Therapists are forever searching for treatment activities that can be incorporated into everyday life. It can be challenging to find fun, motivating, activities that individuals seek out on their own time. Cycling frequently fits the bill and can accomplish a variety of therapeutic objectives, such as improving leg strength, balance, fitness, and endurance. Age appropriateness is never an issue with a bike. Children and adults of all ages enjoy cycling, which encourages socialization and the development of friendships. To many parents and caregivers of children with special needs, this is equally as important as the therapeutic benefits.
There are a variety of bicycles, tricycles, and handcycles available that can be adapted for different special physical demands. Cycles can be powered by leg or arm motion. Tricycles, or three-wheel bikes, which come in all sizes, are more stable than two-wheelers. A low center of gravity also improves stability. Some trikes for children with more severe physical involvement have an attendant bar for pushing or pulling.
A variety of adaptations can be added to provide postural support. I frequently adapt tricycles with simple footplates and front pulley systems for young children who have spastic diplegia. I often add a back support and handlebar adaptation to support a rider with quadriplegic cerebral palsy. Adaptations can also be added to prevent leg scissoring.
Bikes and trikes can be adapted for riders who have little or no functional control of their legs so that they can propel themselves with reciprocal hand and arm movement or a pumping movement of the handlebars.
Any bike rider knows that seat design is critical to comfort and function. A broad, well-padded seat is a good choice. Many of the three-wheeled bikes that senior citizens have enjoyed for years come with this as a standard feature. A seat belt may also be necessary.
I adapt pedals with footplates and Velcro strapping if the feet need to be secured. Often, toe boxes are all that is necessary.
Brakes can be controlled by hand or foot. The caregiver should be attentive to the child’s speed and safety. Riders should wear helmets at all times.
Specially-adapted cycles bought commercially can be expensive. You can minimize your costs by adapting a typical bike or trike with commercially available components. Some families work with local carpenters and metal fabricators to keep costs down for these parts. Unfortunately, liability issues may change the availability of this option. Purchasing a cycle complete with all the necessary adaptations is definitely less labor- and time-intensive. Unfortunately, insurance funding is unlikely, so some families seek funding from family support agencies. Schools may also offer cycles as part of their adaptive programs. Many people consider the purchase of a bike a worthwhile investment because they place a high value on fun and fitness.
Freedom may take many forms; mobility is recognized as one of those most valued.
Exceptional Parent Magazine November 1998
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This article reprinted with the expressed consent and approval of Exceptional Parent, a monthly magazine for parents and families of children with disabilities and special health care needs. Subscription cost is $39.95 per year for 12 issues; Call (877) 372-7368.
Have a look at Rifton’s Adaptive Tricycles
Tips for writing a Letter of Medical Necessity for a Rifton Tricycle (pdf)
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