title: Translational neurorehabilitation research in the third world: what barriers to trial participation can teach us.
abstract: OBJECTIVE
  Most stroke rehabilitation studies have been performed in high-income countries. The aim of this study was to identify the main barriers for patient inclusion in a research protocol performed in Brazil.
  
  
  METHODS
  We evaluated reasons for exclusion of patients in a pilot, randomized, double-blinded clinical trial of stroke rehabilitation. Descriptive statistical analysis was performed.
  
  
  RESULTS
  Only 5.6% of 571 screened patients were included. Recurrent stroke was responsible for exclusion of 45.4% of potentially eligible patients.
  
  
  CONCLUSIONS
  Recurrent stroke represented a big barrier to enroll patients in the protocol. External validity of rehabilitation trials will benefit from definition of study criteria according to regional characteristics of patients, including rates of recurrent stroke.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT01333579.
authors.affiliation: From the Neurology Clinical Division, Neurology Department, Hospital das Clínicas, São Paulo University, São Paulo, Brazil (S.M.A., K.N.F.d.A., A.B.C.); Human Cortical Physiology and Stroke Rehabilitation Section, National Institutes of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (L.G.C.); School of Psychology, University of Surrey, Guildford, United Kingdom (A.S.); and Hospital Israelita Albert Einstein, São Paulo, Brazil (A.B.C.).
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Anjos
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
authors.forename: Annette
authors.initials: A
authors.lastname: Sterr
authors.forename: Karina N F
authors.initials: KN
authors.lastname: de Andrade
authors.forename: Adriana B
authors.initials: AB
authors.lastname: Conforto
mesh_terms: D000368:Aged; D001938:Brazil; D002986:Clinical Trials as Topic / Q000592:standards*; D003906:Developing Countries; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D012008:Recurrence; D000071939:Stroke Rehabilitation; D057170:Translational Research, Biomedical / Q000592:standards*
keywords: rehabilitation; stroke