Skip to main content
. 2021 Jul 1;2021(7):CD003586. doi: 10.1002/14651858.CD003586.pub4

Choi 2019.

Study characteristics
Methods 3‐group parallel RCT 
Setting: hospital, South Korea
Participants Inclusion: individual with diagnosis of unilateral neglect from a medical doctor and number of lines neglected in Albert test > 70%; individual without brain lesions other than stroke; individual with less than 3 months since stroke; individual with Korean version of Mini‐Mental Status Examination (K‐MMSE) score ≥ 20, who can follow directions and does not have hearing or vision impairment
Age: mean, SD
  • 62.90 ± 8.64, Group A

  • 67.70 ± 9.76, Group B

  • 66.00 ± 12.09, Group C


Sex: 17 women, 13 men 
Hemisphere damaged: not specified 
Time since stroke: 1 to 3 months
Interventions This study has 3 intervention groups
  • PA plus FES group (Group A)

  • PA group (Group B)

  • FES group (Group C)


‐ Group A received 30 minutes of conventional occupational therapy, followed by FES application on upper limb on the affected side and PA treatment for 20 minutes, for a total of 50 minutes. Conventional occupational therapy was conducted for 30 minutes and included joint movement, task‐oriented training, and daily life activity training. Joint movement was conducted and included passive joint movement, active adjuvant joint movement, and active joint movement. Task‐oriented training considered functional level of patients and used tools to sequentially conduct activities such as cup‐stacking and skateboarding. Daily life activity training included using the restroom, eating a meal, performing personal hygiene activities, wearing and taking off clothes, and transferring to chair or bed. Participants wore prism glasses that deflect the axis of vision to the right by 15 degrees, with the proximal surface shaped like a triangle facing the left. For FES, a product from Microstim was used. One channel was used and was set to apply, in shifts, 10 seconds of rest and 10 seconds of stimulation. It was attached below the elbow on the affected side. Although an intensity of 20 Hz is normally recommended, the threshold for electrical stimulation is different for each participant. Therefore, it was set to contract muscles enough to produce sufficient finger and wrist movements
‐ Group B received 30 minutes of conventional occupational therapy, followed by PA on the upper limb on the affected side for 20 minutes, for a total of 50 minutes
‐ Group C received 30 minutes of conventional occupational therapy, followed by FES application for 20 minutes, for a total of 50 minutes
Outcomes
  • K‐MMSE

  • Albert test

  • MVPT

  • CBS


All taken immediately post intervention with no longer‐term follow‐up
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk No detail offered. Exactly 10 per group
Allocation concealment (selection bias) High risk No detail offered. Exactly 10 per group
Blinding of participants High risk Outcome group: all 
Blinding not possible
Blinding of personnel High risk Outcome group: all 
Blinding not possible
Blinding of outcome assessment (detection bias)
All outcomes High risk Outcome group: all 
Blinding not possible
Incomplete outcome data (attrition bias)
All outcomes Low risk No attrition
Selective reporting (reporting bias) Low risk No suggestion of this
Other bias Low risk Not obvious