Byl 2013

Methods	RCT
Participants	Recruited via the University of California, USA 15 participants completed the study: 5 intervention, 5 intervention, 5 control Inclusion criteria: stroke survivors more than 6 months post stroke between 25 and 75 years of age. Participants were independent in self care and independent in the community with minimal to moderate voluntary function in the upper limb (Upper Limb Fugl Meyer score 16 to 39). Participants needed to speak English or attend with an interpreter Exclusion criteria: people were excluded if they suffered from a neurological disease other than stroke, had co‐morbidities that would impact on participation, were in severe pain, were not mentally alert or had a skin condition that would prevent wearing the robotic orthosis Mean (SD) age: intervention group 65.2 (5.4), control group 54.2 (20.5) Stroke details: 70% right hemiparesis Timing post stroke: intervention group 8.4 (4.2), control group 10.2 (5.0) months
Interventions	This trial had 3 arms: 2 of the intervention groups performed virtual reality tasks; 1 of the virtual reality groups performed bilateral tasks and the other group performed unilateral tasks Virtual reality intervention: the participant wore a robotic orthosis. Each session started with a motor control evaluation task and then followed with treatment in which participants performed repetitive movements while playing task‐specific games Control intervention: repetitive task practice involved reaching, grasping, object manipulation and self care activities. Dynamic orthoses were not included in training Sessions were 90 minutes for 12 treatment sessions (approximately 18 hours total)
Outcomes	Outcomes recorded at baseline and post‐intervention Upper limb function outcomes: Fugl Meyer, Motor Proficiency Speed (abbreviated Wolf Motor Function Test and Digital Reaction Time Test) Hand function outcomes: motor skill performance (Box and Block test and Tapper test) Activity limitation outcomes: functional independence (CAFE40) Quality of life outcomes: Stroke Impact Scale
Notes	—
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated
Allocation concealment (selection bias)	Low risk	Allocated prospectively using a computer program
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinded assessment
Incomplete outcome data (attrition bias) All outcomes	Low risk
Selective reporting (reporting bias)	Low risk	All outcomes reported