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. 2022 Mar 29;2022(3):CD006430. doi: 10.1002/14651858.CD006430.pub3

Hasanzadeh Pashang 2020.

Study characteristics
Methods Design: RCT
Duration of trial: not reported
Unit of randomisation: people with right cerebral cortical ischaemic stroke with attention impairments 6 months to 3 years poststroke
Recruitment and allocation: using purposive sampling of participants with attention impairment, 20 participants randomised to IG (n = 10) or CG (n = 10).
Participants Setting: stroke rehabilitation clinic
Country: Iran
Sample size: 20 adults, 75% men; IG: 10; CG: 10
Inclusion criteria: first‐time ischaemic stroke, thrombotic ischaemia in right cerebral cortical region, confirmed attention impairment, 13–15 consciousness on Glasgow Coma tables, no previous treatment for attention deficits, able to read and write, 6 months to 3 years after stroke
Exclusion criteria: white matter lesion of brain, and cerebral atrophy (with no previous symptoms); alcohol and drug addiction; hearing loss; complete memory recovery before the end of intervention; impaired consciousness or brain "re‐attack"; no speech power; the lack of co‐operation of patients' families
Age: mean: IG: 53.90 (SD 9.73) years; CG: 57.70 (SD 12.16) years
Time since onset of stroke: mean: IG: 11.90 months; CG: 20.3 months
Types of stroke: thrombotic ischaemia
Site of lesion: right cerebral cortical region
Interventions Intervention group
Brief name: cognitive rehabilitation
Recipients: adults 6 months to 3 years poststroke with attention impairment
Why: to improve visual and auditory attention performance through group work including focused stimulation, learning compensatory coping strategies, acquiring insight and awareness, emotional adjustment, and improved self‐efficacy of feeling more 'in control' (Powell 2017).
What (materials): the Brain Injury Workbook. Exercises for Cognitive Rehabilitation (Powell 2017). www.routledge.com/The-Brain-Injury-Workbook-Exercises-for-Cognitive-Rehabilitation-2nd/Powell/p/book/9781315172897
What (procedures): routine rehabilitation plus cognitive rehabilitation delivered according to the Brain Injury Workbook (Powell 2017)
Table 1 of paper outlines content of 8 sessions:
  • determining the purpose and familiarity with stroke and its effects on attention, memory, and daily life;

  • defining attention and its types. Attention persistence training. Training (backward training);

  • memorising pictures, names, and face, and practicing word listing;

  • meaning evocation training, and completing words;

  • family name training, and word finding training to promote the divided attention;

  • different‐options training, and using memory auxiliaries;

  • training how to remember arrangements and gathering training;

  • training how to remember numbers and review of some training, solving problems and responding to patient questions.


Who provided: not reported; Powell 2017 stated that the workbook can be used by therapists working with brain‐injured people in groups and can be used by people with brain injuries themselves and their carers.
How: face‐to‐face in groups of 2–10 people, as per workbook
Where: stroke rehabilitation clinic with no further description
When and how much: 8 sessions, 1 hour per week (total of 8 hours)
Tailoring: none reported, although content appears amenable to individual tailoring, e.g. family name training
Modifications: none reported
How well (planned): none reported
How well (actual): none
Comparator group
Brief name: routine rehabilitation
Recipients: adults 6 months to 3 years poststroke with attention impairment
Why: to provide routine rehabilitation.
What: drug therapy combined with physiotherapy
Who provided: not reported, presumably relevant rehabilitation clinic staff
How: individual and face‐to‐face
Where: stroke rehabilitation clinic
When and how much: not reported
Tailoring: none reported
Modifications: not reported
How well (planned): not reported
How well (actual): not reported
Outcomes Primary: none
Secondary
  • IVA‐CPT


Methods of data collection: not reported
Data collection time points: before and after the intervention (8 weeks) and 6 weeks after completion of intervention
Notes Funding: none
Conflict of interest: none
Published trial protocol: none located
Trial registration: none reported
Ethics approval: yes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Method for randomisation not reported.
Allocation concealment (selection bias) Unclear risk Method of allocation not reported.
Blinding of participants and personnel (performance bias)
All outcomes High risk Not reported but it is apparent that participants could have known which group they were allocated to.
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Not reported.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk Not clearly reported.
Selective reporting (reporting bias) Low risk It appears that all planned outcomes were reported.
Other bias Low risk No other identifiable bias.