title: Challenges and recommendations for placebo controls in randomized trials in physical and rehabilitation medicine: a report of the international placebo symposium working group.
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.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
authors.forename: Marta
authors.initials: M
authors.lastname: Imamura
authors.forename: Hsin Fen
authors.initials: HF
authors.lastname: Chien
authors.forename: Henry L
authors.initials: HL
authors.lastname: Lew
authors.forename: Paulo
authors.initials: P
authors.lastname: Boggio
authors.forename: Ted J
authors.initials: TJ
authors.lastname: Kaptchuk
authors.forename: Marcelo
authors.initials: M
authors.lastname: Riberto
authors.forename: Wu Tu
authors.initials: WT
authors.lastname: Hsing
authors.forename: Linamara Rizzo
authors.initials: LR
authors.lastname: Battistella
authors.forename: Andrea
authors.initials: A
authors.lastname: Furlan
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D018579:Patient Selection / Q000941:ethics; D010810:Physical and Rehabilitation Medicine / Q000592:standards*; D010919:Placebos / Q000592:standards*; D011369:Professional-Patient Relations / Q000941:ethics; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012046:Rehabilitation / Q000592:standards*
chemical_list: D010919:Placebos