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Abstract Despite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific premise for different interventions as one critical factor that has led to suboptimal study outcomes. To examine this issue in greater detail, we conducted a thematic analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020. Our results revealed three primary findings: (i) most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach. These results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.
Ranganathan et al. (Thu,) studied this question.