REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium.
Sensors (Basel). 2023 Jan 12;23(2):875. doi: 10.3390/s23020875.
The current important limitations to the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot-or can only partially-be applied in rehabilitation. Well-powered, high-quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drug validation studies, limited funding since not sponsored by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high levels of evidence are sparse. The current limitations of EBP in rehabilitation are presented in this narrative review, and innovative solutions are suggested, such as technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the current limitations. The development and implementation of new technologies can increase the quality of research and the level of evidence supporting rehabilitation, provided some adaptations are made to our research methodology.
目前,康复领域实施循证实践(EBP)的重要限制与干预措施的验证过程有关。实际上,为验证新药而制定的大多数严格指南(即双盲或三盲、严格控制剂量和强度)不能——或者只能部分地——应用于康复领域。在康复领域,组织强有力的、高质量的随机对照试验更加困难(例如,康复干预的持续时间更长,与药物验证研究相比更难标准化干预,由于不受大型制药公司的赞助,资金有限),这降低了进行系统评价和荟萃分析的可能性,因为目前证据水平较低。本文通过叙述性综述介绍了康复领域中 EBP 的当前局限性,并提出了一些创新的解决方案,例如技术支持的康复系统、持续评估、实用试验、康复治疗规范系统和先进的统计方法,以应对当前的局限性。新技术的开发和应用可以提高康复研究的质量和支持康复的证据水平,但需要对我们的研究方法进行一些调整。