BurtVision™ for Arm Rehabilitation in Chronic Stroke Survivors:

The proposed study is a single-blinded randomized clinical trial to evaluate the effect of using the BurtVistion on motor gains after robot-assisted upper-limb. Study participants (stroke survivors) will be recruited at the Spaulding Rehabilitation Hospital - Boston. Subjects will be randomly assigned to one of the two different groups: unimanual or unimanual + bimanual arm therapy using a block-randomized allocation procedure to ensure important covariates, such as baseline Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) scores and chronicity, are balanced between groups.

Inclusion criteria

• Male or female, 18-80 years old;
• Unilateral ischemic or hemorrhagic stroke at least 6 months and no more than 5 years prior to study enrollment;
• Upper extremity hemiparesis as characterized by initial scores on upper limb subtest of the Fugl-Meyer Assessment (FMA-UE) between 12 and 40;
• Some active pro-supination range of motion;
• Some active metacarpal-phalangeal joint in the hemiparetic hand;
• Intact cognitive function to understand the robotic therapy procedures (MMSE>23 and able to follow 3 step command) during initial evaluation visit;

Exclusion criteria

• Undergoing upper-limb rehabilitation therapy during the period of the study.
• Severe spasticity (defined as a Modified Ashworth scale score of 3 or more) that would prevent safe use of the robotic system;
• Visual impairments as assessed by the NIH Stroke Scale Visual Field subscale (only subjects with no visual loss will participate in the study); or hemispatial neglect that would impair the subject's ability to play the interactive games (as assessed with the line bisection test);
• Severe proprioceptive deficits that impair the ability to process haptic or visual feedback, as assessed by physical examination during screening;
• Communication impairments such aphasia that impair the subject's ability of providing feedback (as reported by a physician in his/her medical record);
• Individuals with open wounds or recent fracture (<3 months) in the upper extremity, fragile skin or active infection;
• Upper-extremity orthopedic injuries or severe pain resulting in movement limitations.