Differences in stroke rehabilitation motor and cognitive randomized controlled trials by world region: Number, sample size, and methodological quality.

BACKGROUND: Stroke rehabilitation research is important for informing clinical practice and directing health care resources. OBJECTIVE: To examine how motor- and cognitive-based stroke rehabilitation randomized controlled trials (RCTs) vary by world region, overall and over time, with respect to 1) publication volume, 2) sample size, and 3) methodological quality. METHODS: Using the Evidence-Based Review of Stroke Rehabilitation (EBRSR), all motor- and cognitive-based stroke rehabilitation RCTs were identified. The following data were extracted: first author, year of publication, country of origin, and sample size. Countries were categorized into seven regions, as defined by the World Bank. RESULTS: In total 1410 motor-based RCTs and 293 cognitive-based RCTs were published between 1972-2018. For motor RCTs, the East Asia/Pacific region accounted for the largest volume of RCTs (n = 530; 37.6%), followed closely by the Europe/Central Asia region (n = 445; 31.6%). Conversely, the largest producer for cognitive RCTs was Europe/Central Asia (n = 167; 57.0%), followed by East Asia/Pacific (n = 62; 21.2%). For both motor and cognitive RCTs, there was no significant difference between world regions with respect to mean sample size or methodological quality. CONCLUSIONS: Efforts should be directed towards improving methodological quality and increasing sample sizes of stroke rehabilitation-related studies.