This report relays practical clinical information about the modification and use of commercially available training robot manipulators. Such manipulators were used to increase independence in the activities of daily living of patients with advanced Duchenne muscular dystrophy. The control panels of five industrial robot manipulator training devices were modified for use by advanced Duchenne muscular dystrophy patients. Six patients with only residual finger movement, three of whom were dependent on respiratory support, mastered the use of these devices. The four patients with long-term access employed their manipulators for facilitation of activities of daily living an average of 8 h a day for 3 +/- 1.8 yr. There was approximately 3 h of estimated attendant care time saved per patient per day.