Visual feedback therapy for restoration of upper limb function of stroke patients.

Only 31 of the 46 randomised patients were included in the analysis, so the result depends on a small analysed sample. The paper does not state which outcome was primary, and it reports several clinical, electrophysiological and brain imaging outcomes. Follow-up included only 17 patients, and fMRI was done in a non-random subgroup of 9 VFT and 8 control patients. The VFT was added to a package of conventional stroke medical therapies and traditional rehabilitation, so the separate contribution of each component of that package cannot be isolated. The blinding description is unclear because patients and rehabilitation specialist nurses were said to be blinded to assignment, while the same rehabilitation specialist nurse demonstrated the VFT actions. The authors state that the sample size was small and that the fMRI data were limited.

The study was supported by Zhejiang province medical and health technology achievement funding, a Zhejiang province medical and health science and technology project, the Zhejiang province natural science foundation, and a Jiaxing city traditional Chinese medicine key discipline project. The authors declared no conflicts of interest.

Do not conclude that visual feedback therapy alone restored arm function. All patients received conventional stroke medical care and traditional rehabilitation, including nutrient intervention, improvement of microcirculation and cerebral metabolism, control of blood pressure and sugar, exercise and occupational therapies, Bobath and Brunnstrom approaches, proprioceptive neuromuscular facilitation, physical exercise, daily activities, physiotherapy and occupational therapy. The study only compared adding VFT to that package with the same package without VFT, and only 31 of 46 randomised patients were analysed.