Abstract Purpose: To characterize physical activity of people using manual wheelchairs with spinal cord injury in Manitoba. Methods: An observational study of manual wheelchairs users with spinal cord injury. Participants completed surveys related to self-efficacy for exercise, physical activity participation, and shoulder pain. Accelerometers were worn for 7 days on the wrist and trunk (GT3X, 100 Hz, 5 s epochs) and completed an activity log concurrently. Individual specific thresholds were determined for moderate intensity during a pace graded wheeling trial. Physical activity and sedentary time were characterized using various derived variables. Results: Twenty five participants (12 tetra:13 para, 21M:4F) demonstrated excellent accelerometer adherence achieving an average of 6.2 days worn for over 13 hours per day. A total of 74.6 min (all activity) and 115 min (contiguous bouts of activity) were achieved over time worn (6.2 days), corresponding to 11.8 and 18.5 min/day respectively. The participants substantially exceeded the published SCI guidelines (40 min/week, P<0.01) but were under the able bodied threshold of 150 min/week (P<0.01). No relationships were observed between surveys and objectively measured PA. Characterization of PA bouts revealed few participants (n=7) exhibiting single bout durations greater than 10 minutes, with an average contiguous bout duration of 30 s. A new functional classification scheme revealed positive correlations to PA variables and wheeling performance. Sedentary times ranged from 6.25 to 8.4 hours per day depending upon accelerometer placement. Conclusion: Arm based accelerometry can be used to determine PA and sedentary characteristics of manual wheelchair users with individual specific moderate intensity thresholds. Participants exceeded the SCI specific activity guidelines in terms of time per week, and failed to reach bout durations of 20 min. This study supports the use of able-bodied PA guidelines as a target. A new functional classification scheme was derived based upon wheeling dependent muscle innervation that had enhanced prediction of PA relative to standard anatomical classification / October 2015

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