Thiagarajan 2014.

Methods	Oculomotor rehabilitation versus sham training for traumatic brain injury Allocation: single masked Masking: single masked Exclusions: 0 Losses: 0 Design: cross‐over RCT
Participants	Country: USA Number of participants randomised: 12 Age: 29 ± 3 years Gender: not specified Aetiologies: type of acquired brain injury not specified Ocular motility condition: any acquired disorder Inclusion criteria: TBI onset at least one year post‐incident to ensure that any subsequent changes during training are not secondary to their natural neurological recovery function period (6‐9 months). Participants exhibit at least one symptom (e.g. skipping lines while reading, blur, diplopia, etc.) and one clinical sign (e.g. receded near point of convergence) of a non‐strabismic oculomotor dysfunction related to impaired sustained reading. Intact cognitive ability to perform the required tasks for the study. Stable systemic health. Exclusion criteria: persons over the age of 40 years, as they typically will not have sufficient accommodation to measure reliably. Best corrected visual acuity poorer than 20/30 in either eye. Constant strabismus, amblyopia, or ocular disease in either eye. Medications that alter oculomotor function or attentional state (or both)
Interventions	Intervention: ocular motor rehabilitation — training of versions, vergence and accommodation for 15 minutes each interspaced with 5 minute rest intervals. Dose: 2 sessions of 60 minutes training per week, block of 6 weeks Control: sham treatment of basic reading tasks Dose: 2 sessions of 60 minutes training per week, block of 6 weeks Duration: 2 blocks of 6 weeks with one‐week interim wash‐out
Outcomes	Measurements: Reading rate, infra‐red eye recording of reading eye movements, saccade ratio — progression and regression saccades by eye movement recording, binocular accommodative amplitude, near point of convergence, convergence insufficiency symptom survey questionnaire Timepoints: Baseline, 6 weeks and post final block
Notes	Health economic costs: not reported Funding: US Army, DoD award, College of Optometrists in Vision Development and SUNY Graduate programme Dates of study: not reported Declaration of interests: no interests to declare Trial registration ID: not specified
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "During phase 1, every odd‐numbered subject first received OMT, and every even‐numbered subject first received ST, and vice‐versa during phase 2."
Allocation concealment (selection bias)	High risk	Single‐masked
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Quote: "A cross‐over, interventional experimental design of a single‐blinded nature (for the subject) was used." Judgement comment: this implies the participants were masked to the intervention, but the intervention and control are so different it is likely that the participants may be influenced by knowledge of the intervention. It is unclear what the impact of this would have been and may be considered to be part of the intervention so we have graded this as unclear risk of bias.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Not masked
Incomplete outcome data (attrition bias) All outcomes	Low risk	No incomplete data
Selective reporting (reporting bias)	Unclear risk	No access to study protocol or trials registry entry.
Other bias	High risk	Additional risk of bias assessment for cross‐over study Was the cross‐over design suitable: probably not Was there a carry‐over effect: uncertain, no analysis done. Was only first period data are available: no, first period data not available Was the analysis correct: unclear, no estimates of effect reported, data for intervention group only reported Comparability of results with those from parallel‐group trials: no parallel group trials

A & E: Accident and Emergency
 AIDS: acquired immune deficiency syndrome
 BT: botulinum toxin
 PD: prism dioptre
 RCT: randomised controlled trial
 SEM: standard error mean
 TBI: traumatic brain injury
 USPHS: United States Public Health Service