What the Proportional Recovery Rule Is (and Is Not): Methodological and Statistical Considerations.

This is a selective methodological review, not a new clinical trial and not a systematic review, so it cannot establish how well the rule works in practice. The authors extracted data from published figures, so some overlapping points could not be identified and the reanalysed datasets may not exactly match the originals. Studies used different methods to label nonrecoverers, including outlier removal, initial score cutoffs, corticospinal tract integrity, and clustering, which makes comparisons difficult. Some datasets showed ceiling effects and uneven error spread, which can make a proportional recovery pattern look valid when it may not be. The paper focuses on group-level regression and does not provide validated individual patient prediction.

The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.

Do not read the proportional recovery rule as a validated way to predict an individual patient's recovery. The review found that many studies were consistent only at the group level, and that uneven error spread, ceiling effects, and inconsistent methods for separating recoverers from nonrecoverers can make the rule look stronger than it is.