Strong evidence suggests that high levels of activity reduce the risk of cardiovascular disease (Froelicher & Brown 1981; Kottke et al. 1984; Leon & Blackburn 1977; Wyndham 1979), obesity (Pollock as al. 1984), diabetes (King et al. 1984), and osteoporosis (King et al. 1984). (Aloia etal. 1978) Cardiovascular diseases appear to be the leading cause of death in persons with spinal cord injury, according to a recent report (Le & Price 1982). Cardiovascular fitness is extremely important in the wheelchair-dependent population due to the considerable circulatory stress imposed by wheelchair propulsion.
