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 9 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.

The objective is to determine if continuous use of TheraBracelet in the home has a clinically meaningful effect in chronic stroke survivors. The study design is a double-blinded randomized controlled trial. We will enroll 40 chronic stroke survivors with moderate hand impairment. Subjects will be randomly assigned to the treatment or control group (n=20 per group). All subjects will wear the TheraBracelet device on the paretic wrist for 8 hours/day every day during their normal daily activity for 1 month. The device will deliver vibration (treatment) or no vibration (control). Double-blinding is possible because the treatment vibration is imperceptible (i.e., subthreshold). Measures of neural plasticity, the amount of the paretic arm use in daily living, clinical hand function, biomechanical grip control, and self-reported abilities for activities of daily living will be assessed at baseline, once a week during the month of wearing the device, and for 3-month follow-up, allowing determination of the efficacy and persistence.