Desrosiers 2005

Methods	Randomly assigned by block randomisation scheme within each stratum (stratified on impairment level of hand and sensibility of the hand) Randomisation completed in blocks of 4 Allocation concealment completed through the use of sealed envelopes
Participants	41 participants Inclusion criteria: unilateral stroke > 10 days but < 2 months, cognitive functioning within normal limits, understand French or English, minimal upper extremity function (stage 2 for hand and stage 3 for arm on Chedoke‐McMaster Stroke Assessment), no severe body neglect or visual perception deficits
Interventions	Group 1 (21 participants): usual care ‐ functional activities and exercises for the arm Group 2 (20 participants): bilateral ‐ package of interventions including bilateral and unilateral tasks Both groups received usual therapy interventions Both interventions provided by same occupational therapy research assistant Both groups received 4 x 45‐minute sessions per week for 5 weeks, in total receiving between 15 and 20 sessions Note: the descriptions of interventions provided in the full‐text paper are confusing; information given in the abstract has been central to the above classifications of the nature of the interventions
Outcomes	Primary outcome: performance in activities of daily living: measure de l'independence fonctionelle (MIF ‐ French translation of FIM) Primary outcome: functional movement ‐ arm functional movement: BBT, TEMPA (BBT selected); hand functional outcome: Purdue Pegboard Test Secondary outcome: motor impairment: motor impairment scales: Fugl‐Meyer (upper limb section); temporal outcomes: co‐ordination (finger to nose, number of movements in 20 seconds); strength outcomes: grip strength (vigorimeter) AMPS also used as outcome measures but not relevant to this review
Notes	Control group received usual care, however this may have contained some bilateral tasks; this could be a confounding factor Descriptions of interventions are unclear and definitions of symmetrical, synchronous and simultaneous are difficult to interpret 5 drop‐outs from Group 1 (lack of interest x 2, early release, fatigue, death) and 3 from Group 2 (death, fracture, refusal)
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	Sealed envelopes
Blinding of outcome assessor?	Low risk	Independent evaluator
Intention to treat analysis?	High risk	Only complete cases were analysed Drop‐outs were accounted for
Baseline similarity	Low risk	No significant differences between groups at baseline