Digital Tools to Support Physical Activity in People With Spinal Cord Injury: Current Evidence, Practical Considerations, and Implications

Individuals with spinal cord injury often have low physical activity due to barriers such as transportation challenges, inaccessible facilities, and lack of adapted programs. Technology-enabled interventions (e.g., synchronous tele-exercise, smartphone apps, and wearable monitors) are emerging as scalable strategies to overcome these barriers. These programs are grounded in behavior-change frameworks (e.g., self-determination and social cognitive theories) and employ goal setting, feedback, and peer support to boost self-regulation skills. Recent studies indicate that supervised tele-exercise (live video-guided strength and aerobic training) is feasible and effective, yielding improved adherence and significant gains in fitness and health. Similarly, theory-driven apps and peer-coaching models have increased activity levels and reduced sedentary time. Importantly, implementation science approaches (e.g., stakeholder codesign) guide integration of these digital solutions into clinical practice. By aligning these innovations with kinesiology principles and implementation frameworks, such interventions can substantially enhance exercise participation in the spinal cord injury population.