Spinal Stimulation for Upper Extremity Recovery in the Home

Inclusion Criteria: * Age 18 or older * History of traumatic SCI * Less than 12 months post SCI * SCI injury level C1-C8 * SCI categorized as AIS B-D * Have passive range of motion (ROM) within functional limits at wrists, shoulders, and elbows * Have caregiver support to attend three in-person sessions and ongoing training at home * Have a caregiver who, in the judgment of the research team, is qualified to assist the participant in the safe use of TSS * Able to complete in-person training sessions and return to Craig Hospital for assessments * Experience no complicating physical or cognitive conditions as determined by their physician that would preclude the safe use of electrical stimulation * If using prescribed anti-spasticity medications, must be at a stable dose for at least four weeks prior to starting study procedures * Agrees to comply with investigational devices instructions for use, protocol visits, and return of the device * Able to provide informed consent Exclusion Criteria: * Experience unstable chronic cardiac or respiratory complaints * Have a recent history of fracture, contractures, or skin pressure injuries that might interfere with the intervention * Received Botox injections to the UEs, neck, or hands within the last three months * Pregnant, planning to become pregnant, or currently breastfeeding * Have breakdown in skin area that will come into contact with electrodes * Prior nerve or tendon transfer procedure for the UEs * Concurrently are participating in another drug or device trial that may interfere with this study * Have an implanted pacemaker, spinal cord stimulator, ventriculoperitoneal shunt, deep brain stimulator, or intrathecal pump * In the opinion of the investigators, the study is not safe or appropriate for the participant