Inclusion Criteria:

• Age between 18 and 70 years.
• Duration since spinal cord injury ranging from 1 to 10 years.
• Spinal cord injury level at or above T4.
• MRI and/or CT imaging confirms adequate spinal cord decompression and spinal stability.
• Stable vital signs and no dependence on mechanical ventilation.
• Stable neurological and psychological status, with no history of neurological deterioration within the past 6 months (e.g., acute worsening of motor or sensory function, new-onset seizures, acute changes in muscle tone, or other neurological symptoms). Participants must be conscious, able to understand, and comply with study instructions. Clinical neurological examinations and imaging findings (MRI or CT) should demonstrate no new abnormalities.
• Willingness to participate in and comply with rehabilitation programs.
• Participants who have completed spinal cord electrical stimulation implantation surgery and/or are currently undergoing conventional rehabilitation therapy.

Exclusion Criteria:

• Patients with untreated fractures of the upper extremities.
• Patients with severe skin lesions or wounds that interfere with EMG electrode placement or the surgical sites for electrical stimulation implantation (e.g., chest/back, upper extremities, posterior cervical region, or subclavicular area).
• Patients with a history of other neurological diseases.
• Patients with known allergy or hypersensitivity to silver (Ag).