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

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

• •
  Researchers should refer to up-to-date reporting guidelines when designing, collecting, and reporting sex and/or gender-based analyses.
• •
  Researchers should engage in sex and gender inclusive research practices when conducting and reporting physiotherapy research.