For adults with chronic spinal cord injuries at or below the T1 level and with moderate to severe paralysis, a 12-week program of twice-weekly upper body exercise and shoulder strengthening leads to a measurable increase in muscle mass compared to not doing any structured exercise.

In adults with chronic spinal cord injury at or below the T1 level and moderate to severe impairment, a 12-week program of upper limb aerobic exercise and shoulder strengthening may lead to a small increase in muscle mass and a small decrease in body fat percentage, as measured by bioelectrical impedance.

For adults with chronic spinal cord injuries at or below the T1 level and classified as AIS C or D, a 12-week program of twice-weekly upper body aerobic exercise and shoulder strengthening is associated with a measurable decrease in body fat percentage compared to no structured exercise.

Bioelectrical impedance analysis can measure changes in muscle mass and body fat in adults with chronic spinal cord injury after 12 weeks of exercise, even though the method is known to be less accurate for this group.

A specific exercise program designed for people with chronic spinal cord injuries, involving 20 minutes of upper body aerobic activity and shoulder strengthening exercises twice a week, can be carried out safely over 12 weeks without causing harmful side effects.