Improving the Development, Monitoring and Reporting of Stroke Rehabilitation Research: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable

Abstract

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations, the group reviewed all stroke rehabilitation trials published in 2015 (n ¼ 182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention call into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless, the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence-based clinical care, we urge the research community to endorse and adopt our recommendations.

Biomarker Application for Precision Medicine in Stroke

“…Partnering with large data analytic companies for Big Data analysis can provide insight on key variables that may otherwise not be captured. Challenges faced in rehabilitation research also demonstrate variability in the types and assessment of biomarkers for tracking clinical outcome, objective assessment of recovery limits, and replication of research findings [19]. In addition, efforts are needed to harmonize biomarker assessment and improve secured portability of data for analysis between research collaborators [12].…”

Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews

“…The main deficit caused by stroke is motor impairment, which can be described as loss or limitation of muscle control function or movement, or limitation in mobility. It typically affects the control of movement of the face, arm and leg on one side of the body and is present in about 80% of patients [6]. Almost two-thirds of stroke survivors have initial mobility deficits, and six months after stroke, more than 30% of survivors still cannot walk independently [7].…”

Comparing two identically protocolized, multicentre, randomized controlled trials on caregiver-mediated exercises poststroke: Any differences across countries?

“…We argue that we should proceed faster to evaluating promising rehabilitation interventions poststroke in large phase III and IV trials. International collaboration to standardize study protocols including study design, outcome measurement and reporting is an important next step to improve robustness of trial outcomes in the field of stroke rehabilitation [ 42 – 44 ]. Awareness of clinical heterogeneity and consensus in trial conduct across countries through the international GAINS network is especially important when designing future global trials.…”