Randomized clinical trials in medical rehabilitation research.

Abstract:

:The purpose of this article is to provide researchers and clinicians with a basic understanding of randomized clinical trials and to discuss their potential application to and limitations in the field of physical medicine and rehabilitation. A brief history of the development of randomized clinical trials, definitions of clinical trials, types of trials, and overview of methodological issues related to design are offered. Information is provided about the need to establish clear and concise study objectives and to explicitly define interventions and expected outcomes. Recommendations for developing clinical protocols and determining adequate sample size are presented, and various statistical considerations, including power, are discussed. Issues related to sampling strategies, and recruitment are reviewed. Importance of randomization and blinding is emphasized. Readers are also referred to other resources available on this topic. Finally, the authors describe shortfalls associated with the use of this design in rehabilitation research. These are further explored and discussed in terms of the actual benefits and limitations of randomized clinical trials in physical medicine and rehabilitation research. Recommendations are made regarding the use of this methodology to address relevant needs in clinical practice.

journal_name

Am J Phys Med Rehabil

authors

Tate DG,Findley T Jr,Dijkers M,Nobunaga AI,Karunas RB

doi

10.1097/00002060-199909000-00016

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

486-99

issue

5

eissn

0894-9115

issn

1537-7385

journal_volume

78

pub_type

杂志文章,评审
  • Sensitivity of median sensory nerve conduction tests in digital branches for the diagnosis of carpal tunnel syndrome.

    abstract:OBJECTIVE:To compare the sensitivity of median sensory nerve conduction tests performed by stimulating digital branches in patients with carpal tunnel syndrome. DESIGN:A prospective study in 506 hands of patients with carpal tunnel syndrome diagnosed electrophysiologically. RESULTS:The sensitivity of median sensory n...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/01.PHM.0000104662.71129.B9

    authors: Aydin G,Keleş I,Ozbudak Demir S,Baysal AI

    更新日期:2004-01-01 00:00:00

  • Calf tissue oxygenation during exercise in men with and without risk factors for developing peripheral arterial disease.

    abstract:OBJECTIVE:This study aimed to compare calf tissue oxygenation responses to calf exercise in men without diagnosed peripheral arterial disease but with selected risk factors for peripheral arterial disease with those without risk factors. DESIGN:A cross-sectional quasi-experimental design was used. The no-risk group (n...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0b013e3182411df9

    authors: Miranda A,Figoni SF,Cha T,Flanagan T,Mandal O,Silva M,Scremin AM,Scremin OU

    更新日期:2012-03-01 00:00:00

  • Physiological basis of fatigue.

    abstract::This work summarizes our knowledge of the physiological basis of fatigue and the effects of exercise and pharmacological interventions on fatigue. Fatigue may be defined as physical and/or mental weariness resulting from exertion, that is, an inability to continue exercise at the same intensity with a resultant deteri...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1097/phm.0b013e31802ba53c

    authors: Evans WJ,Lambert CP

    更新日期:2007-01-01 00:00:00

  • Immunologic profile of patients with fibromyalgia.

    abstract::Fibromyalgia is a musculoskeletal disorder characterized by generalized myalgias, arthralgias widespread tender points in discreet areas on examination. It is frequently accompanied by fatigue, stiffness, and a nonrestorative sleep pattern. These patients generally have a normal blood count and chemistry profile. Ther...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-199705000-00014

    authors: Smart PA,Waylonis GW,Hackshaw KV

    更新日期:1997-05-01 00:00:00

  • Integration of Chronic Disability Management in a Medical Student Curriculum.

    abstract:ABSTRACT:Increasing exposure to the needs of patients with chronic disability is important in fostering confidence and comfort in disability knowledge and management among medical students and residents of all disciplines. The 2013 Association of American Medical Colleges Graduation Survey of graduating medical student...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000001590

    authors: Bosques G,Philip K,Francisco GE

    更新日期:2021-02-01 00:00:00

  • Selective blocking of the anterior branch of the obturator nerve in children with cerebral palsy.

    abstract:OBJECTIVE:To evaluate the effect of selective blocking of the anterior branch of the obturator nerve by using phenol in controlling adductor spasticity in children with cerebral palsy. DESIGN:To study the anatomic location of the anterior branch of the obturator nerve with respect to bony landmarks in the inguinal are...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0b013e31815b6381

    authors: Kwon JY,Kim JS

    更新日期:2009-01-01 00:00:00

  • Selectivity and sensitivity of intramuscular and transcutaneous electromyography electrodes.

    abstract::We evaluated the differences in selectivity and sensitivity of intramuscular fine-wire electrodes and transcutaneous electrodes in detecting dynamic electromyography (EMG) signals from extensor digitorum (EDC) and extensor carpi radialis (ECR) muscles during isolated EDC and ECR contractions in two able-bodied subject...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 临床试验,杂志文章

    doi:10.1097/00002060-200105000-00010

    authors: Chae J,Knutson J,Hart R,Fang ZP

    更新日期:2001-05-01 00:00:00

  • Effects of acute joint effusion on balance in patients with knee osteoarthritis.

    abstract:OBJECTIVES:The purpose of this study was to assess the effects of acute joint effusion on balance in patients with knee osteoarthritis. DESIGN:Forty-four female subjects with painful knee osteoarthritis participated in this single-blind, randomized, controlled clinical trial. All subjects were randomly assigned to eit...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PHM.0b013e318269d78f

    authors: Hong BY,Lim SH,Im SA,Lee JI

    更新日期:2013-01-01 00:00:00

  • Back pain, physical function, and estimates of aerobic capacity: what are the relationships among methods and measures?

    abstract:OBJECTIVES:To establish the correlations of measures of self-reported disability, self-efficacy, physical performance, level of pain, and estimates of aerobic capacity (PvO2 ) in subjects with low back pain. DESIGN:Fifty-one low back pain subjects, ranging in age from 26 to 65 yr, entered the study. Participants compl...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-200212000-00005

    authors: Filho IT,Simmonds MJ,Protas EJ,Jones S

    更新日期:2002-12-01 00:00:00

  • The Uniform Data System for Medical Rehabilitation: report of follow-up information on patients discharged from inpatient rehabilitation programs in 2002-2010.

    abstract:OBJECTIVE:The aim of this study was to present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, trau...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0b013e3182a92c58

    authors: Graham JE,Granger CV,Karmarkar AM,Deutsch A,Niewczyk P,Divita MA,Ottenbacher KJ

    更新日期:2014-03-01 00:00:00

  • Evaluating Physician Knowledge of Commonly Prescribed Inpatient Rehabilitation Unit Discharge Medication's Costs: An Observational Study.

    abstract::The aim of the study was to assess physiatrists' knowledge of the cost of medications commonly prescribed at discharge from inpatient rehabilitation units across the spectrum of practice experience from residents to attending physicians. Investigators contacted 92 pharmacies across four major regions of the United Sta...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000001219

    authors: Capizzi AN,Kirk MN,Lee VA,Cushman DM

    更新日期:2020-02-01 00:00:00

  • Does postural stability affect the performance of eye-hand coordination in stroke survivors?

    abstract:OBJECTIVE:The aim of this study was to investigate eye-hand coordination in stroke survivors while sitting and standing and its relationship with sensorimotor performance. DESIGN:This was a cross-sectional study conducted at university-based rehabilitation center. Fifteen stroke survivors performed a fast finger-point...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0b013e3182876adb

    authors: Tsang WW,Ng SS,Lee MW,Tse SP,Yip EW,Yuen JK

    更新日期:2013-09-01 00:00:00

  • Differences in sensory conduction velocity between different sensory branches and segments of the median and ulnar nerves.

    abstract::Abnormality of absolute values of median sensory conduction velocities and differences in conduction velocity between median and ulnar nerves are used as criteria for abnormality in the diagnosis of carpal tunnel syndrome. Detailed studies of sensory conduction in various median and ulnar branches and segments indicat...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-198910000-00002

    authors: Joynt RL

    更新日期:1989-10-01 00:00:00

  • Medical economics of PM&R. V. Surviving the complexities of academic medical centers.

    abstract::The mission statements of academic medical centers call on them to accomplish many goals. This often leads to conflicting choices when selecting activities and establishing policies. When individual faculty members are expected to divide work time to meet research, teaching and clinical needs, careful planning and dis...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-199302000-00013

    authors: Melvin JL,Pate CM

    更新日期:1993-02-01 00:00:00

  • Motor Unit Number Index in Evaluating Patients with Lumbar Spinal Stenosis.

    abstract:OBJECTIVE:Motor Unit Number Index (MUNIX) is a quantitative electrophysiological measure that provides an index of the number of motor neurons supplying a muscle. The aim of this exploratory study is to assess the utility of MUNIX in the evaluation of patients with lumbar spinal stenosis (LSS). DESIGN:Participants wer...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000001681

    authors: Cai H,Kroll M,Annaswamy T

    更新日期:2021-01-08 00:00:00

  • Heterotopic ossification in moyamoya disease: a case report.

    abstract::Moyamoya disease is a rare disorder of cerebrovascular circulation. A review of the literature failed to reveal the association of heterotopic ossification in patients with this disease; such a case is now presented. The patient described had atraumatic intracranial hemorrhage, was in a coma for a period of time, unde...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-199809000-00021

    authors: Sharma J,Sehgal KV,Harmon RL

    更新日期:1998-09-01 00:00:00

  • Exercise Interventions for Individuals With Neurological Disorders: A Systematic Review of Systematic Reviews.

    abstract::Fall prevention requires a multifaceted approach that should include individual risk assessment and intervention strategies. Exercise interventions may mitigate most risk factors for falls (eg, balance impairment, gait impairment, and muscle weakness). Numerous systematic reviews or meta-analyses have assessed the eff...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章,meta分析

    doi:10.1097/PHM.0000000000001247

    authors: Lai CH,Chen HC,Liou TH,Li W,Chen SC

    更新日期:2019-10-01 00:00:00

  • Expiratory flow maneuvers in patients with neuromuscular diseases.

    abstract:OBJECTIVES:To compare cough peak flows (CPF), peak expiratory flows (PEF), and potentially confounding flows obtained by lip and tongue propulsion (dart flows, DF) for normal subjects and for patients with neuromuscular disease/restrictive pulmonary syndrome and to correlate them with vital capacity and maximum insuffl...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/01.phm.0000197307.32537.40

    authors: Bach JR,Gonçalves MR,Páez S,Winck JC,Leitão S,Abreu P

    更新日期:2006-02-01 00:00:00

  • The "value" of functional independence measure scores.

    abstract::Functional independence measure (FIM) scores are frequently used as if the various sections are of equal importance and as if the interval between each score is equal. We tested this hypothesis by using marketing research techniques to assess the value to rehabilitation nurses and therapists of four of the six section...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Bunch WH,Dvonch VM

    更新日期:1994-02-01 00:00:00

  • Nerve Stimulation Enhances Task-Oriented Training for Moderate-to-Severe Hemiparesis 3-12 Months After Stroke: A Randomized Trial.

    abstract:OBJECTIVE:The aim of the study was to determine whether somatosensory stimulation affects outcomes of motor training for moderate-to-severe upper limb hemiparesis less than 12 mos before stroke. DESIGN:Fifty-five adults participated in 18 intervention sessions pairing 2 hours of active (n = 33) or sham (n = 22) somato...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PHM.0000000000000971

    authors: Carrico C,Westgate PM,Salmon Powell E,Chelette KC,Nichols L,Pettigrew LC,Sawaki L

    更新日期:2018-11-01 00:00:00

  • Clinical tests of ankle plantarflexor strength do not predict ankle power generation during walking.

    abstract:OBJECTIVE:The aim of this study was to investigate the relationship between a clinical test of ankle plantarflexor strength and ankle power generation (APG) at push-off during walking. DESIGN:This is a prospective cross-sectional study of 102 patients with traumatic brain injury. OUTCOME MEASURES:Handheld dynamometry...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000000196

    authors: Kahn M,Williams G

    更新日期:2015-02-01 00:00:00

  • Outcomes of a consult fall prevention screening clinic.

    abstract:OBJECTIVE:To report patient satisfaction and quality outcomes from a standardized, multicenter fall prevention screening clinic. DESIGN:Referrals were made to the fall prevention screening clinic, which was staffed by a physician, pharmacist, therapist, nurse, and the site coordinator. The fall prevention screening cl...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/01.phm.0000233209.49518.46

    authors: Perell KL,Manzano ML,Weaver R,Fiuzat M,Voss-McCarthy M,Opava-Rutter D,Castle SC

    更新日期:2006-11-01 00:00:00

  • Relationship between stride length and walking rate in gait training for hemiparetic stroke patients.

    abstract::Sixty-three male hemiparetic patients in the recovery stage were examined to investigate the relationship between stride length and walking rate during computer-assisted gait training during a period of 4 wk. The maximum walking speed for 10 m was significantly increased from 32.3 to 53.2 m/min on average, and the str...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-199903000-00012

    authors: Suzuki K,Yamada Y,Handa T,Imada G,Iwaya T,Nakamura R

    更新日期:1999-03-01 00:00:00

  • Comparison of Pain Score Reduction Using Triamcinolone vs. Betamethasone in Transforaminal Epidural Steroid Injections for Lumbosacral Radicular Pain.

    abstract:OBJECTIVE:Although the comparative efficacy of particulate vs. nonparticulate steroids for the treatment of radicular pain with transforaminal epidural steroid injection has been investigated, there is minimal literature comparing particulate steroids. The authors aimed to determine whether transforaminal epidural ster...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000000296

    authors: McCormick Z,Kennedy DJ,Garvan C,Rivers E,Temme K,Margolis S,Zander E,Rohr A,Smith MC,Plastaras C

    更新日期:2015-12-01 00:00:00

  • Restoration of Vision After Brain Injury Using Magnet Glasses.

    abstract::Visual impairments are common after traumatic brain injury (TBI) and negatively affect quality of life. We describe a 39-year-old woman with a severe TBI who was evaluated by the inpatient optometry and vision rehabilitation service with findings of complete right homonymous hemianopia and right cranial nerve III pals...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000000592

    authors: Houston KE,Paschalis EI,Angueira DC,Bronstad PM,Barrett AM,Iaccarino MA

    更新日期:2017-04-01 00:00:00

  • Cognitive dysfunction among cancer survivors.

    abstract::Cognitive dysfunction among cancer survivors, commonly referred to as "chemobrain," has gained increased attention in the last decade. Cognitive dysfunction is now well recognized among patients with non-central nervous system cancers. It may be a consequence of the cancer, its treatment, or both. Other common problem...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1097/PHM.0b013e31820be463

    authors: Asher A

    更新日期:2011-05-01 00:00:00

  • Functional outcomes of patients with amputation receiving chronic dialysis for end-stage renal disease.

    abstract:OBJECTIVE:The aim of this study was to compare the rehabilitation length of stay and functional outcome of patients with amputation on chronic dialysis with a similar group of patients not on dialysis. DESIGN:This was a retrospective cohort study. Twenty-five patients with amputations on chronic dialysis and 25 nonren...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0000000000000259

    authors: Arneja AS,Tamiji J,Hiebert BM,Tappia PS,Galimova L

    更新日期:2015-04-01 00:00:00

  • Prevention of secondary osteoporosis postmenopause in hemiplegia.

    abstract:OBJECTIVES:To study secondary osteoporosis postmenopause in women with hemiplegia and to show the therapeutic effects of etidronate and how osteoporotic conditions relate to the activities of daily living (ADL). DESIGN:Eighty-one postmenopausal women with hemiplegia were admitted within 6 mo of their first cerebrovasc...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00002060-200103000-00003

    authors: Ikai T,Uematsu M,Eun SS,Kimura C,Hasegawa C,Miyano S

    更新日期:2001-03-01 00:00:00

  • Amantadine for adynamic speech: possible benefit for aphasia?

    abstract:OBJECTIVE:Dopaminergic agents may stimulate behavior and verbal expression after frontal lobe dysfunction. Although amantadine is used in neurorehabilitation of motivational disorders and head injury, it is not commonly prescribed to improve aphasia. This pilot study examined verbal fluency on and off amantadine for no...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/PHM.0b013e31811473b3

    authors: Barrett AM,Eslinger PJ

    更新日期:2007-08-01 00:00:00

  • Hip hiking and circumduction: quantitative definitions.

    abstract:OBJECTIVE:To define and propose clinically useful quantitative measurements of hip hiking and circumduction using standard three-dimensional motion analysis techniques. DESIGN:We studied pelvic, hip, and thigh motions in 23 subjects with hemiparetic, stiff-legged gait as a result of stroke and compared these motions w...

    journal_title:American journal of physical medicine & rehabilitation

    pub_type: 杂志文章

    doi:10.1097/00002060-200005000-00006

    authors: Kerrigan DC,Frates EP,Rogan S,Riley PO

    更新日期:2000-05-01 00:00:00