Inclusion Criteria- Stroke at more than 5 and less than 26 days ago.(Either first stroke or second stroke without detectable arm weakness after the first stroke).
- Modified ranking scale 0-2 before admission
- Persistent unilateral arm or hand paresis (Scandinavian Strokes scale (SSS) arm motor function 2-5 or SSS hand motor function 2-4)
- Able to lift two fingers with the forearm pronated on the table or able to extend the wrist at least 10 degrees from fully flexed position.
- Able to follow a two step command.
- Mini Mental State examination score of more than 20 (or more than 16 in combination with expressive aphasia)
Exclusion Criteria- Modified Rankin Scale > 4
- Unable to give informed consent
- Large hemispatial neglect (more than two cm on the Line Bisection Test)
- Not expected to survive one year due to other illnesses (eg cardiac, malignancy)
- Injury or condition in the affected upper extremity that limited use prior to the stroke.
- Other neurological condition affecting motor function