tDCS and Physical Therapy in Stroke

Inclusion Criteria: * First time clinical ischemic or hemorrhagic cerebrovascular accident (radiologically confirmed) * Demonstrates adequate balance while wearing a hand restraint on the unaffected arm * Ability to stand from a sitting position and ability to stand with or without upper extremity support * Stroke onset at least 6 months prior to study enrollment Exclusion Criteria: * Significant pre-stroke disability * Any substantial decrease in alertness, language reception, or attention that might interfere with understanding instructions for motor testing * Excessive pain in any joint of the paretic extremity * A terminal medical diagnosis consistent with survival of less than 1 year * Advanced liver, kidney, cardiac, or pulmonary disease * Coexistent major neurological or psychiatric disease (including epilepsy) * A history of significant alcohol or drug abuse in the prior 3 years * Use of neuropsychotropic drugs - such as antidepressants * Patients may not be actively enrolled in a separate intervention study targeting stroke recovery * Patients may not have already received constraint-induced movement therapy and/or tDCS treatment for stroke