Self-Supervised Constraint-Induced Movement Therapy for Stroke Recovery

Inclusion Criteria: * 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. Exclusion Criteria: * 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) * 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 …