Inclusion Criteria- Age, 18 years or older;
- Ischemic or hemorrhagic stroke at least six months before, confirmed by computed tomography or magnetic resonance imaging;
- Moderate to severe motor impairment of an upper limb, defined as a score between 7 and 50 on the Fugl-Meyer Assessment of Sensorimotor Recovery after stroke, a scale with scores for upper limb ranging from 0 (no function) to 66 (normal function);
- Ability to provide written Informed Consent (patient or legal representative);
- Ability to comply with the schedule of interventions and evaluations in the protocol.
Exclusion Criteria- Lack of ability to voluntarily activate any active range of wrist extension;
- Anesthesia of the paretic hand;
- Severe spasticity at the paretic elbow, wrist, or fingers, defined as a score of >3 on the Modified Ashworth Spasticity Scale;
- Active joint deformity;
- Uncontrolled medical problems such as end-stage cancer or renal disease;
- Seizures, if current use of drugs that may decrease seizure threshold such as tryciclic antidepressants;
- Other neurological disorders such as Parkinson's disease;
- Psychiatric illness including severe depression;
- Aphasia or serious cognitive deficits that preclude comprehension of the experimental protocol or ability to provide consent;
- Treatment of upper limb spasticity with botulinum toxin within the past three months.