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. 2015 Feb 12;2015(2):CD008349. doi: 10.1002/14651858.CD008349.pub3

Shin 2013

Methods RCT
Participants Recruited from 2 rehabilitation units and the neurorehabilitation ward of a hospital in Korea
16 participants: 9 intervention, 7 control
Inclusion criteria: hemiparetic upper limb dysfunction due to first‐ever stroke, mild‐to‐severe deficits of the paretic upper extremity (2 to 4 on the Medical Research Council Scale and 2 to 5 on the Brunnstrom Stage of motor recovery)
Exclusion criteria: pre‐existing arm impairment, any painful condition affecting the upper limbs, difficulty in sitting for at least 20 minutes, severe cognitive impairment (Mini Mental State Examination score less than 10 points) and severe aphasia
Mean (SD) age: intervention group 46.6 (5.8), control group 52.0 (11.9) years
50% male
Stroke details: 38% right lesion
Timing post stroke: intervention group mean (SD) 76.6 (28.5) days, control group 67.1 (45.3) days
Interventions Virtual reality intervention: RehabMaster™. The participant sits in a chair in front of a monitor. The therapist can control the program and level of difficulty. Rehabilitation games were designed to combine rehabilitation exercises with gaming elements. The four games suggested were goalkeeper, bug hunter, underwater fire and rollercoaster
Control intervention: conventional occupational therapy
Sessions were 20 minutes of occupational therapy. The intervention group received an additional 20 minutes of virtual reality. The duration of intervention was 10 sessions over 2 weeks
Outcomes Outcomes recorded at baseline and post intervention
Upper limb function outcomes: Fugl Meyer
Activity limitation outcomes; Modified Barthel Index
Other outcomes: passive range of motion of the upper limb, Medical Research Council Score
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 Opaque envelopes
Blinding of outcome assessment (detection bias) All outcomes Low risk Blinded to allocation
Incomplete outcome data (attrition bias) All outcomes Low risk No drop outs
Selective reporting (reporting bias) Low risk All outcomes reported except for the SF36 measure, which will be reported in a subsequent publication