Table 2 Quality and risk of bias assessment tool

A. Selection bias

1.

Randomized sample

2.

Sample size ≥ 30

3.

Adequate test group:

• Were cases selected appropriately (e.g., appropriate diagnostic criteria or definitions)

4.

Adequate control (before and after)

• Inadequate: contralateral side of same patient

5.

Inclusion/exclusion criteria for recruitment

B. Detection or measurement bias

6.

Adequate follow-up

• Inadequate: or follow-up period was not the same between patients, or less than 9 months post-treatment.

7.

Was the intervention assessed using a reliable measure? i.e. pre-treatment muscular tissue assessment

• Example: with MRI, CT, or others.

8.

Were the outcomes assessed using a reliable measure? i.e. MRI muscle tissue assessment measurements

• Example: Inter or intra-examiner agreement reported

9.

Outcome assessors blinded to intervention.

10.

Reported and statistically controlled for confounding factors.

C. Analysis or interpretation bias

11.

Adequate statistical tests used.

Inadequate: e.g. univariate analysis for multivariate outcomes

12.

Adequate and complete reporting of results

Inadequate: e.g. lack of SD or 95% CI, reporting significance based on P value when R²/correlation is <50%.

D. Performance bias

13.

Did researchers rule out any impact from a concurrent intervention or an unintended exposure that might bias results?

Total score