Stroke is particularly prevalent in older people and the effects of stroke can be profound. Not only are the abilities to stand, balance and walk affected, but also the ability to use the upper limb and hand in its diversity of functions in everyday life. Loss of independence of upper limb function contributes enormously to functional disability, affecting quality of life and independence in ‘basic’ (washing, grooming, feeding, dressing, etc.) and ‘instrumental’ activities (shopping, home/financial management, etc.) of daily living. A larger proportion of stroke patients with initial severe upper limb paresis are discharged to institutionalized care (63%) than are discharged home (37%).