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

Zucconi 2012

Methods RCT (3 arms)
Participants Recruited from a neurorehabilitation ward in Italy
33 participants: 11 intervention, 11 control, 11 control
Inclusion criteria: stroke in the MCA territory at least 6 months before enrolment, absence of ideomotor apraxia, neglect and aphasia interfering with verbal comprehension
Exclusion criteria: apraxia, neglect and language disturbances
Median (IQR) age: intervention group 60 (57.25 to 76) years, control group 60 (49 to 74.25) years, control group 64.5 (54.50 to 69) years
39% male
Timing post stroke: intervention group median (IQR) 10.05 (4.05 to 17.90) months, control group 8.75 (2.75 to 24.95) months, control group 5.05 (1.75 to 17.90) months
Interventions Virtual reality intervention (EVER TEACHER group): Reinforced Feedback in Virtual Environment (RFVE). Participants were asked to manipulate sensorised objects (ball, plastic cup or cylinder). Specific feedback was provided (like a virtual teacher) to encourage the participant to emulate the correct movement
Virtual reality intervention (NO TEACHER group): virtual reality intervention but with no feedback
Control intervention: conventional rehabilitation programme
Sessions were 60 minutes, 5 times a week for 4 weeks
Outcomes Outcomes recorded at baseline and post‐intervention
Upper limb outcomes: Fugl Meyer UE, Reaching performance scale
Other outcomes: Modified Ashworth Scale, kinematics
Activity outcomes: Functional Independence Measure
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 Sequentially numbered, opaque, sealed 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 No other outcomes collected

6MWT: 6‐minute walk test CT: computerised tomography IQR: interquartile range MCA: middle cerebral artery MI: myocardial infarction MMSE‐K: Mini Mental State Examination ‐ Korean MRC: Medical Research Council MRI: magnetic resonance imaging RCT: randomised controlled trial ROM: range of motion SD: standard deviation UE: upper extremity