Female Participation Across Different Post-Stroke Motor Rehabilitation Interventions

OBJECTIVE: The objective of this systematic review was to examine the association between female participation and interventions evaluated in randomized controlled trials (RCTs) of upper (UE) and lower extremity (LE) motor rehabilitation post-stroke. DESIGN: For this systematic review, searches for UE were conducted in CINAHL, Embase, PubMed, Scopus and Web of Science, and for LE in MEDLINE, Embase, CINAHL and PsycINFO for RCTs published in English up to December 2024. Two reviewers determined study inclusion and extracted data on the number of participants and intervention investigated, with a third reviewer available where necessary. RESULTS: Overall female participation was 38.3% in UE RCTs and 39.1% in LE RCTs. Higher participation was significantly associated with non-technological interventions in UE (P=0.001) and LE (P<0.001), whereas lower participation was associated with technology-based interventions (P<0.001) when compared to the overall percentages of female participants. No association was found in UE pharmacological RCTs (P=0.14), whereas lower participation occurred in LE RCTs (P<0.001) compared to the overall percentages of female participants. CONCLUSION: Female participation in stroke rehabilitation RCTs appears to vary by the type of intervention studied. These findings can be used to explore the differences and guide future trials to ensure adequate enrollment of female participants.