Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects and Mechanisms of Intensive Robot-Assisted Therapy in Patients With Subacute Stroke: Outcomes in Brain/Movement Reorganization, Sensorimotor and Daily Functions, and Physiological Markers.
Brief Summary: Robot-assisted training (RT) devices developed to date have a significant impact on stroke rehabilitation. Several research groups have developed the robotic devices and examined their efficacy on improving upper limb function after stroke. All these robotic devices have been applied in stroke rehabilitation and their efficacy are evaluated, but the scientific evidence for the mechanisms of RT-induced recovery, the optimal treatment intensity, and the impact on physiological responses is still lacking.

This trial is to examine (1) the immediate effects of treatment intensity in RT on sensorimotor impairments and functional performance in patients with subacute stroke; (2) the long-term benefits of treatment intensity in RT by conducting a 6-month follow up evaluation; and (3) the effects of RT on cortical/movement reorganization as well as on the physiological markers of inflammation, oxidative stress, and erythrocyte deformability. These overall findings will help better understanding of the efficacy of RT on functional outcomes, brain and movement reorganization, and physiological markers.


Options:
A: Inclusion Criteria:

* an ability to complete 10º of wrist or finger extension from a 60 - 65 º flexed position
* score less than a 56 on the UE subscale of the Fugl-Meyer Assessment
* an ability to voluntarily activate slight movements in the wrist and fingers so that the EMG activity reaches a minimal level on the microprocessor for electrical stimulation to be activated
* unilateral, first stroke of ischemic or hemorrhagic origin in the carotid artery distribution
* free of major post stroke complications
* able to attend therapy 2 days/week or 4 days/week for 2 weeks
* score at least a 16 on the Mini Mental Status Examination
* able to discriminate sharp from dull and light touch using traditional sensation tests.

Exclusion Criteria:

* hemiparetic arm is insensate
* motor impairments from stroke on opposite side of body
* pre-existing neurological disorders such as Parkinson's disease, Multiple Sclerosis, or dementia
* Legal blindness or severe visual impairment; 5) Life expectancy less than one year
* Severe arthritis or orthopedic problems that limit passive ranges of motion of upper extremity (passive finger extension \< 40º; passive wrist extension \< 40º; passive elbow extension \<40º; shoulder flexion/abduction \< 80º)
* History of sustained alcoholism or drug abuse in the last six months
* Has pacemaker or other implanted device
* pregnant
B: Inclusion Criteria:

* Patients with clinical diagnosis of acute ischemic stroke (first or recurrent) confirmed by CCT or MRI admitted to the Acute Vascular Unit of HCPA between the first 48 hours of onset of symptoms.
* Patients older than 18 years.
* Patients clinically and hemodynamically stable (SBP 120-220 mmHg, SatO2 up to 92% with or without supplementation, HR between 60 and 100 bmp, body temperature below 38 and RR below 25 bpm).
* Patients are able to react to verbal commands even without being fully alert (Glasgow Scale above 8).
* Prior Rankin until 3
* Motor deficit and / or coordination measured by the NIHSS

Exclusion Criteria:

* Patients with clinical and / or hemodynamic instability
* Patients with hemorrhagic stroke or TIA (transient ischemic attack).
* Patients with progressive neurological disease and acute coronary disease and / or unstable.
C: Inclusion Criteria:

* first episode of unilateral stroke
* time since stroke less than 3 months, i.e., acute or subacute stage
* initial motor part of upper limb of FMA score ranging from 10 to 40, indicating severe to moderate movement impairment
* no serious cognitive impairment (i.e., Mini Mental State Exam score \> 23)

Exclusion Criteria:

* pregnant or breastfeeding women
* aphasia that might interfere with understanding instructions
* major health problems or poor physical conditions that might limit participation
* currently participation in any other research. Potential participants will be also excluded if they have any contraindication to fMRI scanning including claustrophobia, seizures, the presence of pacemaker, mental elements (e.g., steel nails) inside the body or in the eyes, and excessive obesity.
D: Inclusion Criteria:

* Patients informed and giving their written consent.First
* Ever ischemic hemispheric or haemorrhagic stroke, unilateral, occurred between the 25th and the 72nd previous hours
* Age ≥ 18 years old
* Motricity quoted by an NIHSS \>=2 in the upper limb or in the lower limb

Exclusion Criteria:

* Patient without health insurance.
* Coma (NIHSS consciousness \> or = 2)
* Total recovery within the 24 first hours
* Brain stem or cerebellar stroke
* Previous neurological history, specially stroke or dementia
* Inability to understand the study
* Surgical treatment of the stroke
* Autonomy before stroke assessed by Rankin score different from 0
* Scheduled surgery in the following 15 days

Answer: C