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

Prokopenko 2019.

Study characteristics
Methods Design: parallel RCT (note: data only for 2 groups included in this review: study group (IG) and passive CG)
Duration of trial: not reported
Unit of randomisation: people aged 40–65 years, in the early and late recovery period following first hemispheric ischaemic stroke, with cognitive impairments
Recruitment and allocation: not reported in detail; 68 participants receiving restorative treatment at a neurorehabilitation centre were randomised into 3 groups: a study group (IG) (neuropsychological computer programs) (n = 23), an active CG (distracting games) (n = 19), and a passive CG (standard rehabilitation) (n = 26); data only for the IG and passive CG were used in this review.
Participants Setting: neurorehabilitation centre
Country: Russia
Sample size: 49 adults, 65% men; IG: 23; passive CG: 26
Inclusion criteria: aged 40–65 years, early and late recovery period following first hemispheric ischaemic stroke, cognitive impairments at the stage of mild and moderate disorders, informed consent
Exclusion criteria: somatic and neurological diseases in the stage of decompensation, presence of epileptic seizures or epileptic activity on the electroencephalogram, age outside the specified range, profound cognitive or aphatic impairments, visual or auditory pathology preventing sessions
Age: mean: IG: 59.0 (95% CI 54.9 to 66.5); CG: 60.5 (95% CI 55.8 to 68.8)
Time since stroke onset: not reported except recruited in early and late recovery period
Types of stroke: hemispheric ischaemic stroke
Side of lesion: not reported
Interventions Intervention group
Brief name: neuropsychological computer training
Recipients: people in the early and late recovery period following first hemispheric ischaemic stroke, with cognitive impairments
Why: to provide low‐cost stimulation of several cognitive functions "with automatic changes in loadings and assessment of point scores" and ensuring high‐level compliance through high motivation from play aspects of the programmes.
What (materials): the authors' set of original computerised stimulation programs (KrasSMU complex of neuropsychological computer programs), in Russian including:
  • optical‐spatial gnostic training using a computerised version of the "Figure‐Background" test (see Figure 1 in paper);

  • visuospatial memory training using tests based on remembering the position of a card (see Figure 2 in paper);

  • training of attention using computerised Schulte's Tables;

  • training of visual memory using tests for remembering sequences of symbols which are difficult to verbalise;

  • training of optical‐spatial gnosis using a clock hands position test;

  • program to correct impulsivity and the concentration of attention;

  • program for training to count.


What (procedures): in addition to complex restorative treatment, participants completed courses of sessions using the neuropsychological computerised stimulation programs.
Who provided: not stated in paper; however, the authors confirmed in personal correspondence about the same intervention provided in Prokopenko 2013 that the sessions were conducted by occupational therapists.
How: not reported but appeared to be face‐to‐face and individually
Where: neurorehabilitation centre
When and how much: daily for 10 days, each session lasting 30–40 minutes (5 hours to 6 hours 40 minutes in total)
Tailoring: programmes provided "automatic changes in loadings" presumably in response to performance
Modifications: none reported
How well (planned): none reported
How well (actual): none reported
Comparator group
Brief name: standard rehabilitation
Recipients: people in the early and late recovery period following first hemispheric ischaemic stroke, with cognitive impairments
Why: to provide standard rehabilitation.
What: motor rehabilitation only
Who provided: not reported
How: not described but presumably face‐to‐face and individually
Where: neurorehabilitation centre
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
  • IADL

  • MMSE

  • MoCA

  • FAB

  • Schulte's Tables


Other
  • Clock Drawing Test

  • HADS A, HADS D

  • NIHSS


Methods of data collection: no details provided except that participants were assessed before and after treatment.
Data collection time points: before and after treatment (baseline and 10 days)
Notes Funding: none reported
Conflict of interest: none
Published trial protocol: no
Trial registration: no
Ethics approval: none reported
Data: median and 95% CI data converted to means and SDs by a method described in University College London 2010.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Method not reported.
Allocation concealment (selection bias) Unclear risk Method not reported.
Blinding of participants and personnel (performance bias)
All outcomes High risk Not reported but apparent that participants could have known to which group they were allocated.
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Not reported.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk Study did not address this criterion.
Selective reporting (reporting bias) Low risk No protocol reported but it appeared that all planned outcomes were reported.
Other bias Low risk No other identifiable bias.