Foundation principles

Targeted rehabilitation promotes neural plasticity: changes in the brain that support recovery and motor relearning. Intensive bilateral training, where both arms move together in activities which engage the patient, is associated with improvements in chronic stroke patients’ upper limb function.

Studies of animals after stroke suggest that enduring neuroplastic change requires far higher levels of exercise than the average 32 repetitions per session provided by conventional therapy. The body of research indicates that at least 16 hours of additional exercise is required beyond standard background therapy to improve the performance of normal daily tasks.

Clinical sites

stroke recovery pathwayThe ableX system is easy to adopt in a range of practicing rehabilitation settings, with minimal or no additional staff. At Royal Melbourne Hospital the ableX system is accessible to acute patients from Day 2 post-stroke. The 10-week Hand Hub intervention forms part of a patient’s rehabilitation journey from inpatient through to outpatient care.

Specialist rehabilitation centres, such as Laura Fergusson Rehabilitation in New Zealand, incorporate the ableX system into routine care for residential clients and are exploring its application to conditions other than stroke, such as traumatic brain injury.

General rehabilitation units and long term care facilities employ ableX as a stroke treatment tool when expert therapists are unavailable. For individual therapy clients the ableX system enables independent training which augments scheduled contact time. It can be reimbursed when recommended by independent rehabilitation practitioners.

Evidence base

The ableX and ableM devices have each been the subject of clinical studies, in conjunction with the ableX therapy games.

Participants with chronic stroke disability completed interventions of 9 hours (ableX) and 12 hours (ableM) respectively, and in both studies showed a statistically significant improvement in arm function. The published results compare favourably against more expensive robotic devices, and against commercial computer gaming systems.

Participants were also highly motivated to train independently at home on the ableX system, and they perceived additional benefits in concentration, coordination and balance. Contact us for a list of published research for the ableX system.

Implications for your practice

Healthcare providers and care teams are under pressure to make ever-better use of contact time and adopt tools which can both accelerate patient recovery and improve clinical productivity. Patients pass through the healthcare system without reaching their recovery potential because they don’t have enough access to intensive task-based training.

Incorporating the ableX system into routine care provides an immediate and recorded increase in patients’ total rehabilitation time and especially time engaged in active upper limb rehabilitation, for minimal or no change in staffing. The standard ableX intervention of 45-60 minutes per daily session aligns with current clinical recommendations for stroke and brain injury, and it provides far more intensive training than conventional one-to-one therapy. In many healthcare settings adding ableX to existing care represents an increase of >1 times current service provision.

A clinical application would see each patient assessed by a therapist within routine workflow, leading to a personalised ableX training programme. Daily administration of ableX can be performed by physio aides and nursing staff, while the system software automatically records and reports on adherence and progress. This offers the potential to quickly and significantly improve productivity and compliance with service performance targets.

Key features

ableX is designed specifically to be effective stroke treatment, catering for a wide range of abilities in hospital and continuous care after discharge.


  • ableX is easy to install and use, with oversized icons, cursor and text.
  • Simple game design avoids confusion and frustration.
  • Each game provides a progressive intensity of repeated movements, increasing accuracy, concentration and speed.
  • The ableX and ableM devices can be used in different ways, to progressively improve range of movement and control in multiple joints, strength, fine motor skills, and finger function.
  • Patients quickly become self-directed and require minimal to no supervision, making efficient use of nursing and aid staff, and encouraging positive recovery habits.
  • Feedback is automatically provided to patients during training. Data showing activity time (adherence), exercise intensity and progress are easily accessible to the therapist.
  • Training, programme design and prescription support is available to assist optimal use.

Practicing clinicians also apply the ableX system for patients with traumatic brain injury, dementia, cerebral palsy and similar neurophysical conditions where intensive task-based repetitive training improves patient outcomes. Patients with no prior movement in the affected arm have recovered function and even returned to work with the ableX system.

Ask us about our clinical packages to help you tailor ableX training routines for your patients’ rehabilitation goals.