ABSTRACT
Background: Clinical research is the bedrock of clinical innovation, education and practice. Characterization and critical appraisal of clinical research is warranted to avoid implementing misleading research findings into practice, and to task Physiotherapy societies in Nigeria on responsible conduct of clinical research.
Objective: To characterize and critically appraise Physiotherapy interventional research in Nigeria.
Eligibility: Included in this review were peer reviewed Physiotherapy interventional research conducted in Nigeria published between 2009 and 2020. Interventions were of physiotherapeutic interest and administered by a qualified Physiotherapist. Only articles written and published in English were reviewed.
Sources of information: Search was undertaken of the following databases: PUBMED, MEDLINE, Cumulative Index to Nursing and Allied Health Literature and Academic Search Complete. Reference lists of relevant articles were also searched.
Data synthesis: In this review, we employed narrative and quantitative syntheses. Data were selected and extracted according to predesigned eligibility criteria using a standardized data extraction table. Where appropriate, the PeDro risk of bias assessment tool and Cochrane ROBINS 1 were used to examine risk of bias and study quality.
Data analysis: We employed quantitative synthesis approach as recommended by Borenstein et al. (2009) in summarizing study data. Effects sizes were computed from individual study data, in line with Lenhard & Lenhard (2016). We presented a graphical illustration of Pedro quality score using forest plot.
Result: Of the 46 Physiotherapy clinical experiments, randomized control trials were the most prevalent (80.4%). Most of the studies (85.7%) were of suboptimal quality. More than half (68.2%) of the studies recorded medium to large effect sizes. Interventions were mainly exercise, electrotherapy and manual therapy. Of the intervention, exercise was reportedly the most effective, possessing largest effect size. A fair proportion (41.3%) of the studies was confounded. Only a few studies conducted normality test (10%) and intention-to-treat analysis (36%).
Conclusion: Randomized control trials are the highest Physiotherapy clinical experimental design. Physiotherapy interventions especially exercise appears effective, although incongruence between effect size and study quality limits inference. Sources of bias include lack of covariate analysis, intention-to-treat approach, absent assessors and participant blinding and tests of normality.
Keywords: Physiotherapy, clinical research, characterization, appraisal, Nigeria.
