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. 2021 Jul 1;2021(7):CD003586. doi: 10.1002/14651858.CD003586.pub4

Ferreira 2011.

Study characteristics
Methods RCT
Setting: Brazil
Participants 10 ischaemic, right cerebral hemisphere stroke > 3/12 duration
Mental practice = 5, visual scanning = 5
Detection of neglect: score < 129 (out of 146) on BIT
Sex (women/men): mental practice = 2/3, visual scanning = 3/2
Age (range), years: mental practice = 46 to 73, visual scanning = 62 to 80
Time between stroke and treatment, range, months: mental practice = 3 to 62, visual scanning = 4 to 132
Exclusion criteria: locomotor problems or ataxia interfering with task completion, dysphasia, Parkinson’s disease, dementia, any neurodegenerative condition
Interventions Group 1: visual scanning
Group 2: mental practice
Outcomes
  • BIT conventional subtests

  • FIM


Intervention groups were assessed at end of intervention period and at 3 months
Notes "Five patients not willing to participate in the experimental protocols were submitted to a follow‐up exam 2 months later and were included in a control group." We did not include this group in analysis because it was non‐randomised; data only from the 2 intervention groups are presented
We used imputation to calculate post‐intervention scores using 3 of the 5 values provided in each group: minimum, median, maximum
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk “Ten patients were randomly allocated”
Allocation concealment (selection bias) Low risk Randomisation (information from study authors): "Concealed envelopes for every patient (0 or 1). Then patients as they were recruited/included and subsequently randomised by the same method"
Blinding of participants High risk Not possible
Blinding of personnel High risk Not possible
Blinding of outcome assessment (detection bias)
All outcomes High risk States: "the evaluations were always done by a physical therapist not directly involved in patients’ treatment." However, correspondence with study authors confirms: "there were two therapists involved, each one directly responsible for a different treatment strategy (mental practice or visual scanning). For instance, whenever a patient was randomised to mental practice, treatment was done by one and assessments by the other therapist. Hence, the assessor was always the therapist who would not be involved in treatment but he always knew the treatment allocation"
Incomplete outcome data (attrition bias)
All outcomes Low risk All complete
Selective reporting (reporting bias) High risk Total FIM reported more briefly than ‘significant’ subscale (self‐care items)
Other bias Low risk Groups appeared similar at baseline, and no significant differences were found