Barriers to Enrollment in a Post-Stroke Neuromodulation and Walking Study: Implications for Recruiting Women.
Twinkle Mehta, Brice Cleland, Sangeetha Madhavan
PMID 38314561WHAT IT FOUND
Women were significantly more likely to be excluded from a stroke walking trial than men.
Fewer women were enrolled than in the general stroke population. Headache history and cognitive test scores were non-significant barriers that may disproportionately affect women.
Key findings
01A significantly higher percentage of women were excluded from the study compared to men.
02The proportion of women in the enrolled and screened samples was significantly lower than in a representative stroke population.
03No single exclusion criterion significantly excluded more women than men, though headache history and low cognitive scores showed non-significant trends toward higher female exclusion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The comparison population (Chicago Health and Aging Project) only included individuals with ischemic stroke who received emergency treatment and were aged 65 or older, which may not fully represent all stroke survivors requiring gait rehabilitation. The study is retrospective and relies on data from a single site with specific neuromodulation and high-intensity walking inclusion criteria, limiting generalizability to other types of stroke rehabilitation studies. The findings describe who was excluded from a trial, not the efficacy of the treatment itself.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not interpret the non-significant trends for headache and cognitive exclusion as proof that these criteria are the primary cause of lower female enrollment. The study found that women were excluded more often overall, but did not identify a single significant barrier, and the comparison population had specific medical and age restrictions that may skew the generalizability of these recruitment patterns.