Inclusion Criteria:

• Spinal cord injury located at or below the seventh thoracic vertebrae.
• Manual wheelchair user (primary means of mobility)At least 6 months post-SCI.
• At least 18 years of age.
• Able to perform a high-intensity exercise program.
• Willingness to participate in 16 weeks of an exercise program.

Exclusion Criteria:

• Spinal cord injury at or above the sixth thoracic vertebrae.
• Manual wheelchair is not the primary means of mobility (e.g., community ambulators, power wheelchair users).
• Any documented or reported health condition that would be contraindicated to a progressive exercise program (active upper limb musculoskeletal injuries, autonomic instability, unstable cardiopulmonary disease such as unstable angina, COPD, etc., or pregnancy).
• Any illness or condition which, based on the research team’s assessment, will compromise with the patient’s ability to comply with the protocol, patient safety, or the validity of the data collected during this study.