This study will examine the combination of myoelectric computer interface (MyoCI) training with targeted memory reactivation (TMR) in chronic stroke survivors. The study aims to determine whether this training-plus-sleep combination will generalize to improve arm motor function over an extended training protocol in stroke survivors.

Inclusion Criteria:

• Age at enrollment is 21 or older
• Hemiparesis from first ever stroke affecting arm movement at least 6 months prior to screening
• Severe to moderate motor impairment (FMA-UE of 7-40)
• At least some voluntary shoulder and elbow muscle activation

Exclusion Criteria:

• Inability to follow instructions of the MyoCI task
• Visual impairment (such as hemianopia) preventing full view of screen
• Anesthesia or neglect in the affected arm, or visual hemineglect (score of 2 on the NIH Stroke Scale Extinction and Inattention subtest)
• Participation in another study on the affected arm within 6 weeks of enrollment or any pharmacological study
• Inability to understand or follow commands in English due to aphasia or other reason
• Diffuse or multifocal infarcts in both hemispheres
• Substantial arm pain preventing participation for 90 minutes a day
• Spasticity treatment (pharmacological or Botox) within last 3 months
• Ferromagnetic implants that are MRI incompatible

Clinical functional outcomes and analyzed EMG (co-activation) will be uploaded and shared upon publication.

IPD and associated analytic code will be made available upon publication of research results and will remain available for the duration of the funded project.

Outcomes assessors and participant are blinded to groups.