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Asian Spine J > Volume 17(1); 2023 > Article
Sudhakar, Khan, Saraswat, and Makhija: Response to: Influence of Tensioner’s Mobilization on the Centralization of Symptoms in Cervicobrachial Pain Syndrome: A Randomized Controlled Trial
We thank the editor for sending the letter and the researcher who found a special interest in our paper published in the esteemed Asian Spine Journal [1]. We have tried to answer the queries to the best of our knowledge. Hope we are able to answer the queries well.
1. Firstly, in the abstract study design section, the authors have not mentioned the blinding of the study. If mentioned, it would have eased the reader. According to the journal guidelines, authors should use Consolidated Standards of Reporting Trials (CONSORT) guidelines by Schulz et al. [2], but the authors have not used these guidelines properly for the study.
Response: We acknowledge the concern of the researcher for future readers of our paper but would like to clarify and hope that researcher would agree that due to word limitations, everything regarding methodology cannot be put in the abstract section. We want to correct the researcher for the query that “the blinding is not mentioned in study design section.” In the CONSORT for abstract given by Hopewell et al. [3,4], it is clearly mentioned blinding is a part of methods and not study design. Randomization and blinding are clearly mentioned on page 121 of our paper [1].
2. Authors have calculated the sample size from articles by Anikwe et al. [5], but the outcome measures and the condition of treatment used in that article are different from the above study which clearly violates the rule for sample size estimation [6]. The authors should have calculated the sample size by the same outcome measures used in the previous study.
Response: We thank the researcher for pointing this out. For the sample size calculation, the formula mentioned in the reference study was used. When the effect size was calculated for the variables, it was found that the effect size was 2.22 for pain and 0.96 for centralization of pain. For both variables, the effect size was large. This signifies that our results based on sample size calculation stand correct [7,8].
3. Authors have used the Kolmogorov-Smirnov test for testing the normality of the data for the given sample size of 33, whereas it is generally used in handling larger sample sizes with more than 50 samples [9]. It would have been more appropriate if the authors used the ShapiroWilk test.
Response: We thank the researcher for pointing this out. After being pointed we rechecked the normality with the Shapiro-Wilk test, and we found the results to be almost the same.
4. In the discussion and result section, the tabular presentation of results of between the group and within the group of pre-treatment and post-treatment of both experimental and control groups would have given more easiness for the reader of this article along with the effect size and the power of the study.
Response: We explained the results in the discussion and did not find the need to put the table in the discussion section. In the results section, we wrote in a descriptive way for the clarity of the reader. We did not want to duplicate the information in the text and table. Furthermore, we did include two figures for clarity of results to the reader.
5. The study presented the importance of tensioner’s mobilization in the treatment of cervicobrachial pain syndrome in an excellent way. We appreciate this innovative study in the field of physiotherapy, but we would just like to inform authors to be more cautious while preparing the study design and interpretation of the results.
Response: We thank the researcher for the positive comments. However, we reiterate that the paper got accepted after critical comments and suggestions of the esteemed reviewers of the journal. The mentioned comment concerning the methodology and results is ambiguous.


Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contributions

All the work was done by Kavita Sudhakar and her colleagues.


1. Sudhakar K, Khan SA, Saraswat A, Makhija M. Influence of tensioner’s mobilization on the centralization of symptoms in cervicobrachial pain syndrome: a randomized controlled trial. Asian Spine J 2022 16:119–26.
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2. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med 2010 8:18.
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3. Hopewell S, Clarke M, Moher D, et al. CONSORT for reporting randomised trials in journal and conference abstracts. Lancet 2008 371:281–3.
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4. Hopewell S, Clarke M,CONSORT for abstracts. Moher D, Altman DG, Schulz KF, Simera I, Wager E, editors. Guidelines for reporting health research: a user’s manual. Chichester: John Wiley & Sons; 2014. p.68–79.

5. Anikwe EE, Tella BA, Aiyegbusi AI, Chukwu SC. Influence of Nerve Flossing Technique on acute sciatica and hip range of motion. Int J Med Biomed Res 2015 4:91–9.

6. Noordzij M, Tripepi G, Dekker FW, Zoccali C, Tanck MW, Jager KJ. Sample size calculations: basic principles and common pitfalls. Nephrol Dial Transplant 2010 25:1388–93.
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7. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol 2013 4:863.
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8. Marshall E, Marquier B, Knox C. Friedman test in SPSS: non-parametric equivalent to repeated measures ANOVA. Amsterdam: Studocu; 2020.

9. Mishra P, Pandey CM, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth 2019 22:67–72.
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