Contralaterally Controlled Functional Electrical Stimulation Plus Video Games for Hand Therapy After Stroke

Inclusion Criteria

• •\> 6 months since a first clinical cortical or subcortical, hemorrhagic or nonhemorrhagic stroke
• •age 21-80 years old
• •unilateral upper limb hemiparesis with finger extensor strength of grade \<=4/5 on the Medical Research Council (MRC) scale AND a score of \>=1 and \<=11/14 on the hand section of the upper extremity Fugl-Meyer Assessment
• •adequate active movement of the shoulder and elbow to position the hand in the workspace for table-top task practice (necessary for the lab task practice sessions)
• •able to follow 3-stage commands
• •able to recall 2 of 3 words after 30 minutes
• •surface stimulation of the paretic finger and thumb extensors produces functional hand opening without pain (this will exclude those who have degree of flexor hypertonia that prevents stimulated hand opening)
• •Functional passive range of motion (minimal resistance) at elbow, wrist, fingers, and thumb, i.e., there exists enough passive range of motion to reach and acquire table-top objects
• •intact vision and hearing
• •medically stable
• •full voluntary opening/closing of the contralateral (less affected) hand
• •demonstrate ability to follow instructions for operating the stimulator or have a caregiver who will assist them