Inclusion Criteria- single ischemic stroke at least 3 months prior
- no active drug or alcohol abuse
- able to follow 2-step commands
- no history of more than minor head trauma, subarachnoid hemorrhage, dementia, drug or alcohol abuse, schizophrenia, serious medical illness, or refractory depression
- able to elevate UE in scapular plane (combination of flexion and abduction)at least 300 with at least 450 active elbow extension available during this movement and able to extend the wrist 200 and 2 fingers and the thumb 100 three times in a minute.
Exclusion Criteria- no movement in UE or no active 200 of wrist extension and no active 100 of thumb and finger extension three times in a minute
- spasticity greater than 2 on the Modified Ashworth Scale
- scores >3 on Motor Activity Log82 indicating poor use of UE
- able to complete shoulder flexion and abduction to shoulder height easily (e.g., doesn't hold breath, movement is fluid, little to no effort tremor observed) with elbow straight and able to complete checkers item on the WMFT9 within 16 seconds
- greater than mild hearing loss per audiogram.