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Faculty Advisor(s)

Betsy Donahoe-Fillmore, PT, PhD, Trisha Renner, PT, DPT

Description

Purpose/Hypothesis: Cycling has broad health benefits and is therapeutic across many populations. Physical therapists commonly fit children with gross motor delays for adaptive bicycles and assist with training during therapeutic intervention. Limited evidence exists regarding formalized adaptive bicycling programs apart from traditional therapy. The primary aim of this study was to investigate if an after-school adaptive cycling program is feasible in children with motor delay. The secondary aim was to determine if it can improve balance, endurance and functional strength in children with disabilities.

Number of Subjects: Ten children with motor delays, ages 6 to 11 (mean 7.7) years participated. Diagnoses included Dandy-Walker syndrome, TARP syndrome, developmental delay, growth failure, autism, Down syndrome, attention-deficit/hyperactivity disorder, in-toeing gait, and scoliosis.

Materials and Methods: Children participated in an after-school adaptive bicycling program for 30 minutes, once a week, for ten sessions. Pre- and Post- outcome measures included the Pediatric Balance Scale (PBS), 6 Minute Walk Test (6MWT), and Five Times Sit-to-Stand (5STS). Each session, participants biked continuously on AmTryke adaptive tricycles through a variety (spiral, figure 8, speed challenge, circle, and zigzag) of courses for 30 minutes. Descriptive statistics were calculated. Within group change was analyzed using the Wilcoxon Signed Rank test. An a priori power analysis was utilized to establish significance at ɑ ≤ 0.05.

Results: All participants completed the study with an overall attendance of above 90 percent. The Wilcoxon signed-rank test showed that a once weekly 10-week adaptive cycling program resulted in statistically improved PBS (z=-2.524, p=0.012), 6MWT (z=-2.666, p=0.008), and 5STS (z=-2.521, p=0.012) measures. For the PBS, baseline median changed from 33 (IQR 13.50-41.50) to 46 (IQR 35.00-53.00); for the 6MWT, the baseline median changed from 321.38 (IQR 196.21-375.89) to 388.52 (IQR 338.79-416.05); and for the 5STS the baseline median changed from 32.59 (IQR 16.95-43.86) to 11.99 (IQR 8.89-16.86).

Conclusions: A 30-minute weekly after-school adaptive bicycling program is feasible and resulted in improved balance, walking distance, and functional strength among children with motor delay. The small sample size of this study and lack of a control group limit generalization of these findings. Some participants had difficulty completing the 5STS measure without assistance and a different functional strength assessment is needed in future studies to accurately assess lower extremity functional strength. Further research is needed to determine the efficacy of an after-school bicycling program for children with specific diagnoses.

Clinical Relevance: A short 30 minute after-school adaptive bicycling program has potential to improve balance, endurance and functional strength in children with motor delays.

Publication Date

5-8-2025

Disciplines

Physical Therapy | Rehabilitation and Therapy

Comments

Presented on February 13, 2025 at APTA Combined Sections Meeting

An After-School Adaptive Bicycle Program for Children With Disabilities: A Pilot Feasibility Study

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