Table 1.

Inclusion criteria.

• Age 18–90 years old at the time of randomization

• >6 months since a first clinical cortical or subcortical, ischemic or hemorrhagic stroke

• Severe upper limb hemiparesis defined as lacking ≥10-degrees active wrist extension or ≥10-degrees active thumb abduction/extension or ≥10-degrees active extension in at least two additional digits (i.e., will not meet minimum constraint induced movement therapy criteria)

• Memory of at least 2 out of 3 items after 30 min

• Able to perform 3-stage command

• Full volitional hand opening/closing of the non-paretic hand

• Ability to follow instructions for putting on and operating the contralaterally controlled functional electrical stimulation (CCFES) device or have a caregiver available to provide assistance

• Adequate active movement of shoulder and elbow to position the paretic hand on one's lap for performance of functional task practice and CCFES-assisted hand opening exercises

• Skin intact on hemiparetic arm

• Surface electrical stimulation of the paretic finger and thumb extensors produces functional hand opening without pain (this will exclude patients who have too much flexor spasticity)

• Able to hear and respond to cues from stimulator

• Completed occupational therapy at least 2 months prior to enrollment (no concomitant OT)