virtual reality and recreational activity (active control) as addon therapies to conventional rehabilitation after an acute stroke. Outcomes were assessed at the end of the 2 week intervention and again 4 weeks post-intervention. We found no signifi cant diff erence in motor recovery after stroke between non-immersive virtual reality and simple recreational activities, although each group showed a signifi cant improvement relative to baseline. Implications of all the available evidence Our fi ndings suggest that added intensity of training, whether with virtual reality or other simple and inexpensive arm activities (eg, playing cards or dominoes), improves early motor recovery of the upper limb after stroke. Considering that the greatest burden of stroke occurs in low-income and middleincome countries with constrained resources and limited access to technologies and rehabilitation therapists, simple, low-cost, high-intensity, and task-specifi c home-based therapies appear comparable with virtual reality to optimise motor recovery post-stroke.