First, no long-term follow-up data was available after intervention so they did not investigate the long lasting effects.
Second, this study was not a double-blinded randomized clinical trial.
Evaluations were performed by an assessor blinded to study but the participants were blinded to group allocation.
Blinding participants to group allocation was not possible due to the nature of the interventions.
Finally, the sample size in this study was small, as a larger sample size may have been a more clear effect of the subject.