Is there ANY point to mixed intervention studies?

Let me be completely clear here, mixed intervention studies drive me crazy (well, more crazy than usual!)

By a mixed intervention study, I mean a study looking at 2 or more interventions, usually comparing one to another but with other interventions lurking in the background.

A new study looking at low level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) really got me reaching for my happy pills!

The study is entitled:

Combination Therapy Versus Exercise and Orthotic Support in the Management of Pain in Plantar Fasciitis: A Randomized Controlled Trial and it is authored by Cinar et al in Foot & Ankle International, First Published January 12, 2018 

You can read the abstract here. Let's take a look at what they did:

This study aimed at estimating the effectiveness of two commonly used modalities—extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)—each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF).

Can you spot the immediate problem?

This study did NOT just compare LLLT and ESWT.. it compared LLLT, ESWT, Orthotic therapy AND exercises! However, the intevention with orthotic therpy and exercises is placed in parentases, almost as if these tretments are irrelevant to the outcomes.. I am fairly starting to froth at the mouth already!

Simon Bartold
Director of Bartold Clinical