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

Kim 2011.

Study characteristics
Methods RCT
Setting: rehabilitation department, South Korea
Participants Stroke patients who were diagnosed with unilateral spatial neglect
VR group = 12, control = 12
Mean age, years: VR = 62, control = 67
Sex (men/women): VR = 9/3, control = 5/7
Mean days from stroke to treatment: VR = 23, control = 26
Exclusions: patients with severe cognitive impairment or aphasia who could not understand instructions given by therapists, patients with such severely damaged sitting balance that they could not sit down on a chair with a back and armrests, patients with problems in cervical movement due to orthopaedic impairment, patients who could not recognise objects on a computer screen due to severely damaged eyesight
Interventions Physical therapy, occupational therapy, and cognitive therapy of the same intensity and time were applied to all patients. In addition, 2 occupational therapists conducted treatment for unilateral spatial neglect. One therapist conducted conventional rehabilitation programmes for the control group, such as visual tracking, reading and writing, drawing and copying, and puzzles; the other conducted virtual reality treatment on the VR group. Such treatments were applied for 30 minutes a day, once a day, 5 days a week for 3 weeks. The VR system consists of a monitor, a video camera, computer‐recognising gloves, and virtual objects. The video camera recognises movements
Outcomes
  • Star cancellation test

  • Line bisection test

  • CBS

  • BI


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) Unclear risk No details given
Allocation concealment (selection bias) Unclear risk No details given
Blinding of participants High risk Unlike other double‐blind assessments, guardians knew about treatment of their patients, which means this study was not completely double‐blind
Blinding of personnel High risk Not possible
Blinding of outcome assessment (detection bias)
All outcomes High risk "Those tests were conducted by a therapist who was not involved in the treatment and did not know the state of the patients"
However, CBS was filled out by guardians under supervision of the therapist
Incomplete outcome data (attrition bias)
All outcomes High risk Only "seven subjects in the control group and three subjects in the VR group accurately performed the line bisection test and were included in the analysis"
Selective reporting (reporting bias) Low risk Outcomes were reported with equal detail
Other bias High risk 9 women and 3 men in VR groups; differences not accounted for