Approximately 11,000 individuals in North America sustain a spinal cord injury (SCI) every year. Presently there are over 300,000 people living with SCI in the North America. A SCI is one of the most serious injuries known to humankind. The total annual health cost for Canadians with SCI approaches $3.6 billion. Many of these costs are related to the treatment of secondary complications. Heart disease is the number one cause of illness and death among people with SCI, and people with SCI exhibit risks for heart disease younger and more frequently than the general population. The causes of heart disease are poorly understood at present. A SCI causes a break in the connection between the brain and the spinal cord. The major objectives of this research program are to measure the function of the heart and blood vessels following SCI and to investigate the mechanisms that are responsible for any changes that occur. A second objective is to examine the effect that both physical activity, which describes any bodily movement, and structured exercise have on the health of the heart and blood vessels. In people without SCI we know that maintaining an active lifestyle can improve the health of the heart and blood vessels. For people with SCI the type and amount of physical activity and exercise that they can perform is severely limited, and is usually restricted to exercising the arms only. In the present research program Dr. West and his team will investigate whether a new form of exercise that exercises both the arms and the legs of people with SCI is able to improve the health of the heart and blood vessels.