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With many patients with a spinal cord injury experiencing physical deconditioning, we aim to compare the levels of exercise adherence using a customized phone application vs a non-customized application. Some participants will receive E-coaching depending on exercise adherence and we will also compare the effects of the frequency to which participants receive e-coaching.

The objective of this study is to conduct a proof-of-concept SMART study to determine the most effective adaptive intervention to improve exercise adherence and health and functional outcomes by comparing effects of two app-based interventions on adherence to exercise guidelines: customized exercise + non-interactive app  (Group 1) vs. customized exercise + interactive, customized app (Group 2). The effects of two augmented interventions on adherence to exercise guidelines will also be collected: E-coaching administered at different intervals throughout 3 months (if needed).

This study requires at least 3 in person visits to Shirley Ryan Â鶹APP, located in Chicago, IL. Eligibility will be determined through a phone screening with a member of the study team. A Sequential, Multiple Assignment, Randomized Trial (SMART) will be conducted with a timeline of up to 6 months consisting of initial randomization into Group 1 or Group 2 (interactive vs non-interactive app) in addition to an in person visit with the performance of a physical outcome measures. We will observe exercise adherence through the assigned phone app for 3 months. After the initial 3 months, physical outcomes in the lab will be performed again and some participants may receive e-coaching at varying intervals (x times per week) depending on level of adherence. Interventions will be maintained for another 3 months. In person visits to perform physical outcome measures will occur at intake, 12 weeks and 24 weeks.

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• 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 or walk with or without assistive equipment as primary means of mobility 
• 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 download the study apps

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The project is supported by the National Institute on Disability, Independent Living, and Rehabilitation Â鶹APP (NIDILRR), USA (grant no. 90SIMS0015).

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Want to participate in this study? Fill out this interest form.