Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Transcranial Direct Current Stimulation Paired With Robotic Arm Therapy on Recovery of Upper Extremity Motor Function in Stroke Patients
Brief Summary: The purpose of this study is to evaluate if multiple therapy sessions of Transcranial Direct Current Stimulation (tDCS non-invasive brain stimulation) combined with robotic arm therapy lead to a greater functional recovery in upper limb mobility after stroke than that provided by robotic arm therapy alone.


Options:
A: 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.
B: Inclusion Criteria:

* Males and females subjects. Age \> 18 years.
* Diagnosis of first ischemic stroke
* Impairment of the upper limb
* Trunk control defined in the Trunk-Control Test (TCT), with a score \> 50.

Exclusion Criteria:

* anyone who does not have adequate understanding of verbal or written information in Italian sufficient to complete any test
* Impaired cognitive functioning: score less than 24 on the Mini Mental Status Examination (MMSE)
* contraindications to single-pulse transcranial magnetic stimulation (TMS)(TMS will be used to measure cortical excitability): presence of a history of epilepsy, frequent headaches or neck pain, implantable devices (ventriculoperitoneal shunts, pacemakers, intrathecal pumps, intracranial metal implants)
* Contraindications to tDCS: intracranial metal implants that can be stimulated, incorrectly positioned or over-heated by the electric current
* Neurological or psychiatric pathology
* severe cardio-pulmonary, renal, hepatic diseases
* Pregnancy
C: Inclusion Criteria:

* Clinical diagnosis of stroke recorded in the health record;
* Age ≥ 18 years;
* Living at home for at least 3 months;
* Ability to walk a minimum of 10 metres with or without walking aids without assistance from another person;
* Ability to follow verbal instructions or demonstrations of the exercises;
* Ability to speak and read English; and
* Willingness to obtain medical clearance from a healthcare provider and sign a liability waiver.

Exclusion Criteria:

* Self-reported involvement in another formal exercise or rehabilitation program;
* Conditions or symptoms preventing participation in exercise (e.g., unstable cardiovascular disease, significant joint pain);
* Cognitive or behavioural deficits that would prevent cooperation within a group;
* Self-reported ability to walk more than 20 minutes without a seated rest; and
* Self-reported ability to manage environmental barriers (curbs, ramps, and stairs) with relative ease.
D: Inclusion Criteria:

* 18 years of age or older
* First single focal unilateral lesion with diagnosis verified by brain imaging, which occurred at least 6 months prior
* Cognitive function sufficient enough to understand experiments and follow instructions
* Fugl-Meyer assessment of 7 to 58 out of 66 (neither hemiplegic nor fully recovered motor function in the muscles of the shoulder, elbow, and wrist)

Exclusion Criteria:

* Botox treatment within 6 weeks of enrollment
* Fixed contraction of the affected limb
* Complete flaccid paralysis of the affected limb
* History of hemorrhagic stroke
* Ongoing use of CNS active medications
* Ongoing use of psychoactive medications
* Presence of additional potential tDCS/TMS risk factors including damaged skin at site of stimulation, presence of a magnetically/mechanically active implant, metal in the head, family history of epilepsy, and personal history of seizures

Answer: D