School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Alta Vista Campus, Room 101, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute, and Ottawa Hospital Research Institute, C2182 Ottawa Hospital Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.
Syst Rev. 2017 Nov 2;6(1):219. doi: 10.1186/s13643-017-0620-6.
Stroke is a growing global epidemic limiting the ability of millions to function independently due to post-stroke deficits and complications. Although specialized stroke rehabilitation improves the recovery of functional abilities, accessing rehabilitation services has become increasingly challenging as the number of stroke survivors continues to increase and rehabilitation resources remain scarce. Mobile tablet-based therapies (MTBTs) may be a resource-efficient platform for providing stroke rehabilitation services. The feasibility and challenges of offering MTBTs to stroke survivors should be well understood before expensive, large-scale clinical trials are undertaken to study treatment efficacy.
A systematic scoping review will be conducted to describe attempted MTBTs following stroke and the challenges encountered by survivors and study staff. Studies of interest will evaluate MTBTs offered to adult stroke patients in response to post-stroke complications or deficits. Journal databases, gray literature sources, clinical trial registries, relevant organizational websites, and reference lists of eligible studies will be searched to identify suitable studies. Study characteristics, barriers to care, methodological challenges, patient-reported outcomes, and health outcomes will be extracted to describe MTBTs and understand the challenges encountered in context. Results will be presented using descriptive statistics, tables, figures, and narrative description to summarize the scope of the field.
Trends in MTBT feasibility and common challenges will be discussed to summarize major findings and highlight research gaps. Solutions to common challenges experienced by intervention participants and study staff will be proposed. Implications for the conduct of randomized clinical trials of MTBT efficacy and the appropriateness of a systematic review and meta-analysis of completed trials will be discussed. SYSTEMATIC REVIEW REGISTRATION: uO Research ( http://hdl.handle.net/10393/35696 ).
由于中风后出现的功能缺陷和并发症，中风已成为一种日益严重的全球性流行病，使数百万人丧失了独立生活的能力。尽管专门的中风康复治疗可以改善功能能力的恢复，但随着中风幸存者人数的持续增加，而康复资源仍然稀缺，获得康复服务的机会变得越来越困难。基于移动平板电脑的治疗（MTBT）可能是提供中风康复服务的一种资源高效的平台。在进行昂贵的大规模临床试验以研究治疗效果之前，应该充分了解向中风幸存者提供 MTBT 的可行性和挑战。
将进行系统的范围界定综述，以描述中风后尝试使用 MTBT 以及幸存者和研究人员所遇到的挑战。有兴趣的研究将评估针对中风后并发症或缺陷而向成年中风患者提供的 MTBT。将检索期刊数据库、灰色文献来源、临床试验注册处、相关组织网站和合格研究的参考文献列表，以确定合适的研究。将提取研究特征、护理障碍、方法学挑战、患者报告的结果和健康结果，以描述 MTBT 并了解在具体情况下所遇到的挑战。将使用描述性统计数据、表格、图形和叙述描述来呈现结果，以总结该领域的范围。
将讨论 MTBT 可行性的趋势和常见挑战，以总结主要发现并突出研究空白。将提出干预参与者和研究人员所遇到的常见挑战的解决方案。将讨论进行 MTBT 疗效随机临床试验的注意事项以及对已完成试验进行系统评价和荟萃分析的适当性。
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