Eligibility CriteriaInclusion criteria:
- Ischemic or hemorrhagic stroke that occured at least 6 months ago.
- At least 21 years of age
- Persistent arm and hand weakness, with some ability to release a grasp
- Able to provide consent to participate
- No history of a medical condition that limited arm or hand use prior to the stroke
- Medically stable
- Able to participate for 10 months and attend evaluations at the University of Southern California (USC) Health Sciences Campus.
- Able to communicate in English or Spanish.
- Severe upper extremity sensory impairment
- Current major depressive disorder
- Severe arthritis or orthopedic problems that limit arm or hand movement
- Pain that interferes with daily activities
- Currently enrolled in other rehabilitation or drug intervention studies
- Living too far from the training site to participate reliably
- Receiving oral or injected anti-spasticity medications during study treatment.