Limitations
BLIND
The main limitation of this study was the inability to blind the patients and therapists with regard to treatment allocation; therefore, potential performance bias might have been generated. Our study attempted to reduce the possibility of detection bias, including having assessors of outcomes blind to group allocations. Another limitation is that the baseline 6MWT distances of patients in all groups were > 450 m; therefore, further studies are warranted to explore and investigate the effects of combined ACT programs in the population involving patients walking < 450 m at baseline. The final limitation of this study was its relatively short follow-up period for more analyses of outcomes beyond the 1-month follow-up. Additionally, the long-term effect of the combined ACT program requires further investigation.