About this trial

This study is recruiting individuals with chronic incomplete cervical (neck area) spinal cord injuries to test different ways to strengthen nerve circuits to improve hand function. Muscles will be activated either by peripheral nerve stimulation (PNS) over nerves in the arm or by stimulating the brain with transcranial magnetic stimulation (TMS) over the scalp. Stimulation is given when a person is at rest or based on feedback from muscles as participants perform a task. Several stimulation protocols will be compared (PNS only, TMS only, PNS+TMS combined) while not moving or when triggered by muscles during a pinching task. If selected for the trial, all participants will receive all stimulation protocols at rest and while moving. Participants will undergo five different stimulation procedures of 20 minutes each. Researchers will compare outcomes of the various protocols for each participant and to a group of healthy controls to better understand the effects of SCI on stimulation and to determine the optimal approach.