Table 2.

Inclusion/exclusion criteria.

Inclusion criteria
1. Ischemic or hemorrhagic stroke (with confirmatory neuroimaging) within 28 days of admission to inpatient rehabilitation.
2. Age >21 years
3. Able to participate in first study-related treatment session within 30 days of stroke onset.
4. Able to participate in all study-related activities, including 1 year follow up and blood draws.
5. Persistent hemiparesis leading to impaired upper extremity function as indicated by a score ≥1 on the NIHSS motor arm score, AND motor impairment judged clinically appropriate as defined by one or both of the following:
a. Proximal UE voluntary activity indicated by a score of ≥3 on the upper arm item of the motor assessment scale; wrist and finger movement is not required. OR
b. Manual muscle test (MMT) score of ≥2 on shoulder flexion and either elbow flexion or extension.
6. Score of ≤8 on the short blessed memory orientation and concentration scale
7. Follows 2 step commands
8. No upper extremity injury or conditions that limited use prior to the stroke
9. Pre-stroke independence: modified rankin score 0 or 1
Exclusion criteria
1. Inability to give informed consent
2. Prior stroke with persistent motor impairment or other disabling neurologic condition such as multiple sclerosis, parkinsonism, ALS, dementia requiring medication
3. Rapidly improving motor function
4. Clinically significant fluctuations in mental status in the 72 h prior to randomization
5. Hemispatial neglect as determined by an asymmetry >3 errors on the mesulam symbol cancellation test.
6. Not independent prior to stroke (determined by scores of <95 on barthel index or >1 on modified rankin scale
7. Dense sensory loss indicated by a score of 2 on NIHSS sensory item
8. Ataxia out of proportion to weakness in the affected arm as defined by a score ≥1 on the NIHSS limb ataxia item.
9. Active or prior psychosis within 2 years
10. Active or prior (within 2 years) substance abuse
11. Not expected to survive 1 year due to other illnesses (cardiac disease, malignancy, etc)
12. Received UE botulinum toxin within 6 months. (other meds do not exclude)