Five Features to Look for in Early-Phase Clinical Intervention Studies.
Five Features to Look for in Early-Phase Clinical Intervention Studies.
复制标题
在早期临床干预研究中需要寻找的五个特征。
DOI：
10.1177/1545968320975439
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发表时间：
2021-01
影响因子：
4.2
通讯作者：
Winstein, Carolee J.
中科院分区：
文献类型：
--
作者：
Tsay, Jonathan S.;Winstein, Carolee J.
神经康复依赖于神经可塑性的核心原则，以激活和参与潜在的神经连接，促进迂回回路，并逆转损伤。结合这些原则的临床干预措施已被证明可以促进恢复和降低补偿。然而，许多临床医生很难在我们新生的、快速增长的文献中找到以这些原则为中心的干预措施。更不用说来自监管机构和组织资产负债表的巨大压力，这些压力进一步阻碍了时间密集型的促进恢复干预措施，激励临床医生优先考虑实际限制而不是合理的临床决策。现代神经康复实践，从这些压力的结果有利于那些促进恢复鼓励补偿的策略。为了缩小忙碌的临床医生和最前沿的运动恢复文献之间的差距，我们从早期临床干预研究中提炼出5个特征，这些特征更看重更持久的生物恢复过程，而不是更直接的补偿措施。通过这个透镜过滤新兴文献，并定期将有前途的研究纳入日常实践，可以打破有效临床翻译的实际障碍，并最终促进持久的长期结果。这种观点旨在为新一代具有机械思维和关怀的临床医生，学生，活动家和研究学员提供服务，他们不仅准备推进康复科学，而且还建立了基于证据的政策变化，以加速基于恢复的中风护理。
Neurorehabilitation relies on core principles of neuroplasticity to activate and engage latent neural connections, promote detour circuits, and reverse impairments. Clinical interventions incorporating these principles have been shown to promote recovery and demote compensation. However, many clinicians struggle to find interventions centered on these principles in our nascent, rapidly growing body of literature. Not to mention the immense pressure from regulatory bodies and organizational balance sheets that further discourage time-intensive recovery-promoting interventions, incentivizing clinicians to prioritize practical constraints over sound clinical decision making. Modern neurorehabilitation practices that result from these pressures favor strategies that encourage compensation over those that promote recovery. To narrow the gap between the busy clinician and the cutting-edge motor recovery literature, we distilled 5 features found in early-phase clinical intervention studies—ones that value the more enduring biological recovery processes over the more immediate compensatory remedies. Filtering emerging literature through this lens and routinely integrating promising research into daily practice can break down practical barriers for effective clinical translation and ultimately promote durable long-term outcomes. This perspective is meant to serve a new generation of mechanistically minded and caring clinicians, students, activists, and research trainees, who are poised to not only advance rehabilitation science, but also erect evidence-based policy changes to accelerate recovery-based stroke care.
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