Zhu 2015.
| Methods | Randomized clinical trial | |
| Participants | Stroke patients hospitalized in Jiaxing Rehabilitation Medical Center were recruited 70 participants: 35 experimental group; 35 control group Inclusion criteria: patients who met the diagnosis for stroke formulated in the 4th National Academic Conference on Cerebrovascular Disease in 1995, and were confirmed as having a stroke upon CT or MRI; first‐episode patients who began rehabilitation therapy within 6 months, for whom the sitting balance was ≥ Level 1, and the FMA score was ≥ 15 for upper extremity motor function; patients with a stable condition; patients with a normal Kinesthetic and Visual Imagery Questionnaire score; patients who were 42 to 75 years of age; patients who provided informed consent and were willing to participate in the study Exclusion criteria: patients with cognitive impairment MMSE score of < 24 in patients with a junior high school education or < 17 if illiterate; patients with severe upper limb spasticity; patients with severe bone joint malformation or myopathy; patients with severe diseases of the heart, lung, liver, or kidney Mean (SD) age: experimental group: 57.75 (15.57) years, control group: 56.89 (14.93) years Stroke details: not reported by authors Stroke phase: acute |
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| Interventions | Experimental group additionally watched a video showing a specific action of the upper limb and then performed the same exercise after watching 30 videos Control group received conventional drug treatment and traditional physical and occupational therapy Control group received conventional therapy 2 to 5 hours per day, 6 times per week for 8 weeks. Experimental group had additional 30 minutes per day, 6 times per week, for 8 weeks |
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| Outcomes | Outcomes recorded at baseline and post‐intervention Muscle tone of elbow flexor and forearm pronator: MAS Upper limb function: FMA of the upper limb Activities of daily living: BI |
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| 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 | No blinding, but the outcome is not likely to be influenced by lack of blinding |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Evaluators were unaware of the participant grouping status and did not participate in the treatment |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 9 participants were excluded from analysis: 4 from experimental group and 5 from control group. Participants were excluded for absence on 3 consecutive days of intervention and aggravated condition of the participant. Nevertheless the reasons were reported and they have no direct relationship with the outcomes studied, and there is not a substantial imbalance in final number of participants in each group considered for analysis |
| Selective reporting (reporting bias) | Low risk | The study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre‐specified |
| Other bias | Low risk | |
ADLs: activities of daily living ARAT: Action Research Arm Test BBT: Box and Block Test BDI: Beck Depression Inventory BI: Barthel Index CG: control group CMCT: center‐motion conduction time CPT: conventional physical therapy CT: computed tomography EG: experimental group FAT: Frenchay Arm Test FAST: Florida Apraxia Screening Test FIM: Functional Independence Measure FMA: Fugl‐Meyer Assessment fMRI: functional magnetic resonance MAL: Motor Activity Log MAS: Modified Ashworth Scale MBI: Modified Barthel Index MEP: motor evoked potential amplitudes MI: Motricity Index MMSE: mini‐mental state examination MRI: magnetic resonance imaging NHPT: Nine Hole Peg test OTI: observation‐to‐imitate PP: physical practice SD: standard deviation SIS: Stroke Impact Scale TMS: transcranial magnetic stimulation VAS: visual analogue scale WMFT: Wolf Motor Function Test