METHODS: Bibliometric analysis was made, including the publications' profiles, citation analysis and research trends of the relevant literature over the last 60 years. Publications from all time frames were retrieved from Scopus database. A subgroup analysis of publications pertinent to people with SCI was also made.
RESULTS: Research on RMT has been steadily increasing over the last 6 decades and across geographical locations. While medicine continues to dominate the research on RMT, this topic also continues to attract researchers and publications from other areas such as engineering, computer science and social science over the last 10 years. Research collaboration between authors in different backgrounds was observed since 2006. Source titles from non-medical backgrounds have also published articles pertinent to RMT. Among people with SCI, researchers utilised a wide range of technology from simple spirometers to electromyography in both intervention and outcome measures. With various types of interventions implemented, RMT generally improves pulmonary function and respiratory muscle strength among people with SCI.
CONCLUSIONS: While research on RMT has been steadily increasing over the last 6 decades, more collaborations are encouraged in the future to produce more impactful and beneficial research on people who suffer from respiratory disorders.
METHODS: In this study, we conducted a comprehensive literature review to collect information on healthcare decision-making in Malaysia. We also consulted medical education researchers, key opinion leaders, governmental organisations, and patient support groups to assess the extent to which patient involvement was incorporated into the medical curriculum, healthcare policies, and legislation.
RESULTS: There are very few studies on patient involvement in decision-making in Malaysia. Existing studies showed that doctors were aware of informed consent, but few practised SDM. There was limited teaching of SDM in undergraduate and postgraduate curricula and a lack of accurate and accessible health information for patients. In addition, peer support groups and 'expert patient' programmes were also lacking. Professional medical bodies endorsed patient involvement in decision-making, but there was no definitive implementation plan.
CONCLUSION: In summary, there appears to be little training or research on SDM in Malaysia. More research needs to be done in this area, including baseline information on the preferred and actual decision-making roles. The authors have provided a set of recommendations on how SDM can be effectively implemented in Malaysia.
METHODS AND ANALYSIS: We will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for 'Chronic Respiratory Disease' AND 'Pulmonary Rehabilitation' AND 'Home-PR', and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR?
ETHICS AND DISSEMINATION: Research ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences.
PROSPERO REGISTRATION NUMBER: CRD42020220137.
STUDY DESIGN AND SETTING: Forty-seven rehabilitation clinicians of 5 professions from 7 teams (Belgium, Italy, Malaysia, Pakistan, Poland, Puerto Rico, the USA) reviewed 76 RCTs published by main rehabilitation journals exploring 14 domains chosen through consensus and piloting.
RESULTS: The response rate was 99%. Inter-rater agreement was moderate/good. All clinicians considered unanimously 12 (16%) RCTs clinically replicable and none not replicable. At least one "absent" information was found by all participants in 60 RCTs (79%), and by a minimum of 85% in the remaining 16 (21%). Information considered to be less well described (8-19% "perfect" information) included two providers (skills, experience) and two delivery (cautions, relationships) items. The best described (50-79% "perfect") were the classic methodological items included in CONSORT (descending order: participants, materials, procedures, setting, and intervention).
CONCLUSION: Clinical replicability must be considered in RCTs reporting, particularly for complex interventions. Classical methodological checklists such as CONSORT are not enough, and also Template for Intervention Description and Clinical replication do not cover all the requirements. This study supports the need for field-specific checklists.
DESIGN: We downloaded the CONSORT 2010 Statement and all endorsed and unofficial extensions reported on the CONSORT and EQUATOR websites. We extracted all statements on the selection, design, delivery or interpretation of data from comparison groups in clinical trials. We discussed preliminary findings during the Cochrane Rehabilitation Methodology Meeting in Kobe, then further by email before finalizing results.
RESULTS: We identified 24 standards reported across the CONSORT 2010 Statement and ten extensions. Overall, these standards address many, but not all, issues related to reporting of comparison groups in rehabilitation trials.
CONCLUSION: We recommend that additional standards be created for the selection of types of comparisons, choices around reporting of "usual care", reporting of intended "mechanisms of control", and reporting a rationale for the hypothesized superiority of one intervention over another when superiority trial design are used. Rehabilitation research would benefit from development of a specific checklist and guidelines to help researchers make best use of existing extensions.
DESIGN: Cross-sectional survey.
SETTING: Community.
PARTICIPANTS: People of employable age (N=9875; 18-64 y) with traumatic or non-traumatic SCI (including cauda equina syndrome) who were at least 18 years of age at the time of the survey, living in the community, and able to respond to one of the available language versions of the questionnaire.
INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: The observed employment rate was defined as performing paid work for at least 1 hour a week, and predicted employment rate was adjusted for sample composition from mixed logistic regression analysis.
RESULTS: A total of 9875 participants were included (165-1174 per country). Considerable differences in sample composition were found. The observed worldwide employment rate was 38%. A wide variation was found across countries, ranging from 10.3% to 61.4%. Some countries showed substantially higher or lower employment rates than predicted based on the composition of their sample. Gaps between the observed employment rates among participants with SCI and the general population ranged from 14.8% to 54.8%. On average, employment rates were slightly higher among men compared with women, but with large variation across countries. Employment gaps, however, were smaller among women for most countries.
CONCLUSIONS: This first worldwide survey among people with SCI shows an average employment rate of 38%. Differences between observed and predicted employment rates across countries point at country-specific factors that warrant further investigation. Gaps with employment rates in the general population were considerable and call for actions for more inclusive labor market policies in most of the countries investigated.
METHODS: This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or nontraumatic spinal cord injury participating in the International Spinal Cord Injury Community Survey from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection, and quality of life score were extracted from the International Spinal Cord Injury Community Survey questionnaire. The impact of bladder care and urinary complications on quality of life was determined using univariable and multivariable regression analysis.
RESULTS: Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and spinal cord injury-related data, secondary conditions, as well as activity and participation factors, urinary tract infection was an independent negative predictive factor of quality of life score ( P = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method).
CONCLUSIONS: Among bladder care and urinary complication factors, urinary tract infection is the only factor negatively impacting quality of life. These results address the importance of proper bladder management and urinary tract infection prevention in persons with spinal cord injury to improve their quality of life.
DESIGN: A cross-sectional study.
METHODS: Data from the International Spinal Cord Injury Community Survey (InSCI) were analyzed. The PI problems were assessed using the Spinal Cord Injury Secondary Condition Scales (dichotomized to "having problem" and "not having problem". Health service systems were categorized as an inpatient-oriented SCI specialized system and a primary care-oriented system. A directed acyclic graph was applied to create a multivariable logistic regression model to determine the independent influencing factors of PI problems.
RESULTS: Of 790 included participants, 277 (35%) had PI problems. Being recruited from countries with inpatient-oriented SCI specialized systems (Model 1) and visiting rehabilitation medicine/SCI physicians at least once a year (Model 2) is an independent negative correlating factor of PI problems (odds ratio = 0.569 [95%CI: 0.374-0.866] and 0.591 [95%CI: 0.405-0.864], respectively).
CONCLUSION: SCI-specialized health service systems might be a protective factor of PI problems in middle-income country contexts. This result suggests the importance of having SCI-specialized services in middle-income countries to reduce the prevalence of PI problems.