Acta orthopaedica
2026-06-22
Rejestracja i charakterystyka raportowania badań dotyczących terapii ćwiczeniowej po całkowitej artroplastyce kolana: przegląd systematyczny
Registration and reporting characteristics of trials investigating exercise therapy following total knee arthroplasty: a systematic review.
Recenzja AI
Cel badania
Celem badania było zbadanie i porównanie charakterystyki raportowania badań rejestrowanych prospektywnie i retrospektywnie, dotyczących terapii ćwiczeniowej po całkowitej artroplastyce kolana.
Metoda
Zidentyfikowano randomizowane badania porównujące efekty terapii ćwiczeniowej po całkowitej artroplastyce kolana w czterech bazach danych w latach 2000-2024.
Wyniki
W analizie uwzględniono 94 badania z 9396 uczestnikami, z czego tylko 13 było rejestrowanych prospektywnie. Badania prospektywnie zarejestrowane wykazały mniejsze oszacowania efektu oraz niższe ryzyko błędu w porównaniu do badań rejestrowanych retrospektywnie i nie zarejestrowanych.
Znaczenie dla praktyki
Wyniki wskazują na potrzebę promowania prospektywnej rejestracji badań, co może zwiększyć wiarygodność wyników i poprawić jakość terapii ćwiczeniowej w praktyce klinicznej w Polsce.
Abstrakt oryginalny
BACKGROUND AND PURPOSE: Prospectively registering the primary trial outcome is important to reduce selective outcome reporting and increase the trustworthiness of findings, which guide clinical practice. The objectives of our systematic review were to explore and compare the reporting characteristics of prospectively and non-prospectively registered trials investigating exercise therapy following total knee arthroplasty. METHODS: Randomized trials comparing effects of exercise therapy after total knee arthroplasty for osteoarthritis were identified in 4 databases from 2000 to August 12, 2024. One primary outcome per trial was extracted, using a pre-specified hierarchical algorithm, irrespective of outcome domain. Pooled standardized mean differences (SMDs) were calculated on pre-specified outcome domains, and risk-of-bias assessed using the Cochrane Risk-of-Bias tool v2. RESULTS: 94 trials, comprising 9,396 participants, were included, of which 13 were prospectively registered, 33 retrospectively registered, and 48 unregistered. A single primary outcome was defined in 44% of the 94 trials, and 4 trials reported a primary outcome consistent with a prospective registration. The pooled SMD of primary outcomes was 0.06 (95% confidence interval [CI] -0.03 to 0.16) for prospectively registered trials, 0.67 (CI 0.22-1.11) for retrospectively registered trials, and 0.59 (CI 0.32-0.86) for unregistered trials. Lower risk-of-bias ratings and higher proportions of intention-to-treat adherence, dropout reporting, and adverse event reporting were observed among prospectively registered trials. CONCLUSION: Among prospectively registered trials we showed smaller effect size estimates between interventions with lower risk-of-bias ratings, and higher proportions of intention-to-treat adherence, dropout reporting, and adverse event reporting in contrast to trials without prospective registration; furthermore, clear specification of a single primary outcome was uncommon among trials evaluating exercise therapy after total knee arthroplasty.