Finger Movement Training After Stroke

Human development as a species has been strongly associated with the ability to dexterously manipulate objects and tools. Unfortunately, current therapy efforts typically fail to restore fine manual control after stroke. The goal of this study is to evaluate a new intervention that would combine targeted electrical stimulation of selected nerves with use a soft, pneumatically actuated hand exoskeleton to enhance repetitive practice of independent movements of the fingers and thumb in order to improve rehabilitation of hand function after stroke.The investigators will recruit stroke survivors in the subacute phase of recovery (2-6 months post-stroke). These participants will be involved in a 6-week intervention involving 18 training sessions. During these sessions, participants will train independent movement of the digits of the paretic hand. Evaluation of motor control of the paretic hand will occur prior to initiation of training, at the midpoint of the training period, after completion of training, and one month later.

Inclusion Criteria:A single, unilateral stroke 2-6 months prior to enrollmentModerate to mild hand impairment, as determined by a rating of Stage 4-6 on the Stage of Hand section of the Chedoke-McMaster Stroke AssessmentVisual capacity to discern specific shapes on the computer screenCapacity to provide informed consentExclusion Criteria:Rigid contractures in the joints of the upper limbs, or orthopedic issues precluding joint movementHemispatial neglect (as assessed by the Behavioral Inattention Test)Excessive pain in the paretic upper limb (visual analog scale of shoulder pain < 70)