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February 1994

Stroke Rehabilitation Outcome Studies: Selection for Meta-analysis-Reply

Author Affiliations

Faculty of Health Sciences 435 Stockton Kimball Tower Buffalo, NY 14214

Arch Neurol. 1994;51(2):120-121. doi:10.1001/archneur.1994.00540140022009

In reply  Reding and McDowell have argued that our recent article1 using meta-analysis to study the impact of stroke rehabilitation addresses two separate issues. They are: (1) Do patients randomized to focused stroke rehabilitation units do better than those given physical, occupational, and speech therapy on a general medical ward? (2) Is one type of rehabilitation technique better than another in optimizing functional recovery within a stroke rehabilitation unit? Actually, our study deals with several questions related to the effectiveness of stroke rehabilitation. These questions are reviewed in our discussion under the following headings: "Independent Variable," "Dependent Variable," "Design Characteristics," and "Design Interactions." Reding and McDowell contend that by pooling randomized controlled trials examining focused stroke rehabilitation programs with other trials that compare individualized rehabilitation approaches or comparisons with standard medical intervention we "obscure the primary question: Are focused stroke rehabilitation units advantageous?"Our purpose was to "examine the

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