Table 1.

Selected Clinical Studies of Neurotechnology to Improve Upper Extremity Motor Function after Stroke.

Study	N	Study design; Time after stroke; Severity levels included	Improvement	Primary Outcome Achieved#
Therapy
EXCITE (Wolf et al., 2006)	222	RCT, constraint-induced movement (CIMT) therapy versus usual care; chronic stroke; range of severities	Wolf motor function test performance time decreased from 19.3 to 9.3 in CIMT versus 24 to 17.7 in usual care groups. Motor Activity Log (MAL) also increased more in the CIMT vs usual care.	+
CPASS (Dromerick et al., 2021)	72	RCT, 20 hours of additional (beyond usual care) task-specific motor therapy applied at either <= 30 day (acute) versus 2-3 months (subacute) versus >= 6 months (chronic) versus control (usual care); range of severities	Acute and subacute groups showed more ARAT change (~+6 points) as compared to controls while chronic group showed no difference (compared to control change).	+
Brain Stimulation
NICHE (Harvey et al., 2018)	167	RCT, 1 Hz (low-frequency) TMS to contralesional (non-injured) motor cortex vs sham stimulation prior to therapy sessions; chronic stroke; range of severities	UE-FM improved significantly in both experimental and sham stimulation groups (~8 points). Also no differences in improvement in ARAT or Wolf motor function between groups.	−
(Allman et al., 2016)	24	24, anodal tDCS versus sham paired with daily motor training for 9 days; chronic stroke; range of severities	UE-FM improved in both groups (~8 points, no differences between groups). ARAT and WMFT tests improved more in tDCS group compared to sham (10 versus 5 and 10 versus 3 for ARAT and WMFT respectively).	−
EVEREST (Levy et al., 2016)	164	RCT, Electrical epidural motor cortex stimulation (EECS) versus control prior to therapy; chronic stroke; moderate-severe UL deficits	Primary efficacy endpoint, defined as achieving minimum improvement of 4.5 points on UE-FM or 0.21 points of AMAT, was met by 32% in EECS vs 29% in control (no difference).	−
Brain Computer Interfaces
(Ramos-Murguialday et al., 2013)	32	RCT, BCI- (SMR-) driven hand/arm orthosis vs random, non-contingent, movements of orthosis; chronic stroke; severe UL deficits	UE-FM scores improved 3.41 points in the BCI-contingent group and no improvement in the non-contingent group, a significant difference.	+
(Bhagat et al., 2020)	10	Single-arm study of 12 therapy sessions of BCI enabled exoskeleton for elbow training; chronic stroke, range of severities	UE-FM and ARAT scores improved by 3.92 and 5.35 points respectively. 80% of participants achieved MCID on either UE-FM or ARAT.	+
Nerve Stimulation
(Conforto et al., 2010)	22	RCT, peripheral (median) nerve sensory stimulation at two different intensities (subsensory or suprasensory) immediately preceding motor training; subacute stroke; range of severities	Jebsen-Taylor hand scores improved in the subsensory intensity group but not in the suprasensory intensity group.	na
(Carrico et al., 2016)	36	RCT, peripheral nerve stimulation (2 hours) vs sham-stimulation followed by intensive task-oriented training (4 hours) in patients with severe; chronic stroke; severe UL deficits	There were statistically significant effects on UE-FM, WMFT, and ARAT post-intervention and at 1 month follow-up	+
(Dawson et al., 2021)	108	RCT, rehabilitation paired with VNS versus with sham stimulation; chronic stroke; moderate-severe UL deficits	UE-FM increased by 5 points in VNS group vs 2.4 points in control group. UE-FM MCID achieved in 47% (VNS) vs 24% (sham), a significant difference.	+

UE-FM = upper extremity Fugl-Meyer, ARAT = action arm research test, AMAT = arm motor ability test, WMFT = wolf motor function test, RCT = randomized controlled trial, VNS = vagus nerve stimulation, MCID = minimally clinically important difference, BCI = brain computer interface, SMR = sensorimotor rhythm,

^*ongoing trial-targeted enrollment