OBJECTIVE: To examine and compare efficacy of 30-, 60-, and 120-minute repetitive task-specific practice (RTP) sessions incorporating use of an electrical stimulation neuroprosthesis (ESN) on affected upper-extremity (UE) movement. DESIGN: Prospective, single-blinded, randomized controlled trial. SETTING: Outpatient rehabilitation hospital. PARTICIPANTS: Chronic stroke subjects (n = 32) exhibiting moderate, stable affected UE motor deficits. INTERVENTIONS: Subjects participated in 30-, 60-, or 120-minute therapy sessions involving RTP incorporating the ESN, occurring every weekday for 8 weeks. During sessions, they wore the ESNs to enable performance of valued activities that they had identified. A fourth group participated in a 30-minute per weekday home exercise program. MAIN OUTCOME MEASURES: Outcomes were evaluated using the UE section of the Fugl-Meyer Assessment of Sensorimotor Impairment (FM), the Arm Motor Ability Test (AMAT), the Action Research Arm Test (ARAT), and Box and Block (BandB) 1 week before and 1 week after intervention. RESULTS: After intervention, subjects in the 120-minute condition were the only ones to exhibit significant score increases on the FM (p = 0.0007), AMAT functional ability scale (p = 0.002), AMAT quality of movement scale (p = 0.0002), and ARAT (p = 0.02). They also exhibited the largest changes in time to perform AMAT tasks and in BandB score, but these changes were nonsignificant (p = 0.15 and p = 0.10, respectively). CONCLUSIONS: One hundred and twenty minutes a day of RTP augmented by ESN use elicits the largest and most consistent UE motor changes in moderately impaired stroke subjects.

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