Inclusion Criteria- Capacity to give informed consent or witnessed informed consent in the event that the patient is unable to sign informed consent due to physical impairments
- Clinical diagnosis of cortical and/or subcortical ischaemic stroke in an area perfused by the middle cerebral artery (i.e. stroke due to ischaemia resulting in infarct located in the basal ganglia, internal capsule or corona radiata)
- Survived first 7 days following ischaemic stroke.
- A motor handicap 7 days after the onset of the ischaemic stroke, which includes as a minimum, the inability to extend an arm to a horizontal position with the palm upward against gravity and to maintain the arm extended horizontally against gravity without obvious downward drift for 30 seconds.
Exclusion Criteria- Prior history of stroke resulting in permanent, moderate to severe disability (i.e. Rankin Scale greater than 2) (other than the presenting ischaemic stroke)
- Stroke due to haemorrhage
- History of neurological or other disease resulting in significant functional impairment of the paretic arm impairing potential ability to pick up, lift and place a 2.5 cm3 block (e.g. Parkinson's disease, motor neuron disease, arthritis, Dupuytren's contracture or fixed anatomical abnormality)
- Patient with a severe comorbid disorder, not expected to survive more than 12 months
- Considered unlikely to be able to attend for all follow-up visits