Improving Adherence to Spinal Cord Injury Exercise Guidelines Using Smartphone-Based Technology and E-coaching: A Proof-of-Concept SMART-Design Study

Inclusion Criteria

Inclusion Criteria: Phase 1 * Individual with diagnosis of SCI, formal or informal caregiver of an individual with an SCI, or clinician that regularly sees individuals with SCI * 18-80 years of age * English-speaking * Willing to download the study apps Exclusion Criteria: Phase 1 * Severe visual or cognitive problems that would affect the ability to complete the study * Does not own, or is unable to use a smartphone Inclusion Criteria: Phase 2 and 3 * Individual with diagnosis of SCI, complete (only paraplegia) or incomplete, cervical C3- C4 and below * 18-80 years of age * English-speaking * Use a wheelchair as primary means of mobility or walk with or without assistive equipment * At least 1-year post-SCI * Not adhering to SCI-specific exercise guidelines as ascertained by self-report or during structured phone interview * Interested in increasing exercise levels * Ownership of a smartphone that can be used for the study and has a data plan * Willing to successfully download and learn to use the study apps * Able and willing to give written consent and comply with study procedures, including multiple in person follow-up visits Exclusion Criteria: Phase 2 and 3 * Trauma or surgery in the past three months * An active stage 3 or 4 pressure ulcer * Medically unstable to perform the home-based exercise as determined by Dr. Chen and his team, the evaluating physical therapist, or the participants' primary care physician. * Unable to use at least one set of extremities to exercise * Enrolled in a structured exercise program over the past three months * Severe visual or cognitive problems that would affect the ability to complete the study * Does not own, or is unable to use a smartphone