Landscape of Canadian Stroke Motor and Cognitive Rehabilitation Trials: Trends, Strengths and Future Directions

Abstract

ABSTRACT This study aims to systematically identify and describe all randomized controlled trials (RCTs) evaluating post-stroke motor and cognitive rehabilitation conducted in Canada, within the broader context of global post-stroke rehabilitation research. The present secondary descriptive/bibliometric analysis used data derived from five integrated systematic reviews conducted by the same research group, from inception to 2024. A subset of data was examined in Canadian trials, including number of RCTs, sample size, participant sex, time post-stroke, methodological quality, intervention types and outcome measures. In total, 106 out of 3602 global RCTs were conducted in Canada. Canadian RCT relative contribution to global research has slowed down over time. Sample size was significantly smaller in the chronic post-stroke phase compared to acute and subacute phases in both Canadian ( p = 0.013) and global trials ( p < 0.001). Compared to global trials, Canadian RCTs had comparable sample size ( p = 0.72) and methodological quality ( p = 0.94) but were more likely to be conducted in the chronic phase ( p = 0.001), evaluate exercise-based and rehabilitation-oriented interventions and assess activity and participation outcome measures. Chronic trials were more likely to be led by academic therapists ( p = 0.031), while the acute and subacute trials were more likely to be led by academic physicians ( p = 0.003). Canadian RCTs have made important contributions to stroke rehabilitation research. However, expanding research into earlier recovery phases, integrating technology-driven interventions and incorporating outcome measures across all three International Classification of Functioning, Disability and Health domains will be important to strengthening Canada’s impact and advancing stroke rehabilitation evidence.