R01.Aim 2.Study 1: IsoReach

Prior treatment

• Botox or other botulinum toxin injection to the affected upper extremity within the previous 4 months
• Concurrent participation in upper extremity rehabilitation either as part of a research intervention protocol or a prescribed therapy

Other illness

• Aphasia, cognitive impairment, or affective dysfunction that would influence the ability to perform the experiment, This will be assessed using the Mini Mental State Examination31, with cut-off scores (adjusted for education level) as follows:
• Visual deficits, and hemispatial neglect that would prevent the participants from seeing the targets. A vision test will be done if the participant indicates in their screen that their stroke has affected their vision. This will be tested using the following assessments:
• diffuse/multiple lesion sites or multiple stroke events
• Neurological, neuromuscular, or orthopedic diseases (i.e. injuries to your affected arm or hand)

Other

• Severe medical problems (including cardiovascular, orthopedic, or neurological)
• Medical problems affecting movement, range of motion, strength, or coordination of the upper extremities.
• Visual deficits that would influence the ability to perform the experiment . This will be assessed using the following assessments:
• Visual field deficits will be assessed using the BIVABA acuity testing. (cutoff score \> 20/100)
• Depth perception deficits will be assessed using the Stereofly test (require at least an angle of stereopsis at 16 inches is 3,552 seconds of arc).
  • 4\) Blood pressure above 140 systolic and/or 90 diastolic mmHG
  • 5\) Blood oxygen reading of less than 92% by finger pulse oximeter testing.
• Bilateral paresis
• Participants whose education are 7th grade or lower, a score 22 or lower
• Participants whose education attainment level is 8th grade or some high school (but not a graduate), a score of 24 or lower
• Participants whose education attainment level is high school graduate, a score of 25 or lower
• Participants whose education attainment level is some college or higher, a score 26 or lower
• Visual field loss will be assessed using the BIVABA acuity test10. (cutoff score \> 20/100)
• Visual Extinction and Inattention using Star Cancellation Test9. (cutoff score of \<44)
• Depth perception deficits will be assessed using the Stereofly test (require at least an angle of stereopsis at 16 inches is 3,552 seconds of arc).
• Modified Ashworth score of 4 at shoulder or elbow joints.
• Rated below 15 on the FMUE scale
• Inability to provide an informed consent
• severe current medical problems
• Severe sensory deficit in the affected limb (Cannot be absent in any part of affected UE)
• Inability to attain and maintain testing positions
• Other neurological issues (Parkinson's, CP)
• Blood Pressure above 140 systolic and/or 90 diastolic mmHg
• Blood oxygen reading of less than 92% on finger pulse oximetry testing.

• 18 years old
  • No history of stroke
  • Ability to provide informed consent .
• 18 years old
  • Chronic stroke (8+ months post)
  • Available medical records and radiographic information about lesion locations
  • Hemiparesis
  • Primary motor cortex involvement
  • Some degree of both shoulder and elbow movement capability