OBJECTIVE: To investigate the effectiveness of MT combined with bilateral arm training and graded activities to improve motor performance in the paretic upper limb following stroke. DESIGN: Randomized, controlled, assessor-blinded study. SETTING: Inpatient stroke rehabilitation center of a tertiary care teaching hospital. PARTICIPANTS: Twenty patients with first time ischemic or hemorrhagic stroke, confined to the territory of the middle cerebral artery, onset less than 6 months prior to commencement of the study. INTERVENTION: MT and control group participants underwent a patient specific multi-disciplinary rehabilitation program including conventional occupational therapy, physical therapy and speech therapy for 5 days per week, 6 hours a day, over three weeks The participants in the MT group received one hour of MT in addition to the conventional stroke rehabilitation. MAIN OUTCOME MEASURES: The Upper Extremity Fugl-Meyer Assessment (FMA) for motor recovery, Brunnstrom stages of motor recovery for the arm and hand, Box and Block test (BBT) for gross manual hand dexterity and Modified Ashworth Scale to assess the spasticity (MAS). RESULTS: After three weeks of MT, the mean change scores were significantly greater in the MT group than in the control group for the FMA (p = 0.008), Brunnstrom stages for arm (p = 0.003) and hand (p = 0.003) and BBT (p = 0.022). No significant difference was found between the groups for MAS (p = 0.647). CONCLUSIONS: MT when combined with bilateral arm training and graded activities was effective in improving motor performance of the paretic upper limb following stroke than conventional therapy without the MT.

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