In people with spinal cord injury, the use of a manual standard wheelchair increases energy needs, heart rate, oxygen consumption and ventilation, especially as speed and resistance levels increase, compared to ultralight wheelchairs and pushrim-activated, power-assisted wheelchairs. In addition, a carefully planned weight management program incorporating physical activity has been shown to reduce and/or maintain weight in overweight and obese individuals with spinal cord injury.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.