The Reporting of Somatic Sensory Training Interventions in Individuals After a Stroke Is Suboptimal: A Systematic Review and Meta-research Study.

OBJECTIVE: The purpose of this systematic review is to assess adherence to the "template for intervention description and replication" checklist among all published randomized controlled trials of sensory retraining strategies for patients with a history of stroke. METHODS: Medline, the Cochrane Register of Controlled Trials, and the Physiotherapy Evidence Database were investigated, without time restrictions, until September 1, 2021. In addition, a search for additional studies was carried out using the included studies' reference list. Only randomized controlled trials of adults with a history of stroke who aimed to improve sensation, via any type of intervention, were included. The template for intervention description and replication checklist was used to assess the completeness of reporting on each intervention. RESULTS: A total of 61 trials were included. None of the included studies declared to have used the template for intervention description and replication checklist to report interventions. Overall, the median percentage of adherence to the 12 items of the template for intervention description and replication was 33% (interquartile range, 25%-50%). Only five of the single items were adequately described in more than 50% of the studies. None of the randomized controlled trials reported the entirety of the core intervention components, as described in items 3 to 9. CONCLUSIONS: This systematic review demonstrates that interventions in sensory retraining strategy trials are described below desirable standards. Without this information, clinicians and researchers cannot reliably replicate interventions.

Exercise for Depressive Symptoms in Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: To evaluate the efficacy of physical exercise in improving depressive symptoms in Parkinson disease (PD). DATA SOURCE AND STUDY SELECTION: We conducted a systematic review of randomized controlled trials (RCTs) following a prespecified protocol guidance (PROSPERO CRD42021243142). Two independent authors searched for studies in MEDLINE, Cochrane Register of Controlled Trials, Physiotherapy Evidence Database, Embase, PsycINFO, and Sports Discus from database inception to June 2022. DATA EXTRACTION: Two independent authors extracted the data and evaluated the risk of bias using the revised Cochrane risk of bias tool. We performed random-effects meta-analyses and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. DATA SYNTHESIS: A total of 36 RCTs met the inclusion criteria, 14 of which were pooled in the quantitative synthesis. Depression symptomatology significantly decreased in the exercise group compared with usual care (standardized mean difference [SMD], -0.49; 95% confidence interval [CI], -0.74 to -0.24; very low quality of evidence; 14 RCTs; 961 participants). Physical exercise also improved patients' quality of life (SMD, -0.51; 95% CI, -0.81 to -0.21; 7 RCTs; 485 participants). As for acceptability, we did not find any difference between exercise and usual care (relative risk, 1.01; 95% CI, 0.97 to 1.05; 12 RCTs; 1048 participants). We judged all the studies except 2 to be at high risk of bias. CONCLUSIONS: Results from our systematic review identify physical activity as a viable option to reduce depressive symptoms in PD. Future clinical practice guidelines should consider physical exercise in their recommendations for depression symptomatology reduction in people with PD.

Completeness of Outcomes Description Reported in Low Back Pain Rehabilitation Interventions: A Survey of 185 Randomized Trials.

Purpose: To assess reporting completeness of the most frequent outcome measures used in randomized controlled trials (RCTs) of rehabilitation interventions for mechanical low back pain. Methods: We performed a cross-sectional study of RCTs included in all Cochrane systematic reviews (SRs) published up to May 2013. Two authors independently evaluated the type and frequency of each outcome measure reported, the methods used to measure outcomes, the completeness of outcome reporting using a eight-item checklist, and the proportion of outcomes fully replicable by an independent assessor. Results: Our literature search identified 11 SRs, including 185 RCTs. Thirty-six different outcomes were investigated across all RCTs. The 2 most commonly reported outcomes were pain (n=165 RCTs; 89.2%) and disability (n=118 RCTs; 63.8%), which were assessed by 66 and 44 measurement tools, respectively. Pain and disability outcomes were found replicable in only 10.3% (n=17) and 10.2% (n=12) of the RCTs, respectively. Only 40 RCTs (21.6%) distinguished between primary and secondary outcomes. Conclusions: A large number of outcome measures and a myriad of measurement instruments were used across all RCTs. The reporting was largely incomplete, suggesting an opportunity for a standardized approach to reporting in rehabilitation science.

Objectif : évaluer l'exhaustivité des déclarations en ce qui concerne les mesures de résultats utilisées le plus fréquemment dans les essais cliniques randomisés (ECR) portant sur les interventions en réadaptation pour les douleurs chroniques au bas du dos. Méthodes : nous avons mené une étude transversale des ECR inclus dans toutes les revues systématiques Cochrane publiées jusqu'en mai 2013. Deux auteurs ont indépendamment évalué : la nature et la fréquence de chacune des mesures de résultats rapportées, les méthodes utilisées pour effectuer ces mesures, l'exhaustivité des déclarations de résultats (à l'aide d'une liste de contrôle en 8 points) et la proportion des résultats qui peuvent être complètement reproduits par un évaluateur indépendant. Résultats : notre recension de la littérature a identifié 11 revues systématiques comprenant un total de 185 ECR. Trente-six résultats différents ont été étudiés dans l'ensemble des essais cliniques. Les deux résultats les plus fréquemment rapportés étaient la douleur (n=164 ECR; 89,2%) et l'incapacité (n=118; 63,8%), qui ont été évalués respectivement par 66 et 44 instruments de mesure. Les résultats relatifs à la douleur et à l'incapacité se sont avérés reproductibles dans seulement 10,3% (n=17) et 10,2% (n=12), respectivement, des essais cliniques. Seuls 40 (21,6%) des ECR ont fait la distinction entre le résultat principal et les résultats secondaires. Conclusion : un grand nombre de mesures de résultats et d'instruments de mesure ont été utilisés dans l'ensemble des ECR. Les déclarations sont pour la plupart incomplètes; il pourrait y avoir là une occasion de mettre au point une approche standardisée pour la communication des résultats en science de la réadaptation.

Reporting of Rehabilitation Intervention for Low Back Pain in Randomized Controlled Trials: Is the Treatment Fully Replicable?

STUDY DESIGN: Methodological review of randomized controlled trials (RCTs). OBJECTIVE: To assess the quality of reporting of rehabilitation interventions for mechanical low back pain (LBP) in published RCTs. SUMMARY OF BACKGROUND DATA: Reporting of interventions in RCTs often focused on the outcome value and failed to describe interventions adequately. METHODS: We systematically searched for all RCTs in Cochrane systematic reviews on LBP published in the Cochrane Database of Systematic Reviews until December 2013. The description of rehabilitation interventions of each RCT was evaluated independently by 2 of the investigators, using an ad hoc checklist of 7 items. The primary outcome was the number of items reported in sufficient details to be replicable in a new RCT or in everyday practice. RESULTS: We found 11 systematic reviews, including 220 eligible RCTs, on LBP. Of those, 185 RCTs were included. The median publication year was 1998 (I-III quartiles, 1990 to 2004). The most reported items were the characteristics of participants (91.3%; 95% confidence interval [CI], 87.3-95.4), the intervention providers (81.1%; 95% CI, 75.4-86.7), and the intervention schedule (69.7%; 95% CI, 63-76). Based on the description of the intervention, less than one fifth would be replicable clinically. The proportion of trials providing all essential information about the participants and interventions increased from 14% (n = 7) in 1971 to 1980 to 20% (n = 75) in 2001 to 2010. CONCLUSION: Despite the remarkable amount of energy spent producing RCTs in LBP rehabilitation, the majority of RCTs failed to report sufficient information that would allow the intervention to be replicated in clinical practice. Improving the quality of intervention description is urgently needed to better transfer research into rehabilitation practices. LEVEL OF EVIDENCE: 1.

Survey of the reporting characteristics of systematic reviews in rehabilitation.

BACKGROUND: Systematic reviews (SRs) have become increasingly important for informing clinical practice; however, little is known about the reporting characteristics and the quality of the SRs relevant to the practice of rehabilitation health professionals. OBJECTIVE: The purpose of this study was to examine the reporting quality of a representative sample of published SRs on rehabilitation, focusing on the descriptive, reporting, and bias-related characteristics. METHODS: A cross-sectional study was conducted by searching MEDLINE for aggregative and configurative SRs indexed in 2011 that focused on rehabilitation as restorative of functional limitations. Two reviewers independently screened and selected the SRs and extracted data using a 38-item data collection form derived from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The data were analyzed descriptively. RESULTS: Eighty-eight SRs published in 59 journals were sampled. The median compliance with the PRISMA items was 17 (63%) out of 27 items (interquartile ratio=13-22 [48%-82%]). Two thirds of the SRs (n=66) focused on interventions for which efficacy is best addressed through a randomized controlled trial (RCT) design, and almost all of these SRs included RCTs (63/66 [95%]). More than two thirds of the SRs assessed the quality of primary studies (74/88 [84%]). Twenty-eight reviews (28/88 [32%]) meta-analyzed the results for at least one outcome. One half of the SRs reported positive statistically significant findings (46%), whereas a detrimental result was present only in one review. CONCLUSIONS: This sample of SRs in the rehabilitation field showed heterogeneous characteristics and a moderate quality of reporting. Poor control of potential source of bias might be improved if more widely agreed-upon evidence-based reporting guidelines will be actively endorsed and adhered to by authors and journals.