Inclusion Criteria- acute phase of stroke
- first stroke episode.
- no history of peripheral nerve injury or musculoskeletal disease
- no contracture of the affected wrist or fingers (Modified Ashworth<3)
- no history of any invasive procedure (Botulinum toxin type A) for the treatment of spasticity for at least 6 months prior to the start of this study.
- paralysis of the wrist and fingers
Exclusion Criteria- unstable medical disorders, active Complex Regional Pain Syndrome (CRPS) severe spatial neglect, aphasia, or cognitive problems.
- scored greater than 4 points on the Beck Depression Inventory (BDI)
- more than 30 points in the State Trait Anxiety Inventory (STAI)