This study attempts to identify a difference between a virtually simulated program of repetitive task practice and a similar program of traditionally presented activities. 30 subjects with chronic stroke performed one of the two programs for eight three hour sessions which were performed in a two week period. Both groups demonstrated statistically significant improvements in Upper Extemity Fugyl-Meyer Assessment (UEFMA), Wolf Motor Test and Jebsen-Taylor Tests of Hand Function. Gains in UEFMA were maintained at follow-up. WMFT and JTHF retention scores exceeded baseline at a less than significant level. When comparing the two groups, there were no statistically significant differences at any of the three measurement times and no significant group time interactions. Notable differences in therapist supervision and space requirements suggest that VR based interventions may be able to produce comparable outcomes in a more efficient manner. Continued decreases in the cost of technology may leverage these efficiencies to the point that VR based interventions may become a more cost effective alternative than real-world based therapy.