Inclusion Criteria:  Age 18 to 85 years Suffered from a single ischemic stroke (radiologically confirmed) at least 6-months prior to enrollment An ability to score at least 3 blocks on the Box and Block Test  Exclusion Criteria:  A substantial decrease in alertness, language reception or attention Pregnant or lactating Advanced liver, kidney, cardiac or pulmonary disease Plan to alter any current participation in other rehabilitation therapy in the time period of the study A terminal medical diagnosis consistent with survival < 1 year Coexistent major neurological disease Coexistent major psychiatric disease A history of significant alcohol or drug abuse in the prior 3 years Current enrollment in another study related to stroke or stroke recovery Any other medical contraindication to participation in this study evaluated by our team physician.