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. 2015 Nov 7;2015(11):CD006876. doi: 10.1002/14651858.CD006876.pub4

Hsieh 2014

Methods RCT
Methods of randomisation: random‐number table
Participants Country: Taiwan
Sample size: 48
Inclusion criteria: at least 6 months after onset of a unilateral stroke, an initial score of the FMA arm assessment of 20 to 50 (SD 25), minimal hand function (i.e. extension of the wrist ≥ 10°, extension of at least 2 fingers > 0° and > 10°, and abduction of thumb ≥ 10°, no excessive spasticity in any of the joints of the affected arm (MAS ≥ 4), no arm fracture within 3 months or painful arthritis of the joints, and able to follow study instructions and perform study tasks (Mini‐Mental State Examination score ≥ 22)
Exlusion criteria: none described
Interventions 3 groups:
  1. RT + CIT group (robot‐assisted arm therapy (Bi‐Manu‐Track) + constraint‐induced therapy)

  2. RT group (robot‐assisted arm therapy (Bi‐Manu‐Track))

  3. CT group (received a therapist‐mediated intervention using conventional occupational therapy techniques, including neurodevelopmental techniques, functional task practice, fine‐motor training, arm exercises or gross‐motor training, and muscle strengthening)


Participants in each group received 20 training sessions of 90 to 105 min/day, 5 days/week for 4 weeks. In addition to the intervention provided in the clinics, all participants were encouraged to use their affected upper limb during activities in their daily life situations (e.g. at home)
Outcomes Outcomes were recorded at baseline and post‐treatment after 4 weeks
  • FMA

  • WMFT

  • MAL

  • accelerometers (actigraphy activity monitor)

Notes We combined the results of both the RT + CIT group and the RT group (collapsed) group and compared this collapsed group with the results of the CT group
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomisation assignments were generated from a random‐number table
Allocation concealment (selection bias) Low risk Sequentially numbered, sealed, and opaque envelopes and a blinded investigator assigned each participant to a treatment group
Blinding of outcome assessment (detection bias) All outcomes Low risk Blinded assessor
Selective reporting (reporting bias) Unclear risk Insufficient information to permit judgement