IpsiHand System for Rehabilitation of the Arm and Hand After Stroke

Inclusion Criteria: * Diagnosis of stroke(s), with most recent stroke at least 6 months prior to study start (can be ischemic or hemorrhagic) * PROM: Full extension of digits 2 and 3 at MPs, PIPs, and DIPs * English speaking * Intact cognition to provide informed consent * Intact language skills to comprehend and follow directions * Experiencing difficulty performing ADLs with affected upper limb * Upper extremity Botox allowable, but not required * Botox users must continue regimen at regular intervals for duration of study * Botox users will provide clinic note for each injection (date, dose, and muscle location) * Botox + Study Schedule * At study initiation, Botox injection will occur between 3-7 days prior to baseline measurement and initiation of device use * Repeat Botox injections must be completed at least 3 days prior to any administration of the outcome measures Exclusion Criteria: * Concurrent participation in another study * Co-morbid orthopedic condition/pain limiting functional use of the impaired upper limb * History of neurological disorder other than stroke * Botox user unable to comply with above noted requirements * Ongoing physical or occupational therapy addressing the upper limb * Ongoing electric stimulation or other rehabilitative devices (e.g. robotics, virtual reality) to upper limb * Cognitive impairment: Short Blessed Test Score 9 * Significant spasticity: Modified Ashworth Scale score 3 at the elbow * Significant hemispatial neglect: Mesulam Cancellation Test 3 unilaterally * Insufficient Strength: Motricity Index score for shoulder abduction 18 * Significantly impaired sensation of impaired upper limb: National Institutes of Health Stroke Scale - Item 8 (Sensory) score of 2 * History of cranioplasty * History of seizure disorder * No changes to usual exercises, splint use, or oral baclofen/anti-spasticity medication use during trial