Transcutaneous Spinal and Peripheral Stimulation and Wrist Robotic Therapy for Patients With Spastic Stroke

Inclusion Criteria: * ≥ 18 years of age * First and only single focal unilateral hemisphere lesion with diagnosis verified by brain imaging (MRI or CT scans) that occurred at least 6 months prior * Cognitive function sufficient to understand the experiments and follow instructions (per interview with PI or study investigators) * Fugl-Meyer assessment (minimum score of 12 out of 66 - not completely plegic in the muscles of affected wrist) * A Modified Ashworth score between 1-3 points for wrist flexors and extensors * A minimum of 15 degrees wrist passive ROM for wrist flexion and extension from wrist neutral position * Body fat range of 15-25mm for females/10-20mm for males of adipose tissue at the cervical neck level and a body fat range of 10-40mm for females/5-35mm for males of adipose tissue at the suprailiac crest, as determined by a body fat caliper Exclusion Criteria: * Botox or phenol alcohol treatment of the upper extremity within 3 months of stimulation intervention * Fixed contracture or complete flaccid paralysis of the affected wrist * Introduction of any new rehabilitation interventions during study * Pregnant or plan on becoming pregnant or breastfeeding during the study period as determined by self-report * Focal brainstem or thalamic infarcts * Prior surgical treatments for spasticity of the upper limb * Ongoing use of CNS-active medications for spasticity (enrollment to be determined by PI review) * History of spinal cord injury or weakness * Chronic pain…