Huang 2003.

Study characteristics
Methods	Study design: RCT Method of randomisation: stratified randomisation
Participants	Number of participants: n = 50 Inclusion criteria: "Diagnosis of stroke, confirmed by CT or MRI scan, medically stable within a week, did not exceed 2 weeks on enrolment to study, aged 40‐80 years, Glasgow Coma Score > 8 and deficits in limb function" Exclusion criteria: "Absence of malignant tumour(s), high blood pressure, no psychological conditions, not deaf, not mute and not have paralysis of four limbs"
Interventions	(1) Rehabilitation group (n = 25) "Both groups received routine treatment (such as medicine). For the participants in the treatment group, exercise therapy combined Bobath, Rood, Motor Relearning Program and proprioceptive neuromuscular facilitation (PNF) techniques; in terms of electrotherapy, early use of electrical stimulation, acupuncture is carried out, with additional appropriate electrical stimulation for participants with shoulder‐hand syndrome. Recovery of each motor function was targeted by using sequential and progressive therapy, using the following methods: (i) correct positioning: teaching patient’s family and caregivers the correct limb positioning of limbs in supine position, lateral position with affected limbs at lower side and healthy limbs at upper side, and lateral position with affected limbs at upper side and healthy limbs at lower side, requesting changing of body position every two hours. (ii) Rolling practice: with both hands intertwined and both elbows extended in front of the body, participants practised rolling to the left and right, with knees in flexion. (iii) Self‐assisted bed exercises: with both hands intertwined, participants extended both elbows in front of the body, overhead, to the left and right, touched the nose and did bridging exercises etc. (iv) Passive ranging bed exercises: upper limb: scapula, shoulder, elbow, wrist joints; truncal extension, shoulder retraction: lower limb: hip, knee, talo‐crural, metatarsal joints. (v) Techniques to facilitate muscle contractions. (vi) Lung clearance: percussions to the posterior segments of the lungs. (vii) Upright sitting training: gradually increasing the inclining angle of the bed, participants sat upright for 30 minutes. Once this was accomplished, the inclining angle is increased by 10 degrees until the participant could sit on the edge of bed. (viii) Stimulation to the muscles of the face, tongue and lips: opening of mouth, bulging of cheeks, gritting of teeth, extending the tongue, placing the tongue on the upper palate, iced cotton swabs (or placing ice cubes in the buccal cavity) and stimulation of taste. (ix) Breathing control practice: participants were requested to take a deep breath, slowly exhale and then relax. (x) Sitting on the edge of bed training: participants practised pushing up from side lying to sitting on the edge of bed without the inclining angle of the bed increased to 90 degrees. (xi) Sitting balance: postural correction, balance training while sitting on the edge of bed, including perturbations to the front, back, left and right. (xii) Exercises in sitting: to further train sitting balance, participants reached forwards, sideways, touched the nose, pointed to objects with intertwined hands and extended arms; lower limb strengthening exercises, taught to participant’s family and caregivers so they could supervise practice of the exercises several times a day. (xiii) Positioning from bed to wheelchair (or chair) training. (xiv) Sit to stand practice: Training of standing tolerance (beside the bed) commenced early to allow re‐gaining of gravitational sense, re‐gaining of control of muscles working against gravity, normalisation of blood pressure, correct standing balance as well as to overcome postural hypotension. Typically, participants with ischemic stroke were expected to be able to sit on the edge of bed within 3‐4 days of rehabilitation, commence standing training within 2 weeks, with the level of assistance given depending on the medical status of the participants; participants with haemorrhagic stroke should aim to sit on the edge of bed within 2 weeks of rehabilitation and commencement of standing training within 4 weeks. (xv) Participants with contractures were treated accordingly. (xvi) Neuromuscular facilitation techniques. (xvii) Gait training. (xviii) Stair practice (up and down)" The individual components delivered are listed in Table 6. Based on the individual components, this intervention is categorised as comprising functional task training, modality, musculoskeletal intervention (active), musculoskeletal intervention (passive) and neurophysiological intervention Length of intervention period: 30 days Number of sessions and length of individual sessions: each session lasting at least 45 minutes, one/d Intervention provider: "one to one sessions with a therapist" (2) Control group (n = 25) Participants in the control group received routine treatment (such as medicine) only The individual components delivered are listed in Table 6. Based on the individual components, this intervention is categorised as comprising no treatment Length of intervention period: no intervention Number of sessions and length of individual sessions: no intervention Intervention provider: no intervention This study is classified as intervention (functional task training, musculoskeletal (active), musculoskeletal (passive), neurophysiological) versus no treatment (Table 7). The intervention group also received modality
Outcomes	Measures of Independence in ADL: Modified Barthel index Measures of motor function: simplified Fugl‐Meyer Other secondary outcome measures: cognitive ability rating (translated) Time points when outcomes were assessed: at enrolment and 30 days after enrolment
Notes	Original study translated from Chinese to English
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Stratified randomisation done, randomisation done by participants’ onset of stroke
Allocation concealment (selection bias)	Unclear risk	Insufficient details
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Outcome assessors did not deliver intervention and were blinded to group allocation
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	No dropouts reported
Free of systematic differences in baseline characteristics of groups compared?	Low risk	No obvious difference between groups for time since stroke, gender, age, side and type of stroke, etc
Did authors adjust for baseline differences in their analyses?	Low risk	No information provided
Other bias	Unclear risk	No information provided