Integrated Tele-exercise for Individuals With Spinal Cord Injury

The objective of this study is to examine the efficacy of an integrated, participant-centered tele-health physical activity program for individuals with SCI on psychological and social factors through a parallel mixed-methods design approach. We will examine changes in psychological (self-efficacy, self-esteem, exercise outcome expectations, depression, positive affect and well-being, quality of life) and social factors (participation and satisfaction with social roles and activities, activity engagement) following participation in an 8-week integrated group tele-exercise health and wellness physical activity program, with retention assessed at 8-weeks following completion (16 weeks from baseline). We will also complete small group interviews with all participants to understand participant experiences of, response to, and recommendations before and following participation in group tele-exercise program. To date, there is extremely limited evidence for the efficacy of psychological and social well-being of remotely delivered community-based exercise to individuals with SCI. A pilot effectiveness trial of a tele-exercise health and wellness program will be conducted using a mixed methods design with a randomized waitlist control group. Quantitative and qualitative data collection is sequential in nature and other data are collected simultaneously. Individuals with SCI (living with injury 12 months or longer) will be recruited based on existing partnerships locally and nationally. To assess limited effectiveness, we aim to enroll 35 individuals with SCI. Recruitment of these participants will stem from the investigator's ongoing community partnership with local and national partners. The tele-exercise health \& wellness program will consist of virtual group class, twice per week, intended to generate physical confidence and strength for individuals living with SCI. Each session will be co-led with by an individual living with SCI.

Inclusion Criteria: * report a complete or incomplete SCI of ASIA grade A, B, C, or D * living with injury at least 12 months * self-reported ability to elevate shoulder 25% motion * self-report being between 18-75 years of age * self report not currently receiving structured rehabilitation, * cleared by screen by ACSM guidelines for participation * Internet access to participate in virtual classes Exclusion Criteria: * absolute contraindications as identified by ACSM21 * self-report previous hospitalization within a month * self report active pressure ulcer * self report recent osteoporotic fracture * self-report uncorrectable vision loss, * self report preexisting neurological conditions other than SCI