Telerehabilitation Early After CNS Injury

Prior treatment

• Shoulder pain that in the judgement of the study team is likely to substantially limit the amount of TR therapy completed

Other illness

• A major, active, coexistent neurological or psychiatric disease that would limit study participation, e.g., advanced dementia or active psychosis

Other

• Expectation that patient's cognitive status will likely interfere substantially with playing assigned games or exercises
• Deficits in communication that interfere with reasonable study participation
• Lacking visual acuity, with or without corrective lens, of 20/50 or better in at least one eye
• Subject does not speak sufficient English to comply with study procedures

• Age 18 years or older
• CNS injury with onset in the prior 90 days
  • For stroke: Stroke that is radiologically verified and due to ischemia or to intracerebral hemorrhage.
  • For traumatic brain injury: History that is consistent with TBI; and score on the Revised Rancho Levels of Cognitive Functioning Scale is at least 6 out of 10.
  • For spinal cord injury: Traumatic or nontraumatic, incomplete cervical SCI.
• At least one arm must have motor deficits that are neither very mild nor devastating (dense arm plegia). Operationally, this requires that the Visit 1 Box \& Block Test score is at least 1 block, but no more than 30 blocks, in 60 seconds.
• Possess enough arm movement to participate in therapy, including able to hold the HandyMotion device in the paretic hand(s), using an assistive device if needed.
• Informed consent signed by the subject (no surrogate consent permitted for this study)
• Able to follow simple instructions
• Study participation is not likely to be significantly limited by agitated behavior