Bridging the gap: Enhancing external validity in rehabilitation research through pragmatic and hybrid trial designs

Rehabilitation research is often constrained by limited generalizability due to the use of highly selective inclusion criteria and controlled environments that do not accurately reflect typical healthcare contexts. This limitation poses challenges for translating research findings into routine clinical practice. This article examines the significance of pragmatic trials in rehabilitation, highlighting their potential to enhance external validity by encompassing broader, more heterogeneous populations and routine care settings. By adopting pragmatic methodologies, researchers can generate more applicable evidence, ensuring that rehabilitation interventions benefit a wider range of patients. The discussion highlights the methodological distinctions between explanatory and pragmatic trials, the need for diverse patient populations, and strategies for striking a balance between scientific rigor and clinical relevance.