Inclusion Criteria- First time unilateral stroke > 3 months post stroke.
- Cognitively be able to follow direction
- Cognitively be able to consent to participation in research study
- Moderate/severe deficits as per the Fugl-Meyer assessment score from 10-50 and the ability to grasp and release a small towel or washcloth.
Exclusion Criteria- Complex medical problems, that would render the subject unable to participate in an extensive home program
- History of pre-existing neurological or psychiatric diseases, orthopedic conditions of the upper limbs, or peripheral nerve injuries that render the subject unable to sit or to move either upper limb
- Hearing and vision impairments which may impede subjects participation in the home program
- Perceptual deficits such as apraxia, neglect, or agnosias as per clinical evaluation which may impede subjects participation in the home program
- Botox injection in affected arm/hand within 3 months
- Global aphasia that may interfere with understanding instruction for testing or home exercise program.