We thank our correspondents for their valuable feedback to our article. In the protocol of the study, which was published before our article, we had planned as our primary endpoint gait velocity and as our secondary endpoints the ability to walk and maximum walking distance. Our statistical analysis of the systematically collected data was done in accordance with this predefined method (2). The only deviation from the protocol consisted in the fact that for the secondary outcome measure, ability to walk, no network meta-analysis was undertaken because of a statistically relevant inconsistency in the data. We therefore adhered to the study protocol and also the statistical-methodological international specifications in the PRISMA protocol (PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
All described endpoints have been described in the literature as important parameters of the rehabilitation of the ability to walk after stroke. Gait velocity is a highly sensitive, valid, and highly reliable marker for the recovery of the ability to walk in patients with mild or very severe impairment after stroke. We think that our research question and inclusion criteria are unproblematic. We included important covariables, such as severity of illness, in our analysis and considered these in the evaluation. Altogether we conducted our analysis with the intention of being open to the result. We attempted to describe the result neutrally. We therefore think that the title reflects the subject of the article adequately.
Prof. Dr. rer. medic. Jan Mehrholz
Medizinische Fakultät der Technischen Universität Dresden
Conflict of interest statement
The authors of both contributions declare that no conflict of interest exists.
|1.||Mehrholz J, Pohl M, Kugler J, Elsner B: Network meta-analysis on randomized trials focusing on the effects of interventions for improving ambulation and gait related outcomes after stroke. PROSPERO 2017. www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017056820 (last accessed on 12 February 2019).|
|2.||Mehrholz J, Pohl M, Kugler J, Elsner B: The improvement of walking ability following stroke—a systematic review and network meta-analysis of randomized controlled trials. Dtsch Arztebl Int 2018; 115: 639–45 VOLLTEXT|