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. 2018 Oct 31;2018(10):CD011887. doi: 10.1002/14651858.CD011887.pub2

Fu 2017.

Methods Randomized clinical trial
Participants Stroke patients who were hospitalized in Zhejiang Jiaxing Second Hospital Rehabilitation Center between June 2014 and September 2016 were recruited in this study
70 participants: 35 experimental; 35 control
Inclusion criteria: conformed to cerebral infarction diagnostic criteria formulated by Chinese Society of Neurology, Chinese Medical Association; unilateral hemiplegia; first‐episode of cerebral infarction determined by CT and MRI; stable vital signs; disease course of 2 to 6 months; age of 40 to 75 years; MMSE score ≥ 27 and treatment instructions can be performed; FMA score ≥ 20 for upper extremity motor function; binocular vision or corrected visual acuity ≥ 1.0; everyday treatment can be tolerated; and providing informed consent and willingness to participate in the study
Exclusion criteria: cerebral hemorrhage, subarachnoid hemorrhage, venous sinus thrombosis, transient ischemic attack, and progressive or reversible ischemic cerebral apoplexy; lesions located in bilateral cerebral hemisphere, cerebellum, or brain stem; joint and other diseases affecting patients sitting or active; heart, lung, liver, kidney, and other serious diseases; metal implantation in the body; a history of epilepsy; and skull defect
Mean (SD) age: experimental group: 62.04 (9.93) years, control group: 59.76 (10.57) years
Stroke details. etiology ‐ ischemic; hemiplegia: control group: 13 right, 12 left; experimental group: 12 right, 16 left.
Stroke phase: subacute
Interventions Experimental group: traditional rehabilitation treatment such as Bobath, Brunnstrom, proprioceptive neuromuscular facilitation, and daily activity ability training. In addition participants were requested to watch upper limbs motion video and required to imitate the action in the video. There were 30 actions in the video, including shoulder joint, elbow joint, wrist joints, forearm, and hand movements in all directions
Control group: traditional rehabilitation treatment such as Bobath, Brunnstrom, proprioceptive neuromuscular facilitation, and daily activity ability training. In addition they watched different geometric patterns and digit symbol, and did the action picked from the 30 actions in the video
In both groups sessions were 20 minutes, 6 day per week, for 8 weeks
Outcomes Outcomes recorded at baseline and post‐intervention
Motor function: FMA and WMFT
Ability of daily living activities: MBI
Movement transmission mechanism: MEP ‒ latency and amplitude, CMCT
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Random number table
Allocation concealment (selection bias) High risk Authors did not report if there was allocation concealment, but randomization type classifies the allocation concealment as high risk
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk There was no blinding of participants and personnel, but this item is not essential for this review
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Assessments were made by 2 trained professional therapists and the whole process was recorded. Subsequently, the average score from another 2 trained professional therapists was used for the analyses
Incomplete outcome data (attrition bias) 
 All outcomes High risk There were 7 exclusions from the experimental group and 10 from the control group after randomization, which corresponded to more than 10% and may compromise the results. Reasons were not reported
Selective reporting (reporting bias) Low risk There is no trial registration, but the outcomes are significant, and there is no selective reporting within the study.
Other bias Low risk