Background Loss of arm function is a common problem after stroke. Robot-assisted training
might improve arm function and activities of daily living. We compared the clinical
effectiveness of robot-assisted training using the MIT-Manus robotic gym with an enhanced
upper limb therapy (EULT) programme based on repetitive functional task practice and with
usual care. Methods RATULS was a pragmatic, multicentre, randomised controlled trial
done at four UK centres. Stroke patients aged at least 18 years with moderate or severe …

Results. eCIMT subjects showed significantly larger MAL gains than controls; mean
posttreatment change was 1.5 versus 0.1, p<. 001. At 1-year follow-up, the MAL gains in the
eCIMT group were only 13% less than at post-treatment. Conclusions. Expanded CIMT
results in very large gains (d= 3.4) in real-world arm use in chronic stroke survivors with
severe upper-extremity hemiparesis. These gains are retained with little loss for at least one-
year afterwards.