McIntyre Amanda, Campbell Nerissa, Vermeer Julianne, Mays Rachel, Janzen Shannon, Teasell Robert
Lawson Health Research Institute, Parkwood Institute, London, Ontario, Canada.
Lawson Health Research Institute, Parkwood Institute, London, Ontario, Canada.
J Stroke Cerebrovasc Dis. 2016 Feb;25(2):248-53. doi: 10.1016/j.jstrokecerebrovasdis.2015.09.024. Epub 2015 Oct 20.
The objective of the study was to evaluate the methodological quality of motor intervention randomized controlled trials (RCTs) published in the stroke rehabilitation literature and to examine trends in quality over time.
A systematic literature search was conducted for all English articles (published up to December 2013) examining rehabilitation for motor recovery poststroke. All RCTs with a human sample, of which at least 50% had a stroke, were included in the analysis. A Physiotherapy Evidence Database (PEDro) score was assigned to assess methodological quality. A one-way analysis of variance was conducted to examine adherence to quality items overall and over time, with post hoc t-tests performed where appropriate.
Six hundred seventy-six RCTs met inclusion criteria, of which 32.0% had excellent, 42.0% good, 23.1% fair, and 3.0% poor methodological qualities. The overall mean PEDro score was 6.6 ± 1.6; with scores improving significantly between 1979-1983 and 2009-2013 (5.0 ± 1.4 versus 7.0 ± 1.5; P = .0003); however, no significant improvements in individual items were found (P > .05).
This study showed improvements in the total methodological quality of motor intervention RCTs in stroke rehabilitation over time. However, no relationship was found between individual quality items and improvement over time.
本研究的目的是评估发表在中风康复文献中的运动干预随机对照试验（RCT）的方法学质量，并研究质量随时间的变化趋势。
对所有研究中风后运动恢复康复的英文文章（截至2013年12月发表）进行系统的文献检索。纳入分析的所有RCT均以人类为样本，其中至少50%的样本患有中风。采用物理治疗证据数据库（PEDro）评分来评估方法学质量。进行单因素方差分析以检验总体及随时间推移对质量项目的依从性，并在适当情况下进行事后t检验。
676项RCT符合纳入标准，其中32.0%的方法学质量优秀，42.0%良好，23.1%中等，3.0%较差。PEDro总体平均评分为6.6±1.6；1979 - 1983年与2009 - 2013年之间评分有显著提高（5.0±1.4对7.0±1.5；P = 0.0003）；然而，各单项未发现显著改善（P > 0.05）。
本研究表明，随着时间的推移，中风康复中运动干预RCT的总体方法学质量有所提高。然而，未发现各单项质量项目与随时间的改善之间存在关联。
