This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a two center, single-blinded randomized clinical trial. A total of 189 stroke survivors within 3 months of their stroke will be enrolled and randomized to one of three groups: 1) cyclic neuromuscular electrical stimulation (NMES), 2) EMG-triggered NMES, and 3) cyclic sensory stimulation. Cyclic NMES will provide repetitive wrist and finger extension without input from the subject, EMG-triggered NMES will provide repetitive wrist and finger extension in response to volitionally activated EMG signal from the paretic wrist extensor, and sensory stimulation will provide repetitive sensory stimulation without motor activation. All subjects will be treated for 80 minutes per day, 5 days per week, for 8 weeks. Initial training will be provided on the inpatient stroke rehabilitation unit and then treatments will be completed at home. Blinded assessments of motor impairment (Fugl-Meyer Motor Assessment) and activity limitation (Arm Motor Ability Test) will be administered at baseline, mid-treatment, end of treatment, and at 1, 3, and 6 months after completion of treatment.
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