Table 1 Characteristics of studies and outcomes

Qualitative

Donoso-Brown (2015)

USA [10]

Qualitative

descriptive

n = 10^a

10 stroke survivors

56.3 (44–69) years

6M:4F

Chronic

NGT

45 min/session

1 session/day

5 days/week

4 weeks

Semi-structured

interviews

X

X

X

–

–

–

–

–

Emmerson (2018)

Australia [39]

Phenomenology

n = 10^b

10 stroke survivors

2 family members

72 (51–85) years

10M:0F

Early Subacute-Chronic

iPad

Dose variable

4 weeks

In-depth

semi-

structured

interviews

X

X

X

–

–

–

–

–

O’Brien Cherry (2017)

USA [52]

Ethnography

n = 10^c

10 stroke survivors

Unknown number of family members

62.2 (49–88) years

10M:0F

Early Subacute-Chronic

HandMentor Pro™

1-2hrs/day

 ≥ 1 session/day

7 days/week

12 weeks

Observation,

in-depth

semi-

structured

interviews

X

X

X

–

–

–

–

–

Parker (2014)

UK [54]

Realistic

evaluation

n = 5

5 stroke survivors

5 family members

71 (62–79) years

4M:1F

Late Subacute-Chronic

SMART System

Sessions/day not

reported

Days/week not

reported

5 weeks

Observation,

interviews,

diary

X

X

–

–

–

–

–

Sivan (2016)

UK [59]

Specific

qualitative

methodology

not reported

n = 17^d

17 stroke survivors

7 therapists

56.4 years

14M:3F

Chronic

hCAAR

30 min/session

1 session/day

5 days/week

8 weeks

Semi-

structured

interviews

X

X

X

–

–

–

–

–

Wingham (2015)

UK [65]

Specific

qualitative

methodology

not reported

n = 18^e

18 stroke survivors

10 family members

65 (35–84) years

11M:7F stroke survivors

8M:2F family members

Early Subacute-Chronic

Nintendo Wii Sports™

45 min/session

1 session/day

7 days/week

6 weeks

Semi-

structured

interviews

X

X

X

–

–

–

–

–

Quantitative

Adie (2017)

UK [28]

RCT

n = 235 (E 117, C 118)^e

E 66.8 (SD 14.6), C 68.0

(SD 11.9) years

E 66M:51F, C 65M:53F

Acute-Chronic

Nintendo Wii Sports™

45 min/session

1 session/day

7 days/week

6 weeks

–

X

X

Adherence

Dropouts

82%^T

Desire not to continue (3); Medically deteriorated

(4); Unable to contact (4)

Incomplete

data (4)

ARAT

COPM

EQ-5D-3L

MAL

SIS

NT

NT

NT

NT

NT

Y

Y

N

U

U

Basteris (2015)

Netherlands, Italy [30]

Case Series

n = 7^f

53.7 (34–66) years

5M:2F

Chronic

SCRIPT*

30 min/session

1 session/day

6 days/week

6 weeks

–

X

Adherence

50%^T

–

–

–

Bernocchi (2018)

Italy [31]

Case Series

n = 21

69 (62–75) years

14M:7F

Early Subacute- Chronic

Glorhea Lite™

45 min/session

1 session/day

6 days/week

8 weeks

–

X

X

Adherence

Dropouts

79%^T

Death (1)

Medically

deteriorated

(1); Nursing home admission (1); Desire not to continue (1)

BI

Grip strength

mAS

Motricity Index

NHPT

Pain VAS

Y

Y

N

Y

Y

N

U

U

U

U

U

U

Brokaw (2015)

USA [33]

Case Study

n = 1

49 years

F

Chronic

HAMSTER,

HandSOME

30 min/session

1 session/day

5 days/week

4 weeks

–

X

Adherence

95%^S

FMA

JHFT

SIS-16

NT

NT

NT

N

U

N

Buick (2016)

Canada, Ireland [34]

Case Series

n = 11

64.18 (54–86) years

10M:1F

Chronic

ReJoyce and FES-ET

60 min/session

1 session/day

5 days/week

6 weeks

–

X

Dropouts

Failed to

complete

intervention

(1)

ARAT

Y

N

PIADS

–

–

Moderate positive

impact on

measures of

competence

(+ 1.01)

adaptability (+ 1.1)

Slight positive impact on self-esteem (+ 0.46)

Burdea (2019)

USA [35]

Case Series

n = 7

7 stroke survivors

7 caregivers

64.14 (48–79) stroke

survivors

60.29 (27–74) caregivers

4M:3F stroke survivors

5M:2F caregivers

Chronic

BrightBrainer

20–40 min/

session

1 session/day

5 days/week

4 weeks

–

X

X

Adherence

105%^T

CAHAI

Y

N

Caregiver feedback survey

–

–

Nil scores > 4/5

FMA

N

N

Grip strength

Y

U

JHFT

N

U

Pinch strength

N

U

Stroke survivor feedback survey

–

–

Score > 4/5 for: useful instruction, decreased boredom, encouraging others to use the device, liking the system overall

UEFI

N

Y

UL ROM

N

U

Butler (2014)

USA [36]

Case Series

n = 13 (UL 9)^c

59.7 (41–74) years

12M:1F

Early Subacute-Chronic

HandMentor Pro™

1–2hrs/session

 ≥ 1 session/day

7 days/week

12 weeks

–

X

X

X

Adherence

Dropouts

13%^T

Unknown (1)

ARAT

Y

Y

FIM-C

N

N

FIM-M

Y

N

Satisfaction Survey

–

–

‘high’ satisfaction

Donoso-Brown (2014)

USA [37]

Interrupted time

series with non-

parallel control

n = 12^a

60 (47–69) years

5M:4F

Chronic

NGT

45min/session

1 session/day

5 days/week

4 weeks

–

X

X

Adherence

Dropouts

79%^T

Medically

deteriorated

(1); Lack of time

(2)

CAHAI

N

N

ROM

N

U

sEMG-Game Play

N

U

sEMG-Lab Assessment

Y

U

WMFT

N

N

Emmerson (2017)

Australia [38]

RCT

n = 62 (E 30, C 32)^b

E 68 (SD 15), C 63 (SD 18) years

E 17M:13F, C 19M:13F

Early Subacute-Chronic

iPad

Dose variable

4 weeks

–

X

Adherence

Dropouts

62%^G

Death (1); Good progress (3)

Grip Strength

NT

N

Satisfaction Survey

–

–

E 71%, C 67%

WMFT-Quality

NT

N

WMFT-Time

NT

N

Fluet (2019)

USA [40]

RCT

n = 11 (E 5, C 6)

E 58 (SD9), C 65 (SD

15) years

M:F not reported

Time since stroke not

reported

HoVRS*

20 min/session

 ≥ 1 session/day

7 days/week

12 weeks

–

X

Adherence

68%^T

BBT

NT

U

FMA

NT

U

IMI

–

–

E participants (n = 5) scored higher than C participants (n = 3) at pre- and post-intervention overall, and on interest/ enjoyment subscales

Housley (2016)

USA [43]

Case Series

n = 20 (UL 10)

67(± 11.4) years

19M:1F

Early Subacute-Chronic

HandMentor Pro™

1-2hrs/session

 ≥ 1 session/day

7 days/week

12 weeks

–

X

X

X

Adherence

Dropouts

79%^T

Medically

deteriorated

(1)

ARAT

Y

Y

FIM-Total

N

N

Satisfaction Survey

–

–

‘high’ satisfaction

Jordan (2014)

NZ [44]

Interrupted time

series with non-

parallel control

n = 13

68.6 (56.3–79.6) years

M:F not reported

Chronic

Smart Skate

45–60 min/

session

1 session/day

3–5 days/week

4–6 weeks

–

X

Dropouts

Personal

reasons (1)

FMA

Y

N

IMI

–

–

Average 6.12/7

Strength

Y

U

King (2012)

NZ [45]

Case Series

n = 3

56.3 (47–65) years

2M:1F

Chronic

CyWee Z

Participant selected

dose

8 weeks

–

X

X

Adherence

100%^G

DASH

NT

U

FMA

NT

N

IMI

–

–

Interest/ enjoyment: 31.33/49

Perceived choice: 18.33/49

Perceived competence: 28/42

Value/usefulness: 43.33/49

Effort/importance: 20.66/35

Langan (2013)

USA [46]

Case Series

n = 7

56 (47–63) years

5M:2F

Chronic

Stereognosis Training System

60 min/session

1 session/day

5 days/week

6 weeks

–

X

Adherence

Dropouts

90%^G

Unknown (1)

Kinematics

Y

U

Proprioception – Joint Movement

N

U

Proprioception – Tactile Discrimination

N

U

WMFT

NT

U

Lin (2013)

USA [47]

Case Series

n = 2

52.5 (48–57) years

0M:2F

Chronic

Looking Glass

60 min/session

1 session/day

7 days/week

–

X

X

Adherence

71%^S

ARAT

COPM

MAL

ROM

NT

NT

NT

NT

Y

Y

U

U

Linder (2013)

USA [48]

Case Study

n = 1

54 years

M

Late Subacute

HandMentor Pro™

3 hrs/day (2hours

HMP, 1hour HEP)

5 days/week

8 weeks

–

X

X

X

Adherence

56%^T

ARAT

NT

Y

FMA

NT

Y

SIS-ADL

NT

Y

SIS-Hand Function

NT

N

SIS-Mobility

NT

Y

SIS-Strength

NT

N

WMFT-Time

NT

Y

WMFT- Quality

NT

Y

Linder (2015)

USA [49]

RCT

n = 99 (E 51, C 48)^g

E 59.4(SD 13.6), C 55.5 (SD 12.6) years

E 31M:20F, C 33M:15F

Late Subacute

HandMentor Pro™

3 hrs/day (2hours

HMP, 1hour HEP)

5 days/week

8 weeks

–

X

X

Adherence

Dropouts

112%^T

Unknown (8)

SIS-ADL

Y

Y

SIS-Hand Function

Y

Y

SIS-Mobility

Y

Y

SIS-Strength

Y

Y

Nijenhuis (2015)

Netherlands, Italy, UK [50]

Case Series

n = 24^f

59 (34–80) years

10M:11F

Chronic

SCRIPT*

30 min/session

1 session/day

6 days/week

6 weeks

–

X

X

Adherence

Dropouts

58%^T

Shoulder

pain (1); Technical

issues (1); Desire not to

continue (1)

ARAT

N

N

FMA

Y

N

IMI

–

–

5.2 (SD 0.9)

MAL

N

N

SIS-ADL

N

N

SIS-Hand Function

N

N

SIS-Mobility

Y

N

SIS-Strength

Y

Y

SUS

–

–

69% (SD 17)

Nijenhuis (2017)

Netherlands [51]

RCT

n = 20 (E 10, C 10)

E 58 (48–65), C62 (54–

70) years

E 7M:2F; C 3M:7F

Chronic

SCRIPT

30 min/session

1 session/day

6 days/week

6 weeks

–

X

X

Adherence

Dropouts

66%^T

Shoulder

pain (1)

ARAT

N

N

BBT

N

N

FMA

N

N

Grip Strength

N

N

IMI

–

–

E 5.4, C 4.9

MAL

N

N

SIS-Overall

N

N

Pareto (2011)

Sweden [53]

Case Series

n = 3

83 (78–87) years

3M:0F

Late Subacute-Chronic

Curictus Immersive

Workbench

20 min/session

1 session/day

7 days/week

12–21 weeks

–

X

Adherence

18%^T

ARAT

BBT

EQ-5D-3L

Grip Strength

NT

NT

NT

NT

Y

U

Y

U

Rand (2015)

Israel [57]

RCT

n = 24 (E 13, C 11)^h

E 59.1 (33–75), C 64.9

(58–80) years

E 9M:4F, C 6M:5F

Chronic

Microsoft X-box

Kinect™ Playstation 2 Eyetoy™

60 min/session

1 session/day

6 days/week

5 weeks

–

X

X

Adherence

Dropouts

63%^T

Personal

reasons (2); Desire not to

continue (2)

ARAT

BBT

MAL

Y

Y

Y

N

U

N

Sivan (2014)

UK [58]

Case Series

n = 17^d

56.4 (SD 11.5) years

14M:3F

Chronic

hCAAR

30 min/session

1 session/day

5 days/week

8 weeks

–

X

X

Adherence

Dropouts

43%^T

Inadequate

space (1); Unable to

use technology

(1)

ABILHAND Questionnaire

Y

U

ARAT

Y

N

CAHAI

Y

Y

FMA

Y

N

mAS

Y

U

Reaching

Y

U

Strength

Y

U

Slijper (2014)

Sweden [60]

Case Series

n = 12

58 (26–66) years

5M:6F

Chronic

Gaming Console

Participant selected

dose

5 weeks

–

X

X

Adherence

Dropouts

100%^O

Medically

deteriorated

(1)

ABILHAND Questionnaire

N

Y

ARAT

Y

Y

FMA

Y

Y

Grip Strength

Y

U

Standen (2017)

UK [62]

RCT Feasibility

n = 27 (E 17, C 10)ⁱ

E 59 (SD 12.03), C 63

(SD 14.06) years

E 8M:9F, C 8M:2F

Early Subacute-Chronic

Virtual Glove

20 min/session

3 sessions/day

7 days/week

8 weeks

–

X

X

X

Dropouts

Medically

deteriorated

(2); Desire not to

continue (1); Family

commitment

(2)

MAL

NEADL

NHPT

WMFT

Y

N

N

N

Y

U

U

N

Thielbar (2020)

USA [64]

Randomised

Crossover

Trial

n = 20 (First SU 10, First MU 10)

First SU 59.7 (SD 10.5) years

First MU 59.8 (SD 4.8) years

First SU 8M:2F, First MU 9M:1F

Chronic

VERGE

60 min/session

1 session/day

4 days/week

4 weeks

–

X

Adherence

84%^G

FMA

Y

N

IMI

–

–

Value/usefulness: 6.6/7

Effort/importance: 6.4/7

Interest/enjoyment: > 5.5/7

Perceived competence: > 5.5/7

Wittmann (2016)

Switzerland [66]

Case Series

n = 11

60 (42–73) years

5M:6F

Late Subacute–Chronic

ArmeoSenso System

Participant selected

dose

6 weeks

–

X

X

X

Adherence

100%^G

Automated Reaching Assessment

Y

U

FMA

Y

N

ROM

N

U

WMFT

N

Y

Wolf (2015)

USA [67]

RCT

n = 99 (E 51, C 48)^g

E 59.1 (SD 12.2), C 54.7 (SD 14.1) years

E 25M:26F, C 31M:17F

Early Subacute-Late

Subacute

HandMentor Pro™

3 hrs/day (C 3 hours HEP; E 2 hours HMP,

1 hour HEP)

5 days/week

8 weeks

–

X

X

Adherence

Dropouts

112%^T

Medically

deteriorated

(1); Poor

adherence

(1); Desire not to

continue (1)

Moved onto

other

therapy (1); Incomplete

data (3)

ARAT

Y

N

FMA

Y

Y

WMFT-Quality

Y

N

WMFT-Time

Y

N

Yacoby (2019)

Israel [68]

RCT

n = 24 (E 13, C 11)^h

E 59.1 (33–74), C 64.9

(58–80) years

E 9M:4F, C 6M:5F

Chronic

Microsoft Kinect™ or Sony EyeToy™

60 min/session

1 session/day

6 days/week

5 weeks

–

X

X

X

Adherence

Dropouts

63%^T

Personal

reasons (2);

Desire not to

continue (2)

Perceived enjoyment

–

–

4.1/5

Perceived exertion

–

–

11.8/20

Perceived UL improvement

–

–

5/13 participants

Satisfaction

–

–

3.9/5

Mixed methods

Alankus (2010)

USA [29]

QL: Case Study

QT: Case Study

n = 1^j

62 years

F

Chronic

Looking Glass

60–75 min/

session

 ≥ 1 session/day

5 days/week

6 weeks

Semi-

structured

in-depth

interviews

X

X

Adherence

101%^T

ARAT

NT

N

RPS

NT

U

Bhattacharjya (2019)

USA [32]

QL: Specific

qualitative

methodology

not reported

QT: Case Series

n = 2

Age not reported

M:F not reported

Time since stroke not

reported

mRehab*

120 reps

 ≥ 1 session/day

5 days/week

6 weeks

Interview

X

X

Adherence

75%^S

–

–

–

Fu (2019)

USA [41]

QT: Case Series

QL: Specific

qualitative

methodology

not reported

n = 7

59.42 (40–77) years

4M:3F

Chronic

CCFES

45 min/session

2 sessions/day

6 days/week

12 weeks

Participant

journals

Interview

X

X

X

Adherence

Dropouts

110%^T

Poor

adherence

(1); Medically

deteriorated

(1); Other

commitment

(2)

AMAT

FMA

NT

NT

U

N

Hayward (2015)

Australia [42]

QL: Specific

qualitative

methodology

not reported

QT: Case Study

n = 1

1 stroke survivor

1 caregiver

57 years

M

Chronic

SMART Arm

60–80 reps/session

 ≥ 1 session/day

5 days/week

4 weeks

Observation,

researcher

and

participant

journals

X

X

X

Adherence

140%^R

MAL

NT

Y

mAS

NT

U

MAS

NT

U

Ritchie Articular Index

NT

U

SIS

NT

U

Strength

NT

U

Tardieu Scale

NT

U

Proffitt (2011)

USA [55]

QL: Specific

methodology

not reported

QT: Case Study

n = 1^j

62 years

F

Chronic

Looking Glass

60–75 min/ session

1 session/day

5 days/week

6 weeks

Observation,

semi-

structured

interviews,

participant

journal

X

X

Adherence

100%^G

ACS

ARAT

ROM

RPS

NT

NT

NT

NT

U

N

U

U

Proffitt (2015)

USA [56]

QL: Grounded

Theory

QT: Case Series

n = 4

57.25 (54–64) years

2M:2F

Chronic

Mystic Isle

4 hrs/week

6 weeks

Semi-

structured

interviews

X

Adherence

63%^T

COPM

NT

N

FMA

NT

N

SS-QOL

NT

U

SUS

–

–

2.70/5

Standen

(2015)

UK [61]

QL: Specific

methodology

not reported

QT: Prospective

Cohort Study

n = 13ⁱ

59 (40–82) years

5M:8F

Early Subacute-Chronic

Virtual Glove

20 min/session

3 sessions/day

7 days/week

8 weeks

Interviews

X

X

X

Adherence

Dropouts

17%^T

Medically

deteriorated

(2); Family

commitment

(2)

–

–

–

Szturm (2020)

Canada [63]

QL: Qualitative

Descriptive

QT: Case Series

n = 10

58 (SD 12) years

6M:4F

Late Subacute-Chronic

GTP

20 min/session

1 session/day

4 sessions/week

16 weeks

Semi-

structured

interviews

X

X

Adherence

Dropouts

100%^T

Unable to

use technology

(2)

Grip Strength

NT

N

Movement onset time – movement variance

NT

U

Object manipulation – average

NT

U

Object manipulation – success rate

NT

U

WMFT – Quality

NT

Y

WMFT – Time

NT

Y