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

Park 2015a.

Study characteristics
Methods Design: parallel RCT
Duration of trial: 6 months (October 2013 to March 2014)
Unit of randomisation: adult inpatients with cognitive impairment after stroke
Recruitment and allocation: of 37 inpatients recruited and screened, 30 were eligible and randomised by random numbers table into IG (n = 15) or CG (n = 15).
Participants Setting: rehabilitation hospital
Country: Korea
Sample size: 30 adults, 47% men; IG: 15; CG: 15
Inclusion criteria: history of 1 stroke; stroke with onset duration of < 3 months; score of ≤ 23 on the Korean version of MMSE; ability to understand instructions; ability to use the controller with the unaffected upper limb; and without unilateral hemispatial neglect and hemianopsia
Age: mean: IG: 64.7 (SD 8.9) years; CG: 65.2 (SD 8.0) years
Time since stroke onset: mean: IG: 1.5 (SD 0.5) months; CG: 1.8 (SD 0.6) months
Types of stroke and lesion: not reported
Interventions Intervention group
Brief name: CoTras
Recipients: adult inpatients with stroke undergoing rehabilitation within 3 months' onset with cognitive impairment
Why: to provide a Korean computer‐based cognitive rehabilitation to enhance attention, concentration, implementation skills, and perception‐motor skills.
What (materials): CoTras program (Netblue Co., Ltd, Korea) computerised cognitive rehabilitation training, made for Koreans; a joystick and a large button on the CoTras panel which make the training easier for people who are unfamiliar with computer use; see www.netblue.co.kr/eng/doc/product01-01.php
What (procedures): during the sessions, all participants completed a standard rehabilitation programme according to a daily inpatient treatment schedule. In addition to standard rehabilitation, all participants received 30‐minute daily sessions of the computer‐based program treatment.
Who provided: not reported; however, the research was conducted by occupational therapists, the software is commercially available, and the intervention is within the scope of practice defined in the review.
How: unclear but appeared it was face‐to‐face and individually.
Where: local inpatient rehabilitation hospital, no further details provided
When and how much: 20 × 30‐minute sessions (i.e. 5 days per week for 4 weeks) (10 hours in total)
Tailoring: training allowed adjusting to individual participant's abilities at all levels of the programme
Modifications: none reported
How well (planned): none reported
How well (actual): none reported
Comparator group
Brief name: conventional cognitive rehabilitation
Recipients: inpatient with stroke with cognitive impairment undergoing rehabilitation
Why: to provide usual rehabilitation services.
What: pencil and paper with emphasis on visual perception ability
Who provided: not reported
How: not reported, assumed face‐to‐face
Where: inpatient rehabilitation hospital
When and how much: matched that for the IG participants in terms of duration (in minutes) (i.e. 20 × 30‐minute sessions)
Tailoring: not reported
Modifications: not reported
How well (planned): not reported
How well (actual): not reported
Outcomes Primary: none
Secondary
  • LOTCA


Other
  • MVPT‐3


Methods of data collection: all outcome measures were administered to the participants by the assistant researcher with 5 years' experience in using the measures.
Data collection time points: baseline and 4 weeks postintervention
Notes Funding: none stated
Conflict of interest: none reported
Published trial protocol: none located
Trial registration: none reported
Ethics approval: unclear, stated, "All subjects provided written informed consent before study inclusion according to the code of ethics of the World Medical Association (Declaration of Helsinki, version 2004)".
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Random numbers table used to randomly assign participants to either CG or IG.
Allocation concealment (selection bias) Unclear risk Not reported.
Blinding of participants and personnel (performance bias)
All outcomes High risk Not reported.
Quote: "All subjects gave their voluntary consent to participate after receiving a detailed explanation of the purpose and methods of the study" and "During the sessions, all subjects participated in a standard rehabilitation program according to a daily inpatient treatment schedule. In addition to standard rehabilitation, all subjects received 30‐min daily sessions of either the CG or the EG [IG] treatment". 
Comment: highly likely that participants and personnel knew which group they were in.
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Quote: "All outcome measures were administered to the patients at baseline and at the end of treatment (after the 4‐week intervention) by the assistant researcher with 5 years' experience in using the measures".
Comment: unclear whether this person was blinded to the allocation.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk Study did not address this criterion.
Selective reporting (reporting bias) Low risk No protocol located but appeared to report all outcomes and data.
Other bias Low risk No other identifiable bias.