Please select the eligibility criteria that correspond to the clinical trial below.
Title: Hybrid Approach to Mirror Therapy and Transcranial Direct Current Stimulation for Stroke Recovery: A Follow up Study on Brain Reorganization, Motor Performance of Upper Extremity, Daily Function, and Activity Participation
Brief Summary: We hypothesize that (1) the hybrid therapy will induce greater improvements on some health-related outcomes compared to other therapies; (2) such benefits will retain at 6-month follow-up; (3) better motor control and brain reorganization will be found in the hybrid therapy than the other therapies; (4) correlations will be found between brain activity and movement kinematics/health-related outcomes.


Options:
A: Inclusion Criteria:

* First episode of stroke in cortical regions
* Time since stroke more than 6 months
* Initial motor part of UE of FMA score ranging from 24 to 52, indicating moderate to mild movement impairment
* No severe spasticity in any joints of the affected arm (Modified Ashworth Scale ≤ 2)
* No serious cognitive impairment (i.e., Mini Mental State Exam score≧ 24)
* Willing to sign the informed consent form.

Exclusion Criteria:

* Aphasia that might interfere with understanding instructions
* Visual/attention impairments that might interfere with the seeing of mirror illusion, including hemineglect/hemianopsia
* Major health problems or poor physical conditions that might limit participation
* Currently participation in any other research
* Previous brain neurosurgery
* Metallic implants within the brain.
B: Inclusion Criteria:

* Adult patients (\> 18 years)
* CT or MRI proven acute ischemic (AIS) or hemorrhagic stroke (ICH) within 72h after onset of symptoms
* Severe hemiparesis (medical research council scale for muscle strength ≤2)
* premorbid modified Rankin Scale (mRS) ≤3
* maximal National Institute of Health Stroke Scale Score (NIHSS) 25
* Voluntary written consent by the patient

Exclusion Criteria:

* Severe cognitive impairment due to aphasia or dementia, prohibiting that physiotherapeutic challenges can be understood.
* Participation on another clinical trial
* Pregnancy
C: Inclusion Criteria:

* single symptomatic stroke more than 3 months ago with hand/arm weakness
* able to perform required tests and provide consent
* Age 18-80
* Modified Ashworth scale \<3
* range of motion functional at shoulder elbow wrist and hand

Exclusion Criteria:

* more than one symptomatic stroke in middle cerebral artery territory or bilateral involvement
* severe medical or psychiatric conditions, drug abuse, seizure disorder
* pregnancy/breast feeding
* subarachnoid hemorrhage, lobar hemorrhage
* patients who can not have tDCS (prior head surgery, pacemakers, metallic implants in the head etc)
* patients taking antiadrenergic medications
D: The inclusion criteria will be as follows:

1. patients with a first time intracerebral (either cortical or subcortical) hemorrhage with unilateral hemiparesis/ hemiplegia confirmed by magnetic resonance imaging or computed tomography;
2. patients with no contraindications to being mobilized (early intervention) within 24 hours of stroke onset (based on the medical team's clinical judgment: including systolic blood pressure (SBP)\<160mmHg in resting; resting heart rate (HR)\<130 bpm; no hydrocephalus; 80\< mean arterial pressure (MAP)\<110 mmHg before intervention);
3. patients with National Institutes of Health Stroke Scale (NIHSS) scores at admission ranging from 1 to 20;
4. patients with total activity of living independence pre-stroke; and
5. patients between 20 and 80 years old.

The exclusion criteria will be as follows:

1. patients with mild to moderate deficits as described above (3);
2. patients who are unable to complete the baseline survey because of serious aphasia, language difficulties, or cognitive deficits;
3. patients with other medical conditions, such as severe heart failure, acute coronary syndrome, or lower-limb disorders, that prevent early mobilization; and
4. patients who are unable to provide informed consent. In addition, we will exclude those showing rapid early deterioration of symptoms, as well as those with a concurrent diagnosis of rapidly deteriorating disease (e.g., terminal cancer).

Answer: A