Reporting of sex and/or gender in randomised controlled trials of physiotherapy interventions remains problematic: a systematic review

Emre Ilhan; Kathleen Solis; Cindy Liu; Jamal Khawaja; Tran Dang Khoa Chau; Kelly Gray

doi:10.1016/j.physio.2024.101450

Reporting of sex and/or gender in randomised controlled trials of physiotherapy interventions remains problematic: a systematic review

Physiotherapy. 2024 Oct 31:126:101450. doi: 10.1016/j.physio.2024.101450. Online ahead of print.

Authors

Emre Ilhan¹, Kathleen Solis², Cindy Liu³, Jamal Khawaja⁴, Tran Dang Khoa Chau⁵, Kelly Gray⁶

Affiliations

¹ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: emre.ilhan@mq.edu.au.
² Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: kathleen.solis@students.mq.edu.au.
³ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: cindy.liu1@students.mq.edu.au.
⁴ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: jamal.khawaja@students.mq.edu.au.
⁵ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: tran.chau@students.mq.edu.au.
⁶ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 5, 75 Talavera Road, Sydney, Australia. Electronic address: kelly.gray@mq.edu.au.

PMID: 39689410
DOI: 10.1016/j.physio.2024.101450

Abstract

Background: Little is known about how sex and/or gender is reported in trials on physiotherapy interventions.

Objectives: To determine the nature and extent of reporting sex and/or gender information in randomised controlled trials of physiotherapy interventions.

Data sources: Physiotherapy, Journal of Physiotherapy, Physical Therapy, Brazilian Journal of Physical Therapy, and Journal of Orthopaedics and Sports Physical Therapy.

Study selection or eligibility criteria: Randomised controlled trials of physiotherapy interventions published between 2018 and 2024 were independently screened by two reviewers throughout title/abstract and full-text stages, then data were extracted from eligible full texts. Information on whether and how sex and/or gender data were collected, reported, and defined were extracted.

Synthesis methods: Data were analysed descriptively using frequencies and percentages.

Results: Of 182 studies included in the review, 153 studies did not have sex and/or gender exclusive recruitment. Of these, 136 studies (89%) used the terms "sex" or "gender" when reporting demographic characteristics. Three studies used the term "sex assigned at birth". When reporting sex and/or gender, 82/139 (59%) studies provided two descriptors for sex and/or gender (e.g., male and female; men and women), 39/139 (28%) studies provided one descriptor (e.g., female) despite not being sex and/or gender exclusive. Four studies provided more than 2 descriptors (e.g., transgender women). In all studies, it was unclear how sex and/or gender was defined. In all but three studies, it was unclear how sex and/or gender was collected and whether data collection methods allowed for gender diverse options (e.g., non-binary) to be selected.

Limitations: Only 5 journals were surveyed.

Conclusions and implications of key findings: The lack of inclusive reporting of gender and/or sex characteristics limits the scope and applicability of research in physiotherapy to the full spectrum of human experiences.

Prospero registration: CRD42022383976. CONTRIBUTION OF THE PAPER.

Keywords: Gender identity; Physiotherapy; Randomised controlled trials; Reporting; Sex.

Publication types

Review