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Abstract Objective The objective of this work was to evaluate if task‐specific training (TST) preceded by bilateral upper limb motor priming (BUMP) reduces upper limb impairment more than TST preceded by control priming ([CP], sham electrical stimulation) in people with chronic stroke. Methods In this single‐blind, randomized controlled trial, 76 adults with moderate to severe upper limb hemiparesis ≥6 months post‐stroke were stratified by baseline impairment and randomized to receive either BUMP or CP prior to receiving the same TST protocol. Participants completed 30 h of treatment in 15 days over 6 weeks. The primary outcome was change in Fugl‐Meyer upper extremity (FMUE) from baseline to 8‐week follow‐up. We also report clinically meaningful response rates defined as a change in FMUE score of 6 points or greater. Results In response to treatment, both groups improved to a significant extent at follow‐up, exceeding the FMUE minimum clinically important difference. Those in BUMP and CP saw a mean change of 5.68 (SE 0.76, p

Stroke is a leading cause of disability worldwide and upper limb hemiparesis is the most common post-stroke disability. Recent studies suggest that clinically significant motor recovery is possible in chronic stroke survivors with severe impairment of the upper limb. Three promising strategies that have been investigated are (1) high dose rehabilitation therapy (2) bilateral motor priming and (3) vagus nerve stimulation. We propose that the future of effective and efficient upper limb rehabilitation will likely require a combination of these approaches.