Myint 2008.
Methods | Randomisation by drawing sealed envelopes, other details were not provided Blinded of outcome assessor Post‐treatment withdrawals: 10%; follow‐up withdrawals: 7.5% Single centre, outpatients | |
Participants | China Recruited from 3 hospitals with rehabilitation facilities 43 participants: 23 intervention, 20 control Inclusion criteria: cerebrovascular accident between 2 to 16 weeks; 10° of active extension to the metacarpophalangeal and interphalangeal joints 20° at wrist Exclusion criteria: severe aphasia, high risk of fall, cerebellar stroke and severe shoulder pain affecting therapy Mean age (SD): intervention group: 63.4 (13.6) years, control group: 63.9 (12.2) years % women: intervention group 56%, control group: 60% Stroke details: ischaemic or haemorrhagic; 48% with right hemiparesis in treatment group, 70% with right hemiparesis in control group Time since stroke, mean (SD): intervention group 1.27 (0.7) months, control group 1.5 (0.95) months |
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Interventions | CIMT versus control CIMT: adaptive task practice (shaping) Amount of restraint: 90% of waking hours Anatomical region restraint: arm and hand Control: bimanual task, compensatory techniques for ADL strength, range of motion, positioning and mobility training Session duration: 4 hours per day, 5 days per week, 2 weeks for each group |
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Outcomes | Measures pre/post treatment and follow‐up at 12 months
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "subjects were randomized by drawing sealed envelopes which were filled at random with indication of which intervention group the patient was allocated to" |
Allocation concealment (selection bias) | Unclear risk | Insufficient information to permit judgment |
Blinding (performance bias and detection bias) All outcomes | Low risk | Quote: "The observer was blinded" |
Incomplete outcome data addressed? (Post‐treatment) | High risk | 5/28 missing from intervention group (due to transport problem, inadequate home support; others changed their mind about trial participation); 0/20 missing participants in the control group. Reasons for missing data outcomes possibly related to the true effect, with imbalance across intervention and control groups |