Wheelchair users with spinal cord injury generally have a relatively inactive lifestyle. A number of studies have shown that an inactive lifestyle is associated with low fitness, poorer health, decreased social participation and lower quality of life for wheelchair users. There are several ways for wheelchair users to stay active in daily life.

• Today, science supports the role of exercise as a means of becoming healthy and fit in people with SCI and its role in improving performance of daily life activities, return to work and quality of life.
• If a wheelchair user with spinal cord injury wants to move from healthy exercise to competitive sports, classification is applied. Classification in Parasport is challenging and in need of research unraveling the impairment and ergonomic impact on sport-specific performance.
• A spinal cord injury, implies the loss of sensitive neural traffic from the periphery and of motor efferents to body regions innervated caudally to the lesion level. Moreover, functions relying on the autonomous nervous system are affected in proportion to the spinal lesion level. What effect do these changes have on the athlete?
• As physicians involved in the care and rehabilitation of aging athletes with SCI we need to know the agingrelated evidence-based recommendations for aging athletes with Spinal Cord Injury.

Health Related Ergonomics are also important, such as:

• The shoulder complex in SCI
• Interface pressure in SCI