Cycling Therapy for Cerebral Palsy

Cycling is a fun and effective way to improve muscle function and gross motor skills in children with cerebral palsy.  Cerebral palsy is a neurological disorder characterized by impaired movement and motor function. Symptoms of cerebral palsy include weakness, overly rigid muscles, poor muscle control and muscle spasms.

Physical therapy is a critical part of a treatment program for children with cerebral palsy, because exercise can improve mobility. Indeed, when children have surgery to improve muscle function and gross motor skills, physical therapy is required to gain maximum benefit form the surgery. Bicycle therapy can be an enjoyable and important part of physical therapy. Cycling can help children with cerebral palsy achieve better movement, more independence and a better quality of life.

Stationary bicycles are optimal for bicycle therapy.  There are many adaptations of stationary bicycles to accommodate the physical disabilities of children with cerebral palsy.  Bicycles can be installed with a restraint system to support a child’s upper body, or a brace can be used to keep the child’s ankle in one plane of motion when pedaling. Restraining key parts of the body allows the child to focus on the movement of cycling instead of involuntary or spastic movements that may occur.  Focusing on certain parts of the body can help strengthen those areas, as well as connections to the brain that control the movement in those areas.

Bicycle therapy should be implemented as part of a regular routine for maximum benefit.  In a review of various studies on cycling for patients with cerebral palsy published in “BMC Pediatrics” in 2007, researchers from multiple universities found that bicycle therapy was most effective when put into practice at least two times per week for 20 – 30 minutes each day.  A physical therapist should be consulted to plan an exercise regimen that’s specific to the child’s body type and abilities.

Bicycle therapy improves all areas of motor function, including coordination, strength and range of motion.  Cycling can also improve the child’s overall fitness level and cardiovascular conditioning. These benefits are reflected in other coordinated movements, such as walking, because the motions target the same brain areas.  Over time, bicycle therapy can even help the child counteract muscle deterioration and overcome specific physical disabilities.

Children with cerebral palsy that are new to bicycle therapy must spend time getting accustomed to using a modified bicycle.  It is common for new bicycle users to expend too much energy and overuse muscle groups unrelated to the activity because they have muscles that involuntarily contract and activate together.  A physical therapist can help identify and target these automatic actions.

After a training period, cycling becomes more efficient and requires less effort from the child. Depending on the bicycle’s design, children may need special physical assistance to learn how to properly achieve the full circular pedaling motion.

Learning to ride a bicycle is a significant milestone for children, and they love the freedom it brings.  In the past, bike riding may not have been an option for special needs children, but today’s modern bikes offer a variety of options to meet the needs of many children that have cerebral palsy and special needs.  Since needs vary, different bikes are needed for each child.

Most children are introduced to cycling through the use of a tricycle.  Some children with cerebral palsy may never graduate from the stability of a three-wheeler, but modern tricycles will take even the oldest children around the block in style.  For younger children, there are a variety of tricycles with adaptive supports. These include self-leveling pedals with straps, dual axle systems to reduce resistance and make pedaling easier, adjustable body support, and specialized handlebars for easy control.

Children with vision impairments require the assistance of a person who can see to ride a bicycle.  Modern tandem bicycles, either two wheel or three wheel, allow the child to sit up front. The person in back can control all the important functions of steering, braking and gearing. The child can then pedal and enjoy the ride.

Many bicycles and tricycles can be retrofitted with hand crank systems that allow a child to ride without the use of her legs.  For a child with limited leg use, some bikes can be retrofitted to allow combined hand and pedal power.  Bicycles can also be modified with one-hand controls, shifter and brake adapters, seat belts and safety harnesses, and electric motors.

Many bicycle manufacturers can build a bike to meet the needs of the physically challenged.  Bicycles and tricycles can be built to accommodate varying heights, paraplegia and other challenges.

Young children love riding in bicycle trailers pulled behind a bike. Trailer options are available for special needs children of all ages.  A peditruck allows somoene to pull a trailer with a wheelchair-bound child.  The trailer includes a ramp and tie downs for easy access and safety. These bikes can be equipped with an electric assist to help pull the added weight of the wheelchair.