Brain/Neural Hand Exoskeleton Control for Restoration of Bimanual Tasks

Inclusion Criteria (Stroke): * single ischemic or hemorrhagic insult with subcortical lesion (medullary canal, internal capsula, pedunculi cerebri) * interval since stroke at least 6 months * substantial motor deficit with: * Medical Research Council (MRC) -score of less than 2 out of 6 possible points (0=no activity; 1=visible contraction without motor effect; 2=movements with elimination of gravity; 3=movements against gravity; 4=movements against weak resistance; 5=normal force) * Fugl-Meyer Test (upper extremity) of less than 31 points, "no to little mobility" Inclusion Criteria (Spinal Cord Injury): * cervical spinal cord injury, height C5-C6 * interval after spinal cord injury at least 6 months * substantial motor deficit with American Spinal Cord Association (ASIA) -Classification B or C (A=no muscle function/sensitivity below the spinal cord injury; B=no muscle function, limited sensitivity present; C=low non-relevant muscle function, sensitivity present; D=functionally relevant muscle functions present; E=fully preserved or restored functions) Exclusion Criteria (Stroke and Spinal Cord Injury): * Alcohol or drug problem (regular consumption of more than 2 alcoholic beverages per day, or taking illegal drugs) * currently undergoing neurological or psychiatric treatment based on a secondary diagnosis * Severe and uncontrollable medical problems: * Non-adjusted malignant high blood pressure, World Health Organization (WHO) Hypertension Grade II * non-adjustable diabetes mellitus, HbA1c \> 58 mmol/mol * renal failure, from KDIGO glomerular filtration rate (GFR) category G3b (moderate to severe impairment) * Liver failure, Child-Pugh stages B and C * Heart failure New York Heart Association (NYHA) grade III-IV * malignant tumor disease * severe arrhythmia in need of treatment * severe oedemas * severe arthritis * serious cognitive impairment (minimum status below 23 points) * Severe spasticity (Ashworth grade ≥ 4) * Pregnancy * Bilateral motor deficit (in stroke patients)