Study Design <p>A 3-city pilot randomized controlled trial.</p> Objectives <p>To evaluate the efficacy of an Active Living Lifestyles for manual Wheelchair users (ALLWheel) program for increasing participants’ leisure time physical activity, motivation, self-efficacy, and satisfaction of basic psychological needs from baseline to post-program (10 weeks) and at follow-up (3 months post-program).</p> Settings <p>Rehabilitation centers and community.</p> Methods <p>Forty adult community-dwelling manual wheelchair users with spinal cord injury were allocated to an intervention (n = 20) or control group (n = 20). The intervention group received a 10-week ALLWheel program. Leisure time physical activity, motivation, self-efficacy, and satisfaction of basic psychological needs were measured at baseline, post-intervention, and 3-month follow-up. Group differences were examined.</p> Results <p>The intervention and the control groups had a significant difference in total leisure time physical activity post-intervention, with a small effect size (Relative Treatment Effect = 0.38, p &lt; 0.05). This difference was not significant at follow-up. The two groups had a significant difference in moderate-heavy leisure time physical activity post-intervention, with a small effect size (Relative Treatment Effect = 0.36, p &lt; 0.05). This difference was not significant at follow-up. No significant group differences were found for the psychological outcomes post-intervention or at follow-up.</p> Conclusions <p>The ALLWheel program had a small effect size for increasing adult wheelchair users’ total leisure time physical activity levels post-intervention, particularly for moderate-to-heavy intensity. However, this increase was not maintained at the 3-month follow-up. Additional refinement and testing of the ALLWheel program is warranted before moving to a larger-scale randomized control trial with active control groups.</p>