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. 2016 Mar 21;2016(3):CD009645. doi: 10.1002/14651858.CD009645.pub3

Mahmoudi 2011.

Methods Study design: sham‐controlled cross‐over randomised trial
Dropouts: not stated, most likely none
Adverse effects: none
Deaths: not stated, most likely none
ITT: not stated
Participants Country: Iran
Number of participants: 10 right‐handed stroke participants with no sensory deficits
Age: (mean ± SD) 60.8 ± 14.1 years
Gender: 3 female (30%)
Type of stroke: ischaemic
Time poststroke: (mean ± SD) 8.3 ± 5.45, range 1 to 16 months
Severity: median Brunnstrom stage 6
Inclusion criteria: single ischaemic stroke with more than 1 month's duration of mild to moderate motor deficit (to ensure that all participants could perform all items on the JTT
Exclusion criteria: clinically significant or unstable medical or psychiatric disorder with history of substance abuse, any neuropsychiatric comorbidity other than stroke and contraindications to tDCS
Interventions Each participant underwent 5 different treatments with at least 4 days of each of the following
  1. A‐tDCS of lesioned M1 (with the cathodal electrode positioned at the contralateral supraorbital area, 1 mA for 20 minutes)

  2. A‐tDCS of lesioned M1 (with the cathodal electrode positioned at the contralateral deltoid muscle, 1 mA for 20 minutes)

  3. C‐tDCS of lesioned M1 (with the anodal electrode positioned at the contralateral supraorbital area, 1 mA for 20 minutes)

  4. Dual‐tDCS: A‐tDCS of lesioned M1 + C‐tDCS of non‐lesioned M1

  5. Sham tDCS (20 minutes)

Outcomes Outcomes used: JTT (with familiarisation sessions)
Time points of measurement: at baseline and after stimulation
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "The order of these conditions was counterbalanced and randomised across patients"
Allocation concealment (selection bias) Unclear risk Not described
Blinding of participants and personnel (performance bias) 
 Subjective outcome measures Low risk There were no subjective outcome measures
Blinding of participants and personnel (performance bias) 
 Objective outcome measures Low risk Participants probably were blinded; blinding of personnel was not described.
Quote: "Patients were then randomised to the double‐blinded, sham‐controlled cross over part of the experiment"
Blinding of outcome assessment (detection bias) 
 Subjective outcome measures Low risk There were no subjective outcome measures
Blinding of outcome assessment (detection bias) 
 Objective outcome measures Low risk Quote: "A blinded physiatrist—instructed not to communicate with the patients during the task—evaluated patients' performance"
Incomplete outcome data (attrition bias) 
 Subjective outcome measures Low risk There were no subjective outcome measures
Incomplete outcome data (attrition bias) 
 Objective outcome measures Unclear risk All participants apparently completed the study. No treatment withdrawals, no losses to follow‐up, no trial group changes and no major adverse events were stated
Selective reporting (reporting bias) Unclear risk All outcomes stated in the methods section were reported