Pain and Fatigue are of clinical interest in informing the results of the trial.  There is a small possibility that either therapy could be associated with an overuse syndrome as expressed by a participant's experience of pain or fatigue.

  1. Pain will be considered to be a Adverse Reaction if (i) a participant reports the onset or increase of paretic upper limb pain (verbally or behaviourally), (ii) the pain is sustained over four therapy sessions and (iii) if the therapist and clinical team are unable to account for this in any other way than involvement in this trial.  This will be addressed by the therapist adjusting the therapy as appropriate or, if indicated, stopping the extra therapy on either a permanent or temporary basis.  The date of Adverse Reaction will be the date of the fourth therapy session.
  2. Fatigue will be considered to be a Adverse Reaction if (i) a participant demonstrates a decrease of two levels in the Motricity Index upper limb score on two consecutive therapy sessions and (ii) the therapist and clinical team are unable to account for this in any other way than involvement in this trial.  This will be addressed by the therapist adjusting the therapy as appropriate or, if indicated, stopping the extra therapy on either a permanent or temporary basis.  The date of Adverse Reaction will be the date of the second therapy session.