Table 4. GRADE* analyses.
Outcome No of participants (studies) Risk of Bias Certainty assessment Mean effect †
(95% CI)
GRADE*
Inconsistency Indirectness Imprecision Other
CT vs. SGL+CON
RSA mean 422
(13 RCTs)
Serious Serious Not Serious Not Serious None -0.99
(-1.44 to -0.54)
□□○○
LOW
RSA best 422
(13 RCTs)
Serious Serious Not Serious Not Serious None -0.88
(-1.25 to -0.51)
□□○○
LOW
RSA fatigue index 388
(12 RCTs)
Serious Serious Not Serious Serious None 0.07
(-0.25 to 0.38)
□○○○
Very LOW
CT vs. SGL
RSA mean 142
(7 RCTs)
Serious Not Serious Serious Not Serious None -0.46
(-0.82 to -0.10)
□□○○
LOW
RSA best 142
(7 RCTs)
Serious Serious Serious Serious None -0.39
(-0.95 to 0.18)
□○○○
Very LOW
RSA fatigue index 142
(7 RCTs)
Serious Serious Serious Serious None 0.02
(-0.63 to 0.66)
□○○○
Very LOW
CT vs. CON
RSA mean 280
(11 RCTs)
Serious Serious Serious Not serious None -1.39
(-2.09 to -0.70)
□○○○
Very LOW
RSA best 280
(11 RCTs)
Serious Serious Serious Not serious None -1.17
(-1.58 to -0.76)
□○○○
Very LOW
RSA fatigue index 246
(10 RCTs)
Serious Serious Serious Very serious None 0.09
(-0.25 to 0.44)
□○○○
Very LOW
* Certainty of evidence according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE): High: We are very confident in the estimated effect. Moderate: Our confidence in the estimated effect is moderate. Low: We have limited confidence in the estimated effect. Very low: We have very little confidence in the estimated effect. † Mean effect calculated as the difference between the CT intervention group and SGL/CON group in how much their RSA changed from baseline to follow-up. RCTs: randomized controlled trial.