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Increasing physical activity is essential for health and quality of life for people with SCI. Physical inactivity leads to a host of secondary health conditions such as cardiovascular disease, type-2 diabetes, autonomic nervous system dysfunction, depression, pain, fatigue, and poor quality of life. Obesity, cardiovascular disease, and diabetes are two to four times higher for people with SCI compared to the general population. SCI physical activity guidelines were developed in 2011 and revised in 2018 that are focused on physical fitness and cardiometabolic health in adults with SCI. To date, no study has demonstrated the health benefits of meeting the SCI physical activity guidelines versus not meeting the guidelines. SCI Model system longitudinal follow-up provides the ideal setting to address this scientific question. Therefore, we propose a multi-site, cross-sectional, observational study with the primary goal of determining whether meeting the SCI physical activity guidelines is associated with improved health-related and psychosocial outcomes. While cross-sectional in nature, the findings from this study will be used to design future clinical trials testing the health benefits of meeting the SCI physical activity guidelines.