Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!



After reading this chapter, the reader will be able to:

  • Analyze the associated health risks of physical inactivity in an individual with a spinal cord injury (SCI)

  • Discuss the roles of rehabilitation professionals in recommending sport and physical activity participation, health promotion, prevention, and performance enhancement for persons with SCIs

  • Establish guidelines for safe and effective physical activity, fitness, training, and sport participation, including principles of exercise prescription and specificity of exercise

  • Access print and online resources to describe the scope of opportunities for physical activity and sport for persons with disabilities

  • Identify equipment and multimedia resources that support physical activity and fitness for persons with disabilities

  • Identify organizational and community resources that promote physical activity or provide recreational and competitive sport opportunities for persons with disabilities

  • Discuss strategies for prevention and reoccurrence of the most common athletic injuries and disability-specific medical conditions in athletes with SCI

  • Contrast functional and medical athlete classification systems used in competitive sport for athletes with disabilities


With increasing awareness of the influence of lifestyle choices on long-term outcomes in the general population, there is an expanding body of knowledge about the long-term health risks faced by the sedentary individual with spinal cord injury (SCI). The first records of sport in wheelchairs appeared in the post-World War II era, involving veterans who had been hospitalized with their war injuries. Since then, we have seen marked changes in the equipment, health care, and performance of athletes with SCI. Even with these significant advances, most persons with SCI fail to meet levels of physical activity recommended by the World Health Organization.1

The impact of a sedentary lifestyle is amplified in individuals with SCI due to unique metabolic factors that increase their risk for diabetes mellitus and heart disease.2,3 Obesity is a major problem in the population with SCI, with the prevalence of overweight and obesity among veterans with SCI estimated at 65.8% and 27.9%, respectively.4

Several authors have pointed to the need for health promotion and prevention of secondary disability in the population with SCI.5,6 Others have noted that health promotion needs after SCI are the same as in the general population, but information on health promotion is not frequently received from health providers.7 Over 20 years ago, the role of rehabilitation professionals in promoting safe participation in wheelchair sports was identified.8 Faced with a national physical inactivity crisis and a growing body of evidence that places the individual with SCI at high risk for cardiovascular disease, rehabilitation professionals must play a key role in promotion of life-long physical activity and prevention of secondary disability in this vulnerable population.

The purpose of this chapter is to present the latest evidence regarding health risks associated with physical inactivity in individuals with SCI; to discuss the role of the rehabilitation professional ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.