Objective: To examine the impact of the COVID-19 pandemic on the publication of randomized controlled trials (RCTs) of motor and cognitive stroke rehabilitation and on female enrollment across trials. Design: Data for this manuscript was obtained from a unique database of RCTs on post-stroke motor and cognitive rehabilitation, developed by conducting five systematic reviews, up to December 2024. Results: A total of 3,602 RCTs on motor and cognitive post-stroke rehabilitation were analyzed, 1,623 on upper extremity, 1,548 on lower extremity, and 596 on cognitive rehabilitation. A decline in RCT publications was observed in 2023 compared with 2022, with the observed number of RCTs being 28.8% lower than predicted by regression model, followed by a rebound in 2024. This decline was accompanied by a significant reduction in female recruitment across all world regions. Overall female enrollment was 39.4%, decreased to 33.4% in 2023 and rebounded to 38.9% in 2024. Conclusions: Our analysis of 3,602 stroke rehabilitation RCTs showed a sudden decline both in publication of trials and female enrollment in 2023, which then partially rebounded in 2024. We speculate that the pandemic led to significant burdens for researchers conducting RCTs, which in turn resulted in publication delays, compared to previous years.
Teasell et al. (2026) studied this question.