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. 2015 Oct 8;2015(10):CD004433. doi: 10.1002/14651858.CD004433.pub3

Atteya 2004.

Methods Randomisation details were not reported
 Blinded outcome assessor
 No information about withdrawals
 Single centre, outpatients
Participants Saudi Arabia
Recruited via the King Saud Univerity
6 participants: 2 intervention, 2 control, 2 no treatment
Inclusion criteria: cerebrovascular accident between 1 and 6 months; 10° of active extension to the metacarpophalangeal and interphalangeal joints and 20° at wrist
Exclusion criteria: significant cognitive impairment, haemorraghic lesion, significant spasticity, significant pain of the upper limb
Mean age (SD): intervention group: 55 (2.8) years, control group: 52 (4.2) years, no treatment group: 56 (15.5) years
 % women: intervention group 50%, control group: 50%, no treatment group: 50%
Stroke details: only ischaemic, 50% with right hemiparesis in each group
Time since stroke, mean (SD): intervention group 5.6 (0.3) months, control group 3.95 (2.3) months, no intervention group 4.65 (1.2) months
Interventions mCIMT versus control versus no treatment
CIMT: physical and occupational therapy focused on PNF with emphasis on ADL tasks, compensatory techniques with the unaffected side, 2 functional tasks of the WMFT with shaping techniques
 Amount of restraint: 5 waking hours per day
Anatomical region restraint: arm and hand
Control: physical and occupational therapy focused on PNF with emphasis on ADL tasks, compensatory techniques with the unaffected side
 Session duration: 1 hour per day, 3 days per week, 10 weeks for each treatment group
Outcomes Measures pre/post treatment
  • Arm motor function: ARAT, WMFT2

  • Perceived arm motor function: MAL

  • Arm motor impairment: FMA

Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "all subjects were randomly assigned ... with an equal probability"
 Comment: insufficient information to make a judgment
Allocation concealment (selection bias) Unclear risk No information provided
Blinding (performance bias and detection bias) 
 All outcomes Low risk Blinding of outcome assessor
Incomplete outcome data addressed? (Post‐treatment) Unclear risk The study provided no information about withdrawals