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. 2013 May 31;2013(5):CD002842. doi: 10.1002/14651858.CD002842.pub2

Schottke 1997

Methods RCT, multicentre study, parallel group design with pair matching
Pairs were matched for side and aetiology of lesion, education level, and participating centre. Allocation of 1 person from each matched pair to treatment group by coin toss. 3 people could not be matched and were allocated to the control group
No concealment of intervention or outcome measurement (assessment and training by same person) Approach: restoration of attentional functions and compensatory strategies
Participants Germany, recruited from 2 hospitals
Total participant sample 29; 0 people lost to follow‐up
Treatment group: n = 16; mean age 64.1 ± 8.5 years; 56.3% males; 51.6 ± 21.5 days since onset; hemisphere of lesion: 5 left, 11 right
Control group: n = 13; mean age 65.4 ± 10.9 years; 46.2% males; 37.5 ± 11.4 days since onset; hemisphere of lesion: 2 left, 11 right
Inclusion criteria: attention deficit defined as standard scores < 80 in any of the attentional tests; stable cardiovascular system; able to travel to training room; cerebral infarct or haemorrhage; neurological symptoms lasting more than 24 hours
Exclusion criteria: aphasia
Interventions Treatment: 13 training sessions in 3 weeks, which included a wide range of different training methods (e.g. computerised reaction training, paper‐and‐pencil tasks, scanning training, cognitive‐behavioural training and relaxation techniques). Duration of a single session not specified Control: treatment as usual
Outcomes Measured after intervention (3 weeks)
Several standardised measures of attention with no definition of primary outcome measure:
  • Tempo‐Lern‐Test (percentile scores for each of the 3 experimental blocks)

  • Wahl‐Reaktions‐Test (percentile scores for 2 reaction time measures)

  • Zahlen‐Verbindungstest (percentile scores)

  • Konzentrations‐Verlaufs‐Test (standard scores for speed, errors and combined speed/errors scores)

  • Visual‐Discrimination‐Conditioner (raw score correct responses)

  • Line Bisection (deviation in % from true mid‐point)

  • Behavioural Test of Inattentiveness in Daily Life (raw scores)

  • Barthel completed by self and another (raw scores)

  • Emotional State Questionnaire (raw scores for the subscales 'depression', 'fear', 'fatigue', 'activity' and 'relaxation')

Notes Time after stroke significantly shorter for controls compared to the treatment group. Visual‐Discrimination‐Conditioner programme used for treatment and outcome assessment
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Coin tossing
Allocation concealment (selection bias) Unclear risk No information reported
Blinding of participants and personnel (performance bias) All outcomes Unclear risk No blinding
Blinding of outcome assessment (detection bias) All outcomes High risk Training and assessment by same person
Incomplete outcome data (attrition bias) All outcomes Low risk No missing outcome data
Selective reporting (reporting bias) Low risk No indication in article, but study protocol not available