Nerve transfer rehabilitation is designed to train the individual in the new neural pathways created by the coaptation of a donor nerve to an injured recipient motor nerve. Patient education and donor muscle activation are the focus of the first of the three phases of the donor activation focused rehabilitation approach (DAFRA). Early attention to preservation of recipient muscle length is encouraged until active control of the muscle is achieved. Phase two highlights the various ways to enhance co-contraction of the donor with assisted motion in the recipient muscle(s). Advancement through the various phases is based on muscle strength assessments using manual muscle testing (MMT) grading system. Individuals who attain 3/5 MMT strength may advance to gradual strengthening in phase three. Recovery of strength is slow, and individuals are instructed to avoid recipient muscle fatigue with exercise and functional activities.