Inclusion Criteria- 18 years of age or older,
- Must be seen within three full working days of admission for screening
- Alert and Oriented to person and place with the ability to complete at a minimum a one step verbal command,
- Demonstrated active range of motion of 10 degrees shoulder flexion / abduction and 10 degrees of elbow flexion / extension
- 1/4 range of volitional finger flexion when the affected hand is passively positioned in a minimum of 15degrees of wrist extension with the MCP’s at neutral and PIP’s / DIP’s in extension
- Patient must be independent with seated posture in a chair with a firm seat and back support but no arm rests
- Patient can maintain independent seated balance when unaffected upper extremity is fully outstretched in any direction
- Admitted to inpatient stroke rehabilitation at Kessler Institute
Exclusion Criteria- Inpatient physician unwilling to clear patient to participate
- Medically unsuitable for therapeutic intervention,
- Using the affected hand and arm, able to volitionally grasp and release a racquet ball x10 at maximal volitional shoulder flexion with wrist extension of 10 degrees or more.
- Flaccidity in the affected UE or hand
- Fixed joint deformities, contractures or joint hypermobility that prevents proper joint positioning in the orthosis.
- Hx of rheumatoid arthritis, carpal tunnel syndrome or other hand neuropathy
- Moderate to severe weeping or pitting edema
- No previous stroke prior to the one prompting admission