Brief ReportRole of Instruction Adherence During Highly Structured Robotic Arm Training on Motor Outcomes for Individuals After Chronic StrokeKim, Grace J. OTR/L, PhD; Chen, Peii PhDAuthor Information From the Department of Occupational Therapy, New York University, New York, New York (GJK); Department of Physical Medicine and Rehabilitation, New York University Langone Health, New York City, New York (GJK); Kessler Foundation, West Orange, New Jersey (PC); and Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, New Jersey (PC). All correspondence should be addressed to: Grace J. Kim, OTR/L, PhD, 82 Washington Sq E, Pless Hall, 6th Flr, New York, NY 10003. Clinical Trial Registration No (primary study): NCT02890446. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com). Online date: November 5, 2019 American Journal of Physical Medicine & Rehabilitation: April 2020 - Volume 99 - Issue 4 - p 353-356 doi: 10.1097/PHM.0000000000001333 Buy SDC Metrics Abstract The aim of this study was to examine the effects of instruction adherence on upper limb motor outcomes after highly structured intervention. A secondary data analysis was completed using mixed linear modeling design. Thirty chronic stroke survivors with moderate-to-severe arm impairment were assigned explicit movement instructions and completed 12 robotic therapy sessions for 4 wks. Instruction adherence was measured weekly using the Manipulation Check Questionnaire. Motor outcomes were measured at baseline, discharge, and at 4-wk follow-up using the Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test–Functional Ability Scale. There were no effects of adherence-related variables on upper limb motor outcomes (P > 0.2). Participant scores improved for both Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test–Functional Ability Scale from baseline to follow-up (P < 0.001). Participants improved motor function after 12 wks of robotic training; however, instruction adherence did not affect motor improvement. Adherence to explicit information may play a limited role in motor learning for stroke survivors with moderate-to-severe arm impairment during highly structured training protocols. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.