Pitfalls in effectiveness research: a comparative analysis of treatment goals and outcome measures in stroke rehabilitation.

ABSTRACT

PROBLEM: There is a great diversity of movement therapies in stroke rehabilitation, each of which is treated as a more or less independent system. OBJECTIVE: To articulate pitfalls in effectiveness research that has been employed to reduce the number of different forms of treatment. METHODS: The contents of treatment goals and outcome measures in clinical and scientific texts on stroke rehabilitation were analysed and contrasted in order to uncover discrepancies. ISSUES The main issue is that theory, and conceptualization of therapy play a diminished role in treatment effectiveness research, which may hinder the interpretation of data. The notion that the methodological and statistical tools, if correctly applied, provide researchers with the distance that is thought to be necessary for an objective judgement will be challenged. CONCLUSION: The analyses indicate that although scientifically credible measurement tools may be neutral with regard to the user, they are not necessarily neutral with regard to the therapies being compared in effectiveness research.