Stinear Cathy M
Department of Medicine, University of Auckland, Auckland, New Zealand.
F1000Res. 2016 Jun 22;5. doi: 10.12688/f1000research.8722.1. eCollection 2016.
Stroke continues to be a major cause of adult disability. In contrast to progress in stroke prevention and acute medical management, there have been no major breakthroughs in rehabilitation therapies. Most stroke rehabilitation trials are conducted with patients at the chronic stage of recovery and this limits their translation to clinical practice. Encouragingly, several multi-centre rehabilitation trials, conducted during the first few weeks after stroke, have recently been reported; however, all were negative. There is a renewed focus on improving the quality of stroke rehabilitation research through greater harmonisation and standardisation of terminology, trial design, measures, and reporting. However, there is also a need for more pragmatic trials to test interventions in a way that assists their translation to clinical practice. Novel interventions with a strong mechanistic rationale need to be tested in both explanatory and pragmatic trials if we are to make a meaningful difference to stroke rehabilitation practice and outcomes.
中风仍然是导致成人残疾的主要原因。与中风预防和急性医疗管理方面的进展相比，康复治疗尚未取得重大突破。大多数中风康复试验是针对处于恢复慢性阶段的患者进行的，这限制了其在临床实践中的应用。令人鼓舞的是，最近有报道称在中风后的头几周内进行了几项多中心康复试验；然而，所有试验结果均为阴性。人们重新关注通过更大程度地统一和标准化术语、试验设计、测量方法及报告来提高中风康复研究的质量。然而，也需要更多务实的试验，以有助于将干预措施应用于临床实践的方式对其进行测试。如果我们要对中风康复实践和结果产生有意义的影响，就需要在解释性试验和务实性试验中对具有强有力机制依据的新型干预措施进行测试。
