Evidence map›Paper›PMID 24867924›Full record

SynthesisStroke2014

Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation.

Keith R Lohse, Catherine E Lang, Lara A Boyd

5 registry-linked trialsAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 272 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
272citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02290353 nacompletednot on this mapstarted 2015, after this paper: background citation

Functional Engagement in Assisted Therapy Through Exercise Robotics

TypeinterventionalSponsorUniversity of British ColumbiaRan2015 to 2015Enrolled10ConditionsStroke, Cerebral Palsy, Traumatic Brain InjuryArmsFEATHERS
NCT02898701 nacompletednot on this mapstarted 2016, after this paper: background citation

Does Practice Beyond Performance Plateau Improve Motor Learning in Healthy Adults?

TypeinterventionalSponsorUniversity of UtahRan2016 to 2020Enrolled65ConditionsAgingArmsMotor Practice of a Standing Serial Reaction Time Task
NCT03641651 nacompletednot on this mapstarted 2018, after this paper: background citation

Feasibility and Cost Description of Intensive Rehabilitation Involving New Technologies in Patients With Sub-acute Stroke:A Multicenter Single Arm Trial of the Swiss RehabTech Initiative

TypeinterventionalSponsorMarkus WirzRan2018 to 2020Enrolled15ConditionsStroke, HemiplegiaArmsRehabilitation technology
NCT03985761 nacompletednot on this mapstarted 2019, after this paper: background citation

Utilizing Gaming Mechanics to Optimize Telerehabilitation Adherence in Persons With Stroke

TypeinterventionalSponsorRutgers, The State University of New JerseyRan2019 to 2023Enrolled33ConditionsStrokeArmsHome Telerehabilitation using HoVRS
NCT04304976 nacompletednot on this mapstarted 2019, after this paper: background citation

Clinical Trial ROBERT® - Project Active Training

TypeinterventionalSponsorLifescience-RoboticsRan2019 to 2020Enrolled8ConditionsApoplexy, Stroke, Spinal Cord Injuries, SafetyArmsROBERT®
3 · Its place in the literature

Who cites it

272 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Corticospinal Responses Following Gait-Specific Training in Stroke Survivors: A Systematic Review.International journal of environmental research and public health · 2022
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

212 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Keith R LohseFrom the School of Kinesiology, Auburn University, AL (K.R.L.); School of Kinesiology (K.R.L.) and Department of Physical Therapy (L.A.B.), University of British Columbia, Vancouver, British Columbia, Canada; and Program in Physical Therapy, Program in Occupational Therapy, Department of Neurology, Washington University School of Medicine in St. Louis, MO (C.E.L.). kelopelli@gmail.com.
Catherine E LangFrom the School of Kinesiology, Auburn University, AL (K.R.L.); School of Kinesiology (K.R.L.) and Department of Physical Therapy (L.A.B.), University of British Columbia, Vancouver, British Columbia, Canada; and Program in Physical Therapy, Program in Occupational Therapy, Department of Neurology, Washington University School of Medicine in St. Louis, MO (C.E.L.).
Lara A BoydFrom the School of Kinesiology, Auburn University, AL (K.R.L.); School of Kinesiology (K.R.L.) and Department of Physical Therapy (L.A.B.), University of British Columbia, Vancouver, British Columbia, Canada; and Program in Physical Therapy, Program in Occupational Therapy, Department of Neurology, Washington University School of Medicine in St. Louis, MO (C.E.L.).

Funding

Translation of in-clinic Gains to Gains in Daily Life After StrokeR01HD068290 · NICHD · WASHINGTON UNIVERSITY · PI LANG, CATHERINE · 2012 to 2021
$4.0M
Translation of In-Clinic Gains to Gains in Daily LifeR37HD068290 · NICHD · WASHINGTON UNIVERSITY · PI Catherine Lang · 2022 to 2026
$2.7M
NICHD NIH HHS R01 HD068290NICHD NIH HHS R37 HD068290
6 · The paper itself

Abstract

background and purposeNeurophysiological models of rehabilitation and recovery suggest that a large volume of specific practice is required to induce the neuroplastic changes that underlie behavioral recovery. The primary objective of this meta-analysis was to explore the relationship between time scheduled for therapy and improvement in motor therapy for adults after stroke by (1) comparing high doses to low doses and (2) using metaregression to quantify the dose-response relationship further.

methodsDatabases were searched to find randomized controlled trials that were not dosage matched for total time scheduled for therapy. Regression models were used to predict improvement during therapy as a function of total time scheduled for therapy and years after stroke.

resultsOverall, treatment groups receiving more therapy improved beyond control groups that received less (g=0.35; 95% confidence interval, 0.26-0.45). Furthermore, increased time scheduled for therapy was a significant predictor of increased improvement by itself and when controlling for linear and quadratic effects of time after stroke.

conclusionsThere is a positive relationship between the time scheduled for therapy and therapy outcomes. These data suggest that large doses of therapy lead to clinically meaningful improvements, controlling for time after stroke. Currently, trials report time scheduled for therapy as a measure of therapy dose. Preferable measures of dose would be active time in therapy or repetitions of an exercise.

Indexed as

Stroke RehabilitationTreatment OutcomeExercise TherapyHumansRandomized Controlled Trials as Topicrehabilitationstroketherapy

Identifiers

PMID24867924
PMCPMC4071164

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.