Kiper 2011
| Methods | RCT | |
| Participants | Recruited from an Institute of Rehabilitation, Italy 80 participants: 40 intervention, 40 control Inclusion criteria: diagnosis of stroke within 1 year of enrolment and score of > 24/30 on the Mini Mental State Examination Exclusion criteria: clinical evidence of cognitive impairment, apraxia, neglect, language disturbance, complete paralysis of the upper extremity, upper limb sensory disorders or post‐traumatic injury, which prevented the execution of exercises Mean (SD) age: 64 (16.4) years 58% male Time since onset of stroke: mean (SD) 5.7 (3.5) months |
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| Interventions | Virtual reality intervention: reinforced feedback in virtual environment (RFVE). Participants in the intervention group received 1 hour of traditional rehabilitation and 1 hour of RFVE. The RFVE involved sitting in front of a wall screen grasping a sensorised real object (ball, disc or cube) with the affected hand. The target objects were displayed on the wall screen. The physiotherapist created a sequence of virtual tasks that the participant had to perform on his workstation (e.g. pouring water from a glass, using a hammer) Control intervention: traditional neuromotor rehabilitation including postural control, exercises for hand pre‐configuration, manipulative and functional skills, proximal‐distal exercises Sessions were 1 hour a day, 5 days a week for 4 weeks (approximately 20 hours total) |
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| Outcomes | Outcomes recorded at baseline and post‐intervention Upper limb function outcomes: Fugl Meyer Activity limitation outcomes: Functional Independence Measure Other outcomes: Modified Ashworth Scale (spasticity) |
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| Notes | — | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated sequence |
| Allocation concealment (selection bias) | Low risk | Opaque envelopes |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Masked to allocation |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No drop outs |
| Selective reporting (reporting bias) | Low risk | |