Approximately 80% of stroke survivors have hand impairment. A majority do not fully recover their hand function despite completing standard rehabilitation. Limited hand function results in learned non-use not only of the hand but also of the whole arm. This limited upper limb movement results in decreased independence and poor quality of life. It is known that training for proper movement patterns is important especially early in rehabilitation. The purpose of this project is to determine if training using hand exoskeleton to improve finger movement is feasible in stroke patients. Stroke survivors will receive training with 4 different control strategies to improve finger joint coordination.

Hand and arm disability after stroke has a profound, negative impact on functional ability and independence. Basic science research suggests that recovery requires high repetitions of task-specific practice. Enough practice cannot be completed during therapy sessions, requiring patients to perform additional task practices at home on their own. Adherence to these home task practices is often limited and is likely a factor reducing the effectiveness of rehabilitation post-stroke. This project will create a system to objectively track stroke survivors' hand and arm task practice at home. The quantity and quality feedback from the system is expected to optimize effective task practice at home by patients. The system is expected to also enable adherence- and progress-driven clinic visits to maximize efficiency of therapy service.

Hand disability after stroke has a profound negative impact on functional ability and independence. Hand therapy may be augmented with sensory stimulation for better outcomes. We have developed a novel sensory stimulation - unfelt vibration applied via a wristwatch. In this study, we will determine if combining this stimulation with hand task practice is superior to hand task practice alone.

The purpose of this study is to determine if 3-dimensional finger force training is an effective tool in restoring hand function post stroke. Persons who survived a stroke 3 to 12 months ago and have a hand impairment will be eligible to participate in this study. Participants will be asked to come to the laboratory to practice controlling the finger force generation 3 times a week for 6 weeks. Participants will see their performance on a computer screen. Participants will also come to the laboratory for additional 4-7 visits for assessments of their upper extremity function. The total duration of the study will be 2.5 months.