Self-Supervised Constraint-Induced Movement Therapy for Stroke Recovery

Prior treatment

• Inability to actively participate in regular therapy sessions (e.g., due to medical complexity, insufficient endurance, transportation, etc.) as determined by participant or by clinical judgement of the evaluating therapist
• Receiving occupational therapy services for the hemiparetic UE during the two-week intervention window (including after pre-assessment and before post-assessment)
• Received focal anti-spasticity drug injection (e.g., Botox) to any muscles of the impaired UE within the past 1 month (or plan to at some point during study enrollment)

Other illness

• Comorbid diagnosis in addition to stroke (e.g., dementia, peripheral neuropathy) that in the opinion of the investigator could impact study results
• Presence of moderate to severe unilateral spatial neglect as indicated by clinical observation or failure on a standardized screening tool (e.g., Line Bisection Test or Bells Test).

Other

• Excessive pain in the affected shoulder, arm, or hand as measured by a score ≥6 on a 10-point visual analogue scale
• Unable to passively reach neutral position for wrist extension and forearm supination
• Excessive spasticity in the affected wrist or finger flexors/extensors and elbow flexors, as defined as a score of \>2 on the Modified Ashworth Scale (MAS)

• Sustained a first-time ischemic or hemorrhagic stroke ≥2 weeks prior to study enrollment
• Age ≥18 and ≤85
• Moderate UE hemiparesis as defined by a score ≥13 and ≤47 on the modified UE section of the Fugl-Meyer Assessment (60-point scale with no reflex testing)
• Ability to actively extend impaired wrist ≥10 degrees
• UE strength and active range of motion within functional limits on the non-hemiparetic side
• Ability to follow two-step commands (visual or verbal) as determined by the clinical investigator
• Nonuse of the more impaired UE as evidenced by an average score ≤2.5 on the Motor Activity Log Amount of Use Scale.