Inclusion Criteria- First unilateral ischemic stroke resulting in hemiparesis at least 6 months prior to enrollment.
- Age at time of enrollment: 30-80 years.
- Voluntary informed consent of patient.
- Patient willing to comply with protocol and is available for all scheduled visits.
- Residual upper extremity hemiparesis.
- No changes in medications planned during 8-week participation.
- No other motor rehabilitative therapy during 8-week participation, including E-stim and acupuncture.
- At least 20 degrees of active wrist extension and 10 degrees of active finger extension against gravity in the affected upper limb, as measured by goniometry.
Exclusion Criteria- Serious cognitive deficits, as evidenced by score of <20 on Modified Mini-Mental Status Exam
- Hemorrhagic or bilateral strokes
- Excessive spasticity at the elbow, wrist, or hand, defined as a Modified Ashworth Scale score of >2
- History of botulinum toxin injection in affected upper extremity in the past 4 months
- Lacking >40 degrees of passive elbow extension
- Less than 45 degrees of passive shoulder flexion
- Global or receptive aphasia present on physical exam
- Hemispatial neglect present on physical exam
- Patient participating in constraint-induced therapy during study time period
- Severe visual deficits or visual field deficits as determined by ability to ascertain number of fingers held up on visual field testing
- Deformity/amputation of unaffected upper limb