Inclusion Criteria- Adult (age >18) patients will be invited to take part if they suffered a stroke between 3 months and 2 years previously
- The patient must have moderate to severe upper limb limitation (Upper Extremity Fugl-Meyer score 2050) due to the stroke
- Patients must have a minimum of 10 degrees of active wrist extension, 10 degrees of active thumb abduction/extension and 10 degrees active extension in at least 2 additional digits.
Exclusion Criteria- Other significant impairment of upper limb e.g. frozen shoulder
- Other diagnosis likely to interfere with rehabilitation/outcome assessments e.g. registered blind
- Patients with insufficient language skills to give informed consent and provide feedback both during the therapy sessions and in a semi structured interview.
- Severe cardiovascular disease or pathological ECG at baseline
- Patients participating in another rehabilitation trial
- Pregnant or trying to get pregnant