AMES + Brain Stimulation

Exclusion Criteria

• •Significant upper-extremity proprioceptive deficit (\<70% correct detection of the direction of passive finger movement, with eyes closed)
• •Cortical stroke involving the primary motor cortex
• •Epilepsy not controlled by medication
• •Botox injections 5 months before or during enrollment; use of intrathecal Baclofen
• •Residual pain in the tested arm
• •Significant neglect involving the affected limb (NIHSS 2 on the extinction and attention items)
• •Exercise intolerant
• •Uncontrolled hypertension or angina
• •Cognitive or behavioral inability to follow instructions
• •Current abuse of alcohol or drugs
• •Terminal illness with anticipated survival of \<12 months
• •Severe apraxia; inability to understand oral directions in English; or inability to communicate adequately with study personnel
• •Circumference of arm incompatible with the AMES device (checked by placing the limb in the device)
• •Contractures, decreased range of motion, or skin condition preventing tolerance of the AMES muscle vibrators
• •Spinal cord injury, arthritis, or fractures of affected limbs resulting in loss of range of motion
• •In the tested arm, peripheral nerve injury or neuropathy resulting in significant motor or sensory loss
• •Pathological neurological/physical condition other than stroke that impairs the function of the impaired arm or that produces pain in the impaired arm
• •Implanted device (e.g., cardiac pacemaker, Baclofen pump) the operation of which might be adversely affected by the brain stimulation
• •Previous vascular surgery on the blood vessels of the brain or heart or heart valve surgery
• •Female and pregnant