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A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole
INTRODUCTION: In experimental trials, new methods are tested against the “best” or “usual” care. To appraise control group (CG) interventions provided as “usual care,” we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention. EVIDENCE ACQUISITION: For...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Edizioni Minerva Medica
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980563/ https://www.ncbi.nlm.nih.gov/pubmed/35634889 http://dx.doi.org/10.23736/S1973-9087.22.07413-5 |
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author | ARIENTI, Chiara BURASCHI, Riccardo POLLET, Joel LAZZARINI, Stefano G. CORDANI, Claudio NEGRINI, Stefano GOBBO, Massimiliano |
author_facet | ARIENTI, Chiara BURASCHI, Riccardo POLLET, Joel LAZZARINI, Stefano G. CORDANI, Claudio NEGRINI, Stefano GOBBO, Massimiliano |
author_sort | ARIENTI, Chiara |
collection | PubMed |
description | INTRODUCTION: In experimental trials, new methods are tested against the “best” or “usual” care. To appraise control group (CG) interventions provided as “usual care,” we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention. EVIDENCE ACQUISITION: For this methodological appraisal, we conducted a systematic review of RCTs without timespan limitation. The PICO included stroke survivors, rehabilitation, control group intervention, lower limb function. To assess the risk of bias, we used the Cochrane risk of bias tool (RoB). We identified the terminology describing the CG Program (CGP), performed a knowledge synthesis and conducted a frequency analysis of provided interventions. EVIDENCE SYNTHESIS: We included 155 publications. 13.6% of the articles did not describe the CG, and 11.6% indicated only the professionals involved. In the remaining 116 studies, three studies provided an intervention according to specific guidelines, 106 different “usual care” CGPs were detected, with nine proposed twice and two between four and five times. The most adopted terminology to state “usual care” was “conventional physiotherapy.” CONCLUSIONS: This study shows that usual care in CG does not actually exist, as both specific terminology and consistency within CGP contents are missing. Reporting guidelines should give better assistance on this issue. These results should be verified in other fields. |
format | Online Article Text |
id | pubmed-9980563 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Edizioni Minerva Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-99805632023-03-07 A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole ARIENTI, Chiara BURASCHI, Riccardo POLLET, Joel LAZZARINI, Stefano G. CORDANI, Claudio NEGRINI, Stefano GOBBO, Massimiliano Eur J Phys Rehabil Med Article INTRODUCTION: In experimental trials, new methods are tested against the “best” or “usual” care. To appraise control group (CG) interventions provided as “usual care,” we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention. EVIDENCE ACQUISITION: For this methodological appraisal, we conducted a systematic review of RCTs without timespan limitation. The PICO included stroke survivors, rehabilitation, control group intervention, lower limb function. To assess the risk of bias, we used the Cochrane risk of bias tool (RoB). We identified the terminology describing the CG Program (CGP), performed a knowledge synthesis and conducted a frequency analysis of provided interventions. EVIDENCE SYNTHESIS: We included 155 publications. 13.6% of the articles did not describe the CG, and 11.6% indicated only the professionals involved. In the remaining 116 studies, three studies provided an intervention according to specific guidelines, 106 different “usual care” CGPs were detected, with nine proposed twice and two between four and five times. The most adopted terminology to state “usual care” was “conventional physiotherapy.” CONCLUSIONS: This study shows that usual care in CG does not actually exist, as both specific terminology and consistency within CGP contents are missing. Reporting guidelines should give better assistance on this issue. These results should be verified in other fields. Edizioni Minerva Medica 2022-05-30 /pmc/articles/PMC9980563/ /pubmed/35634889 http://dx.doi.org/10.23736/S1973-9087.22.07413-5 Text en 2022 THE AUTHORS https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC) 4.0 License. |
spellingShingle | Article ARIENTI, Chiara BURASCHI, Riccardo POLLET, Joel LAZZARINI, Stefano G. CORDANI, Claudio NEGRINI, Stefano GOBBO, Massimiliano A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title | A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title_full | A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title_fullStr | A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title_full_unstemmed | A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title_short | A systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
title_sort | systematic review opens the black box of “usual care” in stroke rehabilitation control groups and finds a black hole |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980563/ https://www.ncbi.nlm.nih.gov/pubmed/35634889 http://dx.doi.org/10.23736/S1973-9087.22.07413-5 |
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