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The evolution of stroke rehabilitation randomized controlled trials
Amanda McIntyre1, Marina Richardson, Shannon Janzen
1Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, Canada.
Summary
Stroke rehabilitation research has grown significantly, with a notable increase in the quality of randomized controlled trials over four decades. However, study sample sizes have not shown a similar increase.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Trials
Background:
- A comprehensive review of stroke rehabilitation literature is essential for resource allocation and future research direction.
- Understanding the trends in randomized controlled trials (RCTs) is crucial for evaluating the progress of stroke rehabilitation.
Purpose of the Study:
- To analyze the evolution of stroke rehabilitation RCTs from 1970 to 2012.
- To examine changes in the number, sample size, and methodological quality of these trials over time.
Main Methods:
- A systematic search of the Evidence-Based Review of Stroke Rehabilitation database was performed.
- RCTs were categorized by primary outcome: motor, cognitive, medical complications, psychosocial, and 'other'.
- Data on the number of studies, sample sizes, and methodological quality (Physiotherapy Evidence Database scores) were analyzed.
Main Results:
- 1,063 RCTs met the inclusion criteria, with motor rehabilitation studies comprising 58.8%.
- The total number of RCTs increased, with 35.2% published in the last five years.
- While methodological quality (median Physiotherapy Evidence Database scores) significantly improved over time, median sample sizes did not show a significant increase.
Conclusions:
- Stroke rehabilitation RCTs have increased in number and methodological quality over the past four decades.
- Despite the growth in research, sample sizes in these trials have not kept pace.
- These findings highlight areas for improvement in the design and execution of future stroke rehabilitation research.
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