Participants and allocationStroke patients were referred to the study by their physicians or physical therapists. Patients were screened and invited to participate in the study on the basis of the following inclusion criteria: (a) they had to have had a first supratentorial stroke within the previous three months, ensured through the diagnosis of the primary care hospital, (b) be aged between 18 and 80 years and (c) be clinically diagnosed with a severe distal hemiparesis of the arm (Medical Research Council grading of 0 or 1 for wrist and finger extensors).Patients were excluded if they had (a) visual impairments which may limit the participation in mirror therapy, (b) severe cognitive and/or language deficits that could prevent them from following instructions, (c) other neurological or musculoskeletal impairments of the upper extremity unrelated to stroke and (d) a severe visuospatial neglect (clinically evaluation: the patients did not turn their face to an examiner on their contralesional side if they were asked to do so).