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

Schroder 2008.

Study characteristics
Methods RCT, 3‐arm study
Setting: Germany
Participants 30 right‐handed participants with right brain damage, moderate left neglect
Experimental 1: n = 10, experimental 2: n = 10, control: n = 10
Number lost to follow‐up: none
Adequacy of matching at baseline? Yes, no significant differences at baseline
Mean age, years, mean (SD): experimental 1 = 68.4, experimental 2 = 60.6, control = 67.3
Sex (men/women): experimental 1 = 7/3, experimental 2 = 5/5, control = 6/4
Time post onset, days, mean (SD): experimental 1 = 43.8 (23.6), experimental 2 = 24.6 (9.6), control = 36.2 (24.2)
Side of damage: right
Method of diagnosing stroke: not stated
Method of diagnosing neglect
  • NET (Neglect test, Fels & Geissner, 1996) using subtests line cancellation, star cancellation, line bisection, figure copy and freehand drawing

  • Neglect subtest from 'Testbatterie zur Aufmerksamkeitsprufung' (TAP)

  • Reading test A from the electronic reading and exploration apparatus (ELEX) manual and writing a dictated sentence ('Heute ist ein schöner Tag')


No details of cutoffs provided
Inclusion criteria: right‐handedness, less than 90 days post stroke, left brain damage, at least moderate neglect
Exclusion criteria: not stated
Visual sensory deficit: not stated
Interventions Visual exploration and TENS: 20 therapy sessions, each lasting 25 to 40 minutes over 4 weeks (TENS: 100 Hz, over left trapezius, applied throughout exploration training) vs visual exploration and OKS 20 therapy sessions, each lasting 25 to 40 minutes over 4 weeks (OKS: small randomly spaced squares moving slowly to the left across a screen, 2 × 10‐minute periods of OKS separated by 10 to 20 minutes of exploration training) vs visual exploration (control) using the ELEX apparatus (stimuli patterns were presented on a screen that subtended 53° vertically and 40° horizontally: after initial fixation, participants had to shift fixation to a yellow stimulus)
Profession of the intervention provider not stated
Outcomes
  • NET subtests: line cancellation, star cancellation, line bisection, figure copy, freehand drawing

  • TAP: neglect subtest (composite values given)

  • Reading test

  • Writing dictated sentence (composite values given)


Measured up to 1 week post intervention
Notes TENS: "a non‐specific activation of the right hemisphere or a directional effect on the egocentric coordinates of extrapersonal space"
OKS "activates multiple cortical (temporoparietal and vestibular cortex, the insula) and subcortical structures (basal ganglia) involved in multisensory integration"
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk "Randomly assigned"; no other details
Allocation concealment (selection bias) Unclear risk Unclear
Blinding of participants High risk No details given
Blinding of personnel High risk No details given
Blinding of outcome assessment (detection bias)
All outcomes High risk No details given
Incomplete outcome data (attrition bias)
All outcomes Unclear risk None reported
Selective reporting (reporting bias) Unclear risk Unclear
Other bias Low risk For the few variables given, groups appear comparable at baseline