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. 2013 Jul 1;2013(7):CD003586. doi: 10.1002/14651858.CD003586.pub3

Weinberg 1977.

Methods RCT
 Setting: USA
Participants 25 (see Notes) stroke rehabilitation inpatients
 Experimental: n = 14, control: n = 11
 (The following data describe the 57 initial participants: see Notes)
 Mean age (SD): experimental: 61.5 years (9.84), control 65.7 years (10.92)
 Onset of testing (weeks): experimental: 9.9, control 10.53
Interventions 20 hours visual training (1 hour each day for 4 weeks in reading, writing and calculation) versus no visual training (but received OT as part of general rehabilitation programme)
For analysis of bottom‐up and top‐down rehabilitation approaches this review coded the experimental condition as top‐down
Outcomes The study collected 3 types of outcomes:
  1. closest to the area being trained (WRAT, simple arithmetic, paragraph reading, copying a name and address)

  2. training‐related tasks (single and double letter cancellation H and C‐E)

  3. related tasks (counting faces, matching faces, WAIS Digit Span, object assembly, picture completion, confrontation, motor impersistence and simultaneous stimulation)


Outcomes assessed after 1 month, i.e. immediate effects
This review used only the single letter cancellation
Notes Hypothesises that neglect underlies visual perceptual problems
 Experimental and control groups appeared similar in age, 2 participants in the experimental group had "aberrantly long times since onset"
 Groups divided into RBD severe and RBD mild
 No reply to request for clarification of randomisation procedure and other outcome measures
 57 patients reported but outcome data reported separately for severe and mild RBD groups and only severe data (n = 25) entered in this review, experimental 14 and Control 11
 Control group better than experimental on single letter cancellation at baseline. No difference in double letter cancellation or digit span
Risk of bias
Bias Authors' judgement Support for judgement
Allocation concealment (selection bias) Unclear risk No details of randomisation provided
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Not stated
Incomplete outcome data (attrition bias) 
 All outcomes Low risk None reported
Free of systematic differences in baseline characteristics of groups compared? High risk Onset since testing may be different but not clear. Two cases with very long onset were excluded from the comparison of time since onset
Did authors adjust for baseline differences in their analyses? Low risk Calculated an effectiveness change index