To better comprehend the upper-limb needs and challenges stroke survivors face, and the issues associated with existing technology, the authors conversed with 153 members of the ecosystem (60 neuro patients, 30 caregivers, and 63 medical providers). Patients fell into two populations depending on their upper-limb impairment: spastic (stiff, clenched hands) and flaccid (limp hands). The authors chose to focus on the second category and developed a set of design constraints based on the information collected through customer discovery. With these in mind, they designed and prototyped OrthoHand Flex, a 3D-printed powered wrist-hand grasping orthosis (exoskeleton) to aid in recovery. The orthosis is easily custom-sized based on two parameters and derived anatomical relationships. The researchers tested the prototype on a survivor of stroke and modeled the kinematic behavior of the orthosis with and without load. The prototype neared or exceeded the target design constraints and was able to grasp objects consistently and stably, as well as exercise the patientsâ\euro™ hands. In particular, donning time was only 42 seconds, as compared to the next fastest time of 7 minutes reported in literature. This device has the potential to revolutionize neurorehabilitation by making assistive devices accessible to patients at home, and it lays the foundation for clinical trials and further device development