Enabling Bedside Brain Measurement of Motor Outcomes Post Stroke

The goal of this basic neuroscience study is to learn whether visual feedback of brain activity can help improve arm and hand recovery in people who recently had a stroke. The study will also examine whether this type of training is practical to use during early stroke rehabilitation. Researchers will compare two groups of participants. Both groups will practice reaching for and grasping a cup, either by physically performing the movement or imagining the movement. One group will receive visual feedback showing their brain activity during practice. The other group will complete the same practice without seeing this feedback. Participants will be randomly assigned to one of these groups. The study will include 60 participants who had a stroke and who have weakness in one arm. Participants will complete 8 in-person sessions over 2 weeks. The first and last sessions will include tests of arm function, disability, quality of life, and brain activity. The 6 sessions in between will involve repeated movement or imagined movement practice. During the sessions, researchers will use functional near-infrared spectroscopy (fNIRS), a non-invasive brain imaging tool that shines light into the scalp to measure changes in brain activity. Small sensors placed on the skin of the arm and hand will also be used to measure muscle activity.

Inclusion Criteria: * Stroke patients in the subacute phase * upper extremity hemiparesis (\< or =4/5 manual muscle grade in at least one of the major upper extremity muscles) * Modified Rankin Scale (mRS) score of \