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 MMSE Exclusion criteria: clinical evidence of cognitive impairment, apraxia, neglect, language disturbance, complete paralysis of the UE, upper limb sensory disorders or post‐traumatic injury, which prevented the execution of exercises Mean (SD) age: 64 (16.4) years 58% men Time since onset of stroke: mean (SD) 5.7 (3.5) months |
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| Interventions | VR intervention: reinforced feedback in virtual environment (RFVE). Participants in the intervention group received 1 h of traditional rehabilitation and 1 h 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 h/d, 5 d/week for 4 weeks (approximately 20 h 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) Adverse events reported |
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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 dropouts |
| Selective reporting (reporting bias) | Low risk | Author confirmed no other outcomes collected |