messaging mobile-based application. The questionnaire was formed incorporating the three-point Likert scale with three domains, 1) Awareness, 2) Challenges and, 3) Strategies and 12 items. The questionnaire validation was carried out by the experts through Delphi survey method until S-CVI/Ave > 0.8. The central tendency and dispersion of continuous variable age were expressed in mean with a 95% confidence interval (CI). Categorical data were reported in frequencies as a percentage (%) and sample size (n). The levels of significance were set at 0.05 to minimize Type 1 error. RESULTS: The content validity index of the questionnaire, S-CVI/Ave = 0.90. By contacting 36 potential participants, a total of 27 survey responses were recorded. Hence, the response rate (RR) was found to be 75%. The mean with 95% CI of age was 30.8 (27.3 to 34.3) years. A total of 94% (n=25) of villagers were aware of COVID-19, 88% (n=24) were facing challenges, and 86% (n=23) of participants are adopting the best strategies which includes, sealing of containment zone, usage of homemade mask made up of clothes, consuming traditional herbal medicine as immunity boosters for prophylaxis and involving in regular physical activity and yoga. CONCLUSION: The rural populations were aware of COVID-19 and having adequate knowledge about COVID-19. They were facing challenges due to COVID-19 and prepared with the best strategies/methods to combat COVID-19.

Ensaio clínico randomizado: padrão ouro de desenhos experimentais - importância, vantagens, desvantagens e preconceitos / Randomized clinical trial: gold standard of experimental designs - importance, advantages, disadvantages and prejudice

Ensaios clínicos randomizados (ECR) são o padrão ouro para desenho experimental de estudo ou ensaio clínico. Apenas por meio de uma investigação do tipo ECR é possível avaliar e demonstrar a relação de causa-e-efeito entre um conjunto de variáveis independentes e dependentes. O ECR adicionou vantagens em relação aos outros modelos experimentais, principalmente devido à presença de um grupo controle. Existem várias críticas à validade interna das pesquisas em saúde, incluindo preconceitos e desvantagens que são apontadas para seu descrédito. OBJETIVO: O objetivo do presente estudo é informar características, vantagens, desvantagens e desvios deste método científico. MATERIAL E MÉTODOS: Análise crítica de método científico com base em revisão narrativa da literatura. Foi consultada a base de dados Medline por meio dos portais PubMed e Scopus, sem data de início e até julho de 2020, para extração das informações relativas aos ECR. Apenas artigos de língua inglesa foram incluídos, usando as palavras-chave "estudo randomizado controlado", "ensaio clínico randomizado", "projeto experimental" e "estudo experimental", intercaladas pelos operadores booleanos "AND ," "OR" e "NOT". Anais de conferências e resumos não foram considerados para a análise dos dados. RESULTADOS: Dos ECR selecionados, foram extraídas características, vantagens, desvantagens, importância e vantagens dos controles em pesquisa, o princípio de equilíbrio, ensaios clínicos randomizados na população pediátrica, ECR na população geriátrica, ameaças à validade interna e medidas para minimização de viéses e preconceitos em ECR. CONCLUSÃO: Tópicos relevantes dos ECR foram explicados nesta revisão que devem guiar pesquisadores clínicos.

Randomized controlled trial (RCT) is the gold standard of experimental design or clinical trial design. Only by RCT in research, the cause-and-effect relationship between a set of independent and dependent variables could be demonstrated. RCT has added advantages over other experimental designs due to the presence of the control group. The importance of control in health research trials and its advantages to be elaborated. Though various threats to internal validity in health research trials could be minimized by RCT, various biases in RCT and disadvantages add to its discredit. OBJECTIVE: The aim of the present narrative review is to brief the characteristics, advantages, disadvantages, and various biases in RCT. METHODS: This review does not follow the PRISMA statement, as it was a narrative review. Two databases, namely, Medline through PubMed and Scopus, were searched from inception to July 2020 for the information pertaining to RCTs and included in this narrative review. Only English language articles were searched with the keywords, "Randomized controlled trial," "Randomized clinical trial," "experimental design," and "experimental study." These keywords are linked together by the Boolean words, "AND," "OR" and "NOT." Conference proceedings and only abstracts were not considered for the review. RESULTS: RCTs were explained under characteristics, advantages, disadvantages, importance, and advantages of controls in research, the principle of equipoise, RCTs in the pediatric population, RCTs in the geriatric population, threats to internal validity and steps to minimize them and various biases in RCTs. CONCLUSION: The narrative presentation of RCTs under various important topics have been explained in this review.