Kalra 1997.
| Methods | RCT Setting: UK |
|
| Participants | 50 (see Notes) stroke patients with visual neglect admitted to a SU The following data are for the 47 surviving patients Experimental n = 24, control n = 23 Mean age (SD): experimental 78 years (9), control 76 years (10) Sex (male): experimental 11, control 9 Side of damage (RBD): experimental 16, control 17 Median time post‐onset (range): 6 days (2 to 14) Inclusion: infarcts partial anterior circulation, known to be sensitive to rehabilitation on basis of impairments of power, balance, proprioception and cognition at 1 to 2 weeks after stroke Exclusion: TIAs, reversible neurological deficits, hemianopsia or severe dysphasia | |
| Interventions | Spatio‐motor cueing based on 'attentional‐motor integration' model and early emphasis on restoration of function versus conventional therapy input concentrating on restoration of tone, movement pattern and motor activity before addressing skilled functional activity For analysis of bottom‐up and top‐down rehabilitation approaches this review coded the experimental condition as bottom‐up | |
| Outcomes | The study collected 6 types of outcomes:
This review used only the BI, RPAB letter cancellation subtest, and discharge home. These were all analysed as immediate effects |
|
| Notes | Principle behind approach: movements of affected limb in the deficit hemispace led to summation of activation of affected receptive fields of 2 distinct but linked spatial systems for personal and extrapersonal space resulting in improvements in attention skills and appreciation of spatial relationships on the affected side. Personal communication supplied further data and clarification of method No difference between groups on demographic variables or initial impairment or disability including BI Outcome data on 47 of 50 stroke patients with visual neglect admitted to a SU: experimental n = 24 (+ 1 died), control n = 23 (+ 2 died). For the 'destination discharge' outcome the total figure of 50 was used in this review as deaths were entered as not going home | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Allocation concealment (selection bias) | Low risk | External randomisation, using random permuted block technique in groups of 10, allocated by telephone by clerical staff using computer‐generated random numbers |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Blinded outcome assessor |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 3 lost to follow‐up, 1 intervention and 2 control. All died so low risk of bias |
| Free of systematic differences in baseline characteristics of groups compared? | Low risk | Groups compared on main characteristics and very similar |
| Did authors adjust for baseline differences in their analyses? | Low risk | Not needed |