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OBJECTIVES: To review the use of near-infrared spectroscopy (NIRS) in stroke rehabilitation and to evaluate NIRS test-retest reliability within-session on a motor control task commonly used in neuroimaging of stroke recovery. DESIGN: Cohort study. SETTING: Hospital-based research laboratory. PARTICIPANTS: Nineteen healthy control subjects (age range, 22-55y). INTERVENTIONS: Subjects performed 2 experimental runs of a finger-opposition task in a block-design paradigm (finger opposition alternated with a fixation rest period) while undergoing multichannel NIRS and physiologic monitoring. MAIN OUTCOME MEASURE: Reliability coefficients (Pearson r) for oxyhemoglobin (O(2)Hb) and deoxyhemoglobin (HHb) correlated amplitude modulations across measurement channels during individual blocks and block averages. RESULTS: Correlations between single blocks (ie, 16-s slices of data) exhibited a correlation intercept of .33+/-.09 for O(2)Hb. This value was minimally decreased by increasing lag between compared blocks (slope, -.012; P=.019) but was substantially enhanced by averaging across blocks (within-run slope, .11; between-run slope, .044). Correlations using 64 seconds of data reached 0.6. Results for HHb were virtually identical. CONCLUSIONS: NIRS modulations were repeatable even when comparing very short segments of data. When averaging longer data segments, the test-retest correspondences compared favorably to neuroimaging using other modalities. This suggests that NIRS is a reliable tool for longitudinal stroke rehabilitation and recovery studies. Copyright © 2006 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation [ABSTRACT FROM AUTHOR]