Research advances in nerve transfer for upper limb function restoration: applications from peripheral nerve injury to central nervous system injury_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XU Jing ^1,2 , JING Yingli ² , GAO Haifeng ² , XIE Yujie ^1,2 , LIU Lina ^1,2 , QI Yuanyuan ^1,2 , CHEN Liang ² , LIU Hongwei ² ,  LI Jun ²

1. School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan Shandong, 250000, P. R. China;
2. Department of Spine and Spinal Cord Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, 100068, P. R. China;

Corresponding?author：

LI Jun, Email: lijun2009crrc@163.com

Keywords：

Nerve transfer; upper limb function reconstruction; brain remodeling; central nervous system injury; peripheral nerve injury

DOI：

10.7507/1002-1892.202601038

Video：

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Objective To review recent research progress on nerve transfer for the reconstruction of upper limb function following peripheral nerve injury and central nervous system injury. Methods A retrospective analysis of recent domestic and international literature on nerve transfer was conducted. The evolution of nerve transfer surgery from its application in peripheral nerve injuries to its extension to central nervous system injuries was described. The current therapeutic status of nerve transfer in upper limb hemiplegia resulting from spinal cord injury and brain injury was discussed, and the central role of central nervous system plasticity in postoperative functional recovery was analyzed. Results Nerve transfer is a crucial technique for upper limb function reconstruction, initially used to treat peripheral nerve injuries such as brachial plexus injuries. In recent years, this technique has gradually expanded into the field of central nervous system injuries. In cervical spinal cord injuries, various nerve transfer procedures can restore elbow flexion, wrist extension, and hand grasping functions, with efficacy correlated with the activation of plasticity in the spinal cord distal to the injury site. In cases of upper limb hemiplegia following brain injury, contralateral C₇ nerve transfer is the primary procedure, which can significantly reduce muscle tone and improve partial motor function; however, its ability to enhance fine motor skills and key muscle strength remains limited, and challenges such as maladaptive plasticity and co-activatory patterns persist. Mechanisms of central plasticity involve interhemispheric reorganization, activation of cortico-red nucleus-spinal pathways, and the remodeling of sensorimotor networks. Conclusion The expansion of nerve transfer techniques from “peripheral repair” to “induction of central plasticity” offers a new strategy for treating central upper limb paralysis. However, current applications in brain injury are limited by a lack of surgical diversity and restricted central plasticity. Future efforts should integrate cell/gene therapy, electrical stimulation, novel transfer techniques, and systematic rehabilitation training to enhance neural regeneration and central plasticity, thereby further improving therapeutic outcomes.

Citation： XU Jing, JING Yingli, GAO Haifeng, XIE Yujie, LIU Lina, QI Yuanyuan, CHEN Liang, LIU Hongwei, LI Jun. Research advances in nerve transfer for upper limb function restoration: applications from peripheral nerve injury to central nervous system injury. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(6): 995-1000. doi: 10.7507/1002-1892.202601038 Copy

1.	Anderson KD, Fridén J, Lieber RL. Acceptable benefits and risks associated with surgically improving arm function in individuals living with cervical spinal cord injury. Spinal Cord, 2009, 47(4): 334-338.
2.	Baer R, Feingold-Polak R, Ostrovsky D, et al. Correlation between kinetic and kinematic measures, clinical tests and subjective self-evaluation questionnaires of the affected upper limb in people after stroke. Front Neurosci, 2023, 17: 1264513. doi: 10.3389/fnins.2023.1264513.
3.	Gu YD, Zhang GM, Chen DS, et al. Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion. J Hand Surg (Br), 1992, 17(5): 518-521.
4.	Jack A, Rajshekar M, Witiw CD, et al. Characterization of spinal cord injury patients for arm functional restoration through nerve transfer. Can J Neurol Sci, 2024, 51(4): 477-481.
5.	Feng J, Li T, Lv M, et al. Reconstruction of paralyzed arm function in patients with hemiplegia through contralateral seventh cervical nerve cross transfer: a multicenter study and real-world practice guidance. EClinicalMedicine, 2022, 43: 101258. doi: 10.1016/j.eclinm.2021.101258.
6.	Yu BF, Chen LW, Qiu YQ, et al. Contralateral seventh cervical nerve transfer can affect the pennation angle of the lower limb in spastic hemiplegia patients: An observational case series study. Brain Behav, 2019, 9(12): e01460. doi: 10.1002/brb3.1460.
7.	Socolovsky M, Malessy M, Lopez D, et al. Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus, 2017, 42(3): E13. doi: 10.3171/2016.12.FOCUS16431.
8.	Lundborg G. Brain plasticity and hand surgery: an overview. J Hand Surg (Br), 2000, 25(3): 242-252.
9.	Vold?ich R, Vondra P, Skalková I, et al. Management of peripheral nerve injuries. Rozhl Chir, 2025, 104(10): 434-440.
10.	Oberlin C, Béal D, Leechavengvongs S, et al. Nerve transfer to biceps muscle using a part of ulnar nerve for C₅-C₆ avulsion of the brachial plexus: Anatomical study and report of four cases. J Hand Surg (Am), 2025, 50(4): 473-478.
11.	顧玉東, 張麗銀, 張高孟, 等. 肌皮神經肱肌支移位重建屈指功能解剖學研究與臨床病例報告. 中華手外科雜志, 2003, 19(4): 213-215.
12.	Xu B, Dong Z, Zhang CG, et al. Clinical outcome following transfer of the supinator motor branch to the posterior interosseous nerve in patients with C₇-T₁ brachial plexus palsy. J Reconstr Microsurg, 2015, 31(2): 102-106.
13.	Durand S, Estoppey D, Mercier J. Nerve transfer of the teres minor motor branch to the long head of the triceps muscle in C₆-T₁ brachial plexus palsy. J Hand Surg (Eur Vol), 2026, 51(2): 218-220.
14.	Anantavorasakul N, Piakong P, Kittithamvongs P, et al. Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve. J Hand Surg (Am), 2023, 48(11): 1168. e1-1168. e6.
15.	George SC, Burahee AS, Sanders AD, et al. Outcomes of anterior interosseous nerve transfer to restore intrinsic muscle function after high ulnar nerve injury. J Plast Reconstr Aesthet Surg, 2022, 75(2): 703-710.
16.	顧玉東. 手外科的現狀與展望. 中華手外科雜志, 2002, 18(1): 1-2.
17.	王樹鋒, 王海華, 蘇彥農, 等. 健側C₇神經根經椎體前通路移位修復臂叢神經損傷療效的初步觀察. 中華骨科雜志, 2004, 24(8): 453-456.
18.	彭峰, 蔡佩琴, 陳德松, 等. 健側C₇神經移位修復臂叢神經根干部損傷的改良術式. 中華手外科雜志, 2003, 19(2): 66-68.
19.	Lou L, Shou T, Li Z, et al. Transhemispheric functional reorganization of the motor cortex induced by the peripheral contralateral nerve transfer to the injured arm. Neuroscience, 2006, 138(4): 1225-1231.
20.	Jiang S, Li ZY, Hua XY, et al. Reorganization in motor cortex after brachial plexus avulsion injury and repair with the contralateral C₇ root transfer in rats. Microsurgery, 2010, 30(4): 314-320.
21.	Zuo CT, Hua XY, Guan YH, et al. Long-range plasticity between intact hemispheres after contralateral cervical nerve transfer in humans. J Neurosurg, 2010, 113(1): 133-140.
22.	Ma H, Zheng M, Lu Y, et al. Cerebral plasticity after contralateral cervical nerve transfer in human by longitudinal PET evaluation. J Clin Neurosci, 2018, 48: 95-99.
23.	Pang Z, Chen Y, Tong C, et al. Crossing nerve transfer restores limb movement by reorganizing the cortico-rubro-spinal pathway in peripheral nerve injury. Cell Rep, 2025, 44(9): 116192. doi: 10.1016/j.celrep.2025.116192.
24.	Wiemer VM, Paul T, Hensel L, et al. Structural reserve-dependent cortical rerouting of motor control after stroke. Brain, 2025. doi: 10.1093/brain/awaf434.
25.	Dechaumont-Palacin S, Marque P, De Boissezon X, et al. Neural correlates of proprioceptive integration in the contralesional hemisphere of very impaired patients shortly after a subcortical stroke: an FMRI study. Neurorehabil Neural Repair, 2008, 22(2): 154-165.
26.	Touvykine B, Mansoori BK, Jean-Charles L, et al. The effect of lesion size on the organization of the ipsilesional and contralesional motor cortex. Neurorehabil Neural Repair, 2016, 30(3): 280-292.
27.	Fox IK, Novak CB, Krauss EM, et al. The use of nerve transfers to restore upper extremity function in cervical spinal cord injury. PM R, 2018, 10(11): 1173-1184.
28.	Texakalidis P, Liu L, Karras CL, et al. Supinator to posterior interosseous nerve transfer to restore hand opening in brachial plexus and spinal cord injury: a systematic review and individual patient-data meta-analysis. J Neurosurg Spine, 2024, 41(5): 621-627.
29.	Bazarek S, Brown JM. The evolution of nerve transfers for spinal cord injury. Exp Neurol, 2020, 333: 113426. doi: 10.1016/j.expneurol.2020.113426.
30.	Emamhadi M, Andalib S. Double nerve transfer for restoration of hand grasp and release in C₇ tetraplegia following complete cervical spinal cord injury. Acta Neurochir (Wien), 2018, 160(11): 2219-2224.
31.	Teng YD, Zafonte RD. Prelude to the special issue on novel neurocircuit, cellular and molecular targets for developing functional rehabilitation therapies of neurotrauma. Exp Neurol, 2021, 341: 113689. doi: 10.1016/j.expneurol.2021.113689.
32.	Xu WD, Hua XY, Zheng MX, et al. Contralateral C₇ nerve root transfer in treatment of cerebral palsy in a child: case report. Microsurgery, 2011, 31(5): 404-408.
33.	Zheng MX, Hua XY, Feng JT, et al. Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis. N Engl J Med, 2018, 378(1): 22-34.
34.	Gao Z, Pang Z, Lei G, et al. Crossing nerve transfer drives sensory input-dependent plasticity for motor recovery after brain injury. Sci Adv, 2022, 8(35): eabn5899. doi: 10.1126/sciadv.abn5899.
35.	Feng J, Hu R, Lyu M, et al. Right C₇ neurotomy at the intervertebral foramen plus intensive speech and language therapy versus intensive speech and language therapy alone for chronic post-stroke aphasia: multicentre, randomised controlled trial. BMJ, 2025, 389: e083605. doi: 10.1136/bmj-2024-083605.
36.	Xiang Y, Xing X, Hua X, et al. Resting-state brain network remodeling after different nerve reconstruction surgeries: a functional magnetic resonance imaging study in brachial plexus injury rats. Neural Regen Res, 2025, 20(5): 1495-1504.
37.	Chapman PD, Kulkarni AS, Trevisan AJ, et al. A brain-wide map of descending inputs onto spinal V1 interneurons. Neuron, 2025, 113(4): 524-538.
38.	李校堃, 劉旭, 劉建華, 等. 細胞生長因子在神經康復與神經可塑性中的研究進展. 中國康復理論與實踐, 2022, 28(2): 175-182.
39.	Sun P, Li C, Yang C, et al. A biodegradable and flexible neural interface for transdermal optoelectronic modulation and regeneration of peripheral nerves. Nat Commun, 2024, 15(1): 4721. doi: 10.1038/s41467-024-49166-4.
40.	Grosu-Bularda A, Vancea CV, Hodea FV, et al. Optimizing peripheral nerve regeneration: surgical techniques, biomolecular and regenerative strategie—A narrative review. Int J Mol Sci, 2025, 26(8): 3895. doi. doi: 10.3390/ijms26083895.
41.	Lei G, Pang Z, Chen Y, et al. An in vivo wireless passive electrical stimulation device for promoting axon regeneration and enhancing sensory afferents after contralateral seventh nerve transfer surgery. Eur J Neurosci, 2025, 62(3): e70208. doi: 10.1111/ejn.70208.
42.	Chen J, Fan Y, Jia X, et al. The supplementary motor area as a flexible hub mediating behavioral and neuroplastic changes in motor sequence learning: A TMS and TMS-EEG study. Neurosci Bull, 2025, 41(5): 837-852.
43.	Wan KR, Ng ZYV, Wee SK, et al. Recovery of volitional motor control and overground walking in participants with chronic clinically motor complete spinal cord injury: restoration of rehabilitative function with epidural spinal stimulation (RESTORES) trial-a preliminary study. J Neurotrauma, 2024, 41(9-10): 1146-1162.
44.	Hu S, Zhu L, Zhao X, et al. Results of finger extension reconstruction in hemiplegic patients after stroke by transferring the flexor carpi radialis branch to the posterior interosseous nerve. J Plast Surg Hand Surg, 2025, 60: 146-152.
45.	Kobraei EM. Simultaneous use of the anterior interosseous nerve as both a target and donor nerve in radial to median nerve transfers. Plast Reconstr Surg Glob Open, 2024, 12(11): e6292. doi: 10.1097/GOX.0000000000006292.
46.	Lee CY, Howe TH. Effectiveness of activity-based task-oriented training on upper extremity recovery for adults with stroke: a systematic review. Am J Occup Ther, 2024, 78(2): 7802180070. doi: 10.5014/ajot.2024.050391.
47.	Xu H, Song L, Ma Y, et al. Effects of different rehabilitation therapies on upper extremity motor function and activities of daily living in hemiplegic patients with stroke: A network meta-analysis. Medicine (Baltimore), 2025, 104(45): e45662. doi: 10.1097/MD.0000000000045662.
48.	Liu J, Li Y, Zhao D, et al. Efficacy and safety of brain-computer interface for stroke rehabilitation: an overview of systematic review. Front Hum Neurosci, 2025, 19: 1525293. doi: 10.3389/fnhum.2025.1525293.

1. Anderson KD, Fridén J, Lieber RL. Acceptable benefits and risks associated with surgically improving arm function in individuals living with cervical spinal cord injury. Spinal Cord, 2009, 47(4): 334-338.
2. Baer R, Feingold-Polak R, Ostrovsky D, et al. Correlation between kinetic and kinematic measures, clinical tests and subjective self-evaluation questionnaires of the affected upper limb in people after stroke. Front Neurosci, 2023, 17: 1264513. doi: 10.3389/fnins.2023.1264513.
3. Gu YD, Zhang GM, Chen DS, et al. Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion. J Hand Surg (Br), 1992, 17(5): 518-521.
4. Jack A, Rajshekar M, Witiw CD, et al. Characterization of spinal cord injury patients for arm functional restoration through nerve transfer. Can J Neurol Sci, 2024, 51(4): 477-481.
5. Feng J, Li T, Lv M, et al. Reconstruction of paralyzed arm function in patients with hemiplegia through contralateral seventh cervical nerve cross transfer: a multicenter study and real-world practice guidance. EClinicalMedicine, 2022, 43: 101258. doi: 10.1016/j.eclinm.2021.101258.
6. Yu BF, Chen LW, Qiu YQ, et al. Contralateral seventh cervical nerve transfer can affect the pennation angle of the lower limb in spastic hemiplegia patients: An observational case series study. Brain Behav, 2019, 9(12): e01460. doi: 10.1002/brb3.1460.
7. Socolovsky M, Malessy M, Lopez D, et al. Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus, 2017, 42(3): E13. doi: 10.3171/2016.12.FOCUS16431.
8. Lundborg G. Brain plasticity and hand surgery: an overview. J Hand Surg (Br), 2000, 25(3): 242-252.
9. Vold?ich R, Vondra P, Skalková I, et al. Management of peripheral nerve injuries. Rozhl Chir, 2025, 104(10): 434-440.
10. Oberlin C, Béal D, Leechavengvongs S, et al. Nerve transfer to biceps muscle using a part of ulnar nerve for C₅-C₆ avulsion of the brachial plexus: Anatomical study and report of four cases. J Hand Surg (Am), 2025, 50(4): 473-478.
11. 顧玉東, 張麗銀, 張高孟, 等. 肌皮神經肱肌支移位重建屈指功能解剖學研究與臨床病例報告. 中華手外科雜志, 2003, 19(4): 213-215.
12. Xu B, Dong Z, Zhang CG, et al. Clinical outcome following transfer of the supinator motor branch to the posterior interosseous nerve in patients with C₇-T₁ brachial plexus palsy. J Reconstr Microsurg, 2015, 31(2): 102-106.
13. Durand S, Estoppey D, Mercier J. Nerve transfer of the teres minor motor branch to the long head of the triceps muscle in C₆-T₁ brachial plexus palsy. J Hand Surg (Eur Vol), 2026, 51(2): 218-220.
14. Anantavorasakul N, Piakong P, Kittithamvongs P, et al. Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve. J Hand Surg (Am), 2023, 48(11): 1168. e1-1168. e6.
15. George SC, Burahee AS, Sanders AD, et al. Outcomes of anterior interosseous nerve transfer to restore intrinsic muscle function after high ulnar nerve injury. J Plast Reconstr Aesthet Surg, 2022, 75(2): 703-710.
16. 顧玉東. 手外科的現狀與展望. 中華手外科雜志, 2002, 18(1): 1-2.
17. 王樹鋒, 王海華, 蘇彥農, 等. 健側C₇神經根經椎體前通路移位修復臂叢神經損傷療效的初步觀察. 中華骨科雜志, 2004, 24(8): 453-456.
18. 彭峰, 蔡佩琴, 陳德松, 等. 健側C₇神經移位修復臂叢神經根干部損傷的改良術式. 中華手外科雜志, 2003, 19(2): 66-68.
19. Lou L, Shou T, Li Z, et al. Transhemispheric functional reorganization of the motor cortex induced by the peripheral contralateral nerve transfer to the injured arm. Neuroscience, 2006, 138(4): 1225-1231.
20. Jiang S, Li ZY, Hua XY, et al. Reorganization in motor cortex after brachial plexus avulsion injury and repair with the contralateral C₇ root transfer in rats. Microsurgery, 2010, 30(4): 314-320.
21. Zuo CT, Hua XY, Guan YH, et al. Long-range plasticity between intact hemispheres after contralateral cervical nerve transfer in humans. J Neurosurg, 2010, 113(1): 133-140.
22. Ma H, Zheng M, Lu Y, et al. Cerebral plasticity after contralateral cervical nerve transfer in human by longitudinal PET evaluation. J Clin Neurosci, 2018, 48: 95-99.
23. Pang Z, Chen Y, Tong C, et al. Crossing nerve transfer restores limb movement by reorganizing the cortico-rubro-spinal pathway in peripheral nerve injury. Cell Rep, 2025, 44(9): 116192. doi: 10.1016/j.celrep.2025.116192.
24. Wiemer VM, Paul T, Hensel L, et al. Structural reserve-dependent cortical rerouting of motor control after stroke. Brain, 2025. doi: 10.1093/brain/awaf434.
25. Dechaumont-Palacin S, Marque P, De Boissezon X, et al. Neural correlates of proprioceptive integration in the contralesional hemisphere of very impaired patients shortly after a subcortical stroke: an FMRI study. Neurorehabil Neural Repair, 2008, 22(2): 154-165.
26. Touvykine B, Mansoori BK, Jean-Charles L, et al. The effect of lesion size on the organization of the ipsilesional and contralesional motor cortex. Neurorehabil Neural Repair, 2016, 30(3): 280-292.
27. Fox IK, Novak CB, Krauss EM, et al. The use of nerve transfers to restore upper extremity function in cervical spinal cord injury. PM R, 2018, 10(11): 1173-1184.
28. Texakalidis P, Liu L, Karras CL, et al. Supinator to posterior interosseous nerve transfer to restore hand opening in brachial plexus and spinal cord injury: a systematic review and individual patient-data meta-analysis. J Neurosurg Spine, 2024, 41(5): 621-627.
29. Bazarek S, Brown JM. The evolution of nerve transfers for spinal cord injury. Exp Neurol, 2020, 333: 113426. doi: 10.1016/j.expneurol.2020.113426.
30. Emamhadi M, Andalib S. Double nerve transfer for restoration of hand grasp and release in C₇ tetraplegia following complete cervical spinal cord injury. Acta Neurochir (Wien), 2018, 160(11): 2219-2224.
31. Teng YD, Zafonte RD. Prelude to the special issue on novel neurocircuit, cellular and molecular targets for developing functional rehabilitation therapies of neurotrauma. Exp Neurol, 2021, 341: 113689. doi: 10.1016/j.expneurol.2021.113689.
32. Xu WD, Hua XY, Zheng MX, et al. Contralateral C₇ nerve root transfer in treatment of cerebral palsy in a child: case report. Microsurgery, 2011, 31(5): 404-408.
33. Zheng MX, Hua XY, Feng JT, et al. Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis. N Engl J Med, 2018, 378(1): 22-34.
34. Gao Z, Pang Z, Lei G, et al. Crossing nerve transfer drives sensory input-dependent plasticity for motor recovery after brain injury. Sci Adv, 2022, 8(35): eabn5899. doi: 10.1126/sciadv.abn5899.
35. Feng J, Hu R, Lyu M, et al. Right C₇ neurotomy at the intervertebral foramen plus intensive speech and language therapy versus intensive speech and language therapy alone for chronic post-stroke aphasia: multicentre, randomised controlled trial. BMJ, 2025, 389: e083605. doi: 10.1136/bmj-2024-083605.
36. Xiang Y, Xing X, Hua X, et al. Resting-state brain network remodeling after different nerve reconstruction surgeries: a functional magnetic resonance imaging study in brachial plexus injury rats. Neural Regen Res, 2025, 20(5): 1495-1504.
37. Chapman PD, Kulkarni AS, Trevisan AJ, et al. A brain-wide map of descending inputs onto spinal V1 interneurons. Neuron, 2025, 113(4): 524-538.
38. 李校堃, 劉旭, 劉建華, 等. 細胞生長因子在神經康復與神經可塑性中的研究進展. 中國康復理論與實踐, 2022, 28(2): 175-182.
39. Sun P, Li C, Yang C, et al. A biodegradable and flexible neural interface for transdermal optoelectronic modulation and regeneration of peripheral nerves. Nat Commun, 2024, 15(1): 4721. doi: 10.1038/s41467-024-49166-4.
40. Grosu-Bularda A, Vancea CV, Hodea FV, et al. Optimizing peripheral nerve regeneration: surgical techniques, biomolecular and regenerative strategie—A narrative review. Int J Mol Sci, 2025, 26(8): 3895. doi. doi: 10.3390/ijms26083895.
41. Lei G, Pang Z, Chen Y, et al. An in vivo wireless passive electrical stimulation device for promoting axon regeneration and enhancing sensory afferents after contralateral seventh nerve transfer surgery. Eur J Neurosci, 2025, 62(3): e70208. doi: 10.1111/ejn.70208.
42. Chen J, Fan Y, Jia X, et al. The supplementary motor area as a flexible hub mediating behavioral and neuroplastic changes in motor sequence learning: A TMS and TMS-EEG study. Neurosci Bull, 2025, 41(5): 837-852.
43. Wan KR, Ng ZYV, Wee SK, et al. Recovery of volitional motor control and overground walking in participants with chronic clinically motor complete spinal cord injury: restoration of rehabilitative function with epidural spinal stimulation (RESTORES) trial-a preliminary study. J Neurotrauma, 2024, 41(9-10): 1146-1162.
44. Hu S, Zhu L, Zhao X, et al. Results of finger extension reconstruction in hemiplegic patients after stroke by transferring the flexor carpi radialis branch to the posterior interosseous nerve. J Plast Surg Hand Surg, 2025, 60: 146-152.
45. Kobraei EM. Simultaneous use of the anterior interosseous nerve as both a target and donor nerve in radial to median nerve transfers. Plast Reconstr Surg Glob Open, 2024, 12(11): e6292. doi: 10.1097/GOX.0000000000006292.
46. Lee CY, Howe TH. Effectiveness of activity-based task-oriented training on upper extremity recovery for adults with stroke: a systematic review. Am J Occup Ther, 2024, 78(2): 7802180070. doi: 10.5014/ajot.2024.050391.
47. Xu H, Song L, Ma Y, et al. Effects of different rehabilitation therapies on upper extremity motor function and activities of daily living in hemiplegic patients with stroke: A network meta-analysis. Medicine (Baltimore), 2025, 104(45): e45662. doi: 10.1097/MD.0000000000045662.
48. Liu J, Li Y, Zhao D, et al. Efficacy and safety of brain-computer interface for stroke rehabilitation: an overview of systematic review. Front Hum Neurosci, 2025, 19: 1525293. doi: 10.3389/fnhum.2025.1525293.

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Research advances in nerve transfer for upper limb function restoration: applications from peripheral nerve injury to central nervous system injury

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