The International Year of the Disabled Person has focused increased attention upon the fitness status of the wheelchair-confined. Review of the world literature indicates that cardio-respiratory assessment has been based relatively equally upon forearm cycling or wheelchair ergometry; each of these techniques have particular advantages. The evaluation of muscular strength and endurance has received much less attention, in spite of the importance of these factors to the daily function of the lower-limb impaired. Also neglected in the past has been the psychological correlates of spinal cord trauma and their possible interaction with attitudes concerning physical activity. Fitness is often poor in the disabled, and everyday wheelchair propulsion does not seem to provide a sufficient stimulus for cardio-respiratory adaptation. Additional training in the form of forearm pedalling, exercises with weights or wheelchair sports may provide an effective means of improving cardio-respiratory fitness and muscle function. Indeed, research on disabled athletes has suggested that with persistent sports participation or fitness conditioning many wheelchair-confined individuals can make a relatively good physiological and psychological adaptation.