Methodological quality of systematic reviews on treatments in stroke rehabilitation: A cross-sectional study
In brief
Only 2 of 140 stroke rehabilitation reviews rated high quality
Of 140 systematic reviews of stroke rehabilitation treatments, only 2 were rated high quality; 130, or about 93%, were rated critically low. Weak reporting of search methods, excluded studies, and funding of the original trials undermines confidence in the reviews, so clinicians should be cautious when relying on their findings.
- Journal
- PM & R : the journal of injury, function, and rehabilitation (Q1)
- Published
- 2 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yin Ting Chan, Sheung Yuen Siu, Chung Hei Mak, Fai Fai Ho, Betty Huan Wang, Claire Chenwen Zhong, et al.
- PMID
- 42825393
- DOI
- 10.1002/pmrj.70202
Why clinicians should know about it
- Picked for Neurology (clinical) (top studies of the week, 4 October 2026): Methodological quality of stroke rehab systematic reviews
- Picked for Rehabilitation (top studies of the week, 4 October 2026): Methodological appraisal of stroke rehab systematic reviews
Abstract
OBJECTIVE: Although high-quality systematic reviews (SRs) could provide reliable evidence on the effectiveness of stroke rehabilitation treatments, methodological flaws may weaken their trustworthiness. This study aimed to evaluate the methodological quality of an up-to-date sample of SRs on stroke rehabilitation treatments. LITERATURE SURVEY: A comprehensive search was conducted in four electronic databases (MEDLINE, EMBASE, PsycINFO, and Cochrane Database of Systematic Reviews) for SRs published between January 2021 and September 2023. Eligible SRs focused on randomized controlled trials and included at least one meta-analysis assessing the effectiveness of stroke rehabilitation treatments. METHODOLOGY: After systematic screening, bibliographical data were extracted from included SRs using a predesigned form. The methodological quality was assessed using the 16-item A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) instrument. Associations between characteristics and methodological quality were examined using Kruskal-Wallis rank test, Spearman's rank correlation coefficient, and multivariable logistic regression models. Meta-analysis was not performed. SYNTHESIS: A total of 140 SRs were appraised. Only two (1.4%) SRs were rated as having high overall methodological quality. The remaining SRs were rated as moderate (n = 2, 1.4%), low (n = 6, 4.3%), or critically low quality (n = 130, 92.9%). Cochrane SRs, SRs led by a corresponding author from the United States or Europe, SRs supported by European funding or those without funding support, SRs reporting intervention harms, and SRs published in journals with higher journal impact factors had a higher overall methodological quality than their counterparts. Only 4.3% of SRs conducted a comprehensive literature search, 12.9% provided a list of excluded studies with justifications, 7.1% explained study design selection for inclusion, 10.7% described the included primary studies in adequate detail, and 7.9% reported funding sources of primary studies. CONCLUSIONS: The methodological quality of SRs on stroke rehabilitation treatment is unsatisfactory. Findings of this study can shed light on potential areas of methodological improvements for future review authors.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.