Piron 2009.
| Methods | RCT | |
| Participants | Study took place in Italy Inclusion criteria: single ischaemic stroke in the middle cerebral artery region with mild to intermediate arm motor impairment (Fugl‐Meyer Upper Extremity Scale score 30 to 55) Exclusion criteria: clinical evidence of cognitive impairment, apraxia (< 62 points on the 'De Renzi' test), neglect or language disturbance interfering with verbal comprehension (> 40 errors on the Token test) Age, years: telerehabilitation group mean = 66 (SD 8), control group mean = 64 (SD 8) years Gender: 58% men Timing post‐stroke: intervention group mean (SD) 15 (7) months, control group 12 (4) months |
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| Interventions | Telerehabilitation intervention: the virtual reality telerehabilitation programme used 1 computer workstation at the participant’s home and 1 at the rehabilitation hospital. The system used a 3D motion tracking system to record arm movements through a magnetic receiver into a virtual image. The participant moved a real object by following the trajectory of a virtual object displayed on the screen in accordance with the requested virtual task. 5 virtual tasks comprising simple arm movements were devised for training. Control intervention: specific exercises for the upper limb with progressive complexity. Started with control of isolated movements without postural control, then postural control including touching different targets and manipulating objects. Sessions were 60 minutes, 5 times per week for 4 weeks (20 hours total). | |
| Outcomes | Timing of outcome assessment: baseline, post‐intervention, and at 1 month Measures: Fugl‐Meyer Upper Extremity Scale, Abilhand Scale, modified Ashworth Scale |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Personal correspondence with study authors reported the use of a simple computer‐generated sequence. |
| Allocation concealment (selection bias) | Low risk | Opaque sequentially numbered envelopes |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Blinded outcome assessor |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No missing data |
| Selective reporting (reporting bias) | Low risk | No other outcomes collected |
| Other bias | Low risk | None apparent |