The objective of this study is to document longitudinal outcomes in persons with traumatic brain injury (TBI) using the myoelectric upper limb orthosis with powered elbow and grasp using both patient centric performance and patient reported outcome measures. Longitudinal observation will allow us to detect both the initial therapeutic effects as well as the later functional outcomes of orthosis use. We plan to recruit 15 Veterans and non-veterans who have TBI and upper limb impairment. The study requires 29 visits over 22 weeks and is divided into four parts: enrollment, orthotic fitting, therapy/training (9 weeks), and home use (9 weeks). Therapeutic and functional benefits will be evaluated every 2 to 3 weeks over 18 weeks using simple, short clinical tests.