Trial sequential analysis constraint-induced movement therapy (CIMT) versus control for arm motor function (ARAT). Diversity-adjusted required information size of 252 patients calculated on basis of 12 MID of ARAT; a variance of 98; alpha = 5%; beta = 20%, and a diversity (D or rather D2 of 91%). The blue cumulative Z-curve crosses first the horizontal green line of conventional statistical significance (alpha = 0.05) during the second trial and then crossed the inward sloping red trial sequential monitoring boundary for benefit during the fifth trial. After the ninth trial, the cumulative Z-score for 199 patients of 2.31 is just below the trial sequential monitoring boundary score of 2.33. With 199 out of 252 (79.0%) patients randomized we still have insufficient evidence to accept or reject an effect of CIMT on ARAT, although it looked promising during the fifth, sixth, and seventh trials (disregarding the risks of bias). The analysis and the figure were made with the TSA software. Legend. Square symbol: z-score for single study; Diamond symbol: trial sequential monitoring boundary for benefit score for single study. Abbreviations: DARIS, diversity-adjusted required information size; MID, minimal important difference; var, variance; D, diversity; a, alpha; b, beta.