Inclusion Criteria:  between 18 and 70 years of age use a manual wheelchair for at least 50% of community mobility able to transfer independently (with or without the use of adaptive equipment) able to achieve humeral elevation of greater than or equal to 90 degrees (bilaterally) cleared for exercise participation as indicated by the ACSM Preparticipation Health Screening (Riebe et al., 2015) able to read and understand English  Exclusion Criteria:  have an active pressure sore or skin breakdown have a presence of shoulder pain as indicated by a score of greater than 12 on the Wheelchair Users Shoulder Pain Index (Mulroy et al., 2015) have impaired upper extremity function as indicated by a score of greater than 40 on the QuickDASH (Angst et al., 2011; Kennedy et al., 2011)