BALANCE Keira was born with infantile spasms and seizures. At six months of age she was diagnosed with epilepsy. Despite numerous medication changes and even the implantation of a vagus nerve stimulator, Keira continues to have two or three significant seizures every week. It was never safe for Keira to ride a regular bicycle with training wheels. But she tried out a Rifton adaptive tricycle for the first time when she was 11 years old. Fortunately, on the adaptive tricycle, her poor balance and risk of seizures was not a barrier. Because of the built-in stability and secure seating with a supportive harness, seatbelt, and side supports, Keira’s sitting balance was a non-issue. This tricycle was completely safe. Keira’s mum could guide the steering with the rearsteering handle. Kiera was excited to ride it and was able to propel herself right away. Now Keira is 13, and riding her tricycle remains one of her favourite activities. On another note, believe it or not, tricycling even has the potential to improve a child’s balance. This was initially borne out in research done in Queensland, Australia.¹ When cycling, a child continually weight-shifts to maintain the centre of gravity over his or her base of support in order to effectively move the trike forward. This repetitive postural practice not only allows a child to sit better and with more control when off the tricycle, but also carries over to improving balance in an upright position while reaching or even running. PROGRESSION LINE For a child who cannot walk independently and sits for long hours in a wheelchair, riding a tricycle can guide alternating and reciprocal leg movement patterns such as those experienced in walking. Activating these key “walking” muscles and patterns has further therapeutic benefits beyond the tricycle. Annie Garcia Rojas received her first tricycle when she was 7 years old. She has quadriplegic cerebral palsy. She loved her new tricycle from the word go. Within the first week, she figured out how to pedal it herself, and a little while later, she was independent in steering it. After one month, her sitting stability improved, and she no longer required the support of the butterfly harness. Now at age 10 she has a medium tricycle, and she is in it every day, never less than 30 minutes, and sometimes for up to two hours in good weather. “Her legs used to be very skinny,” her mum says. “Now her legs look thicker, there is more muscle.” Annie uses a Pacer gait trainer to walk. “Before, when in her Pacer, both her legs would be turned inward during stepping. After she used the tricycle over several months, I noticed that her legs and feet were pointing straight ahead and were better aligned when walking. And now she can run in her Pacer!” Annie doesn’t like to be in her wheelchair. She rides her tricycle when her siblings are biking in the park and she uses her Pacer when her mum is shopping in the mall. Lelis tells, “It’s always a big joke for Annie when she goes
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fast. She looks back at me running to try to keep up! She laughs and laughs.” Parents are the first to celebrate the joy of each child cycling on his or her tricycle! And now therapists and teachers are increasingly recognizing the benefits of the adaptive tricycle as a valuable therapeutic mobility device. Lori Potts PT Physical Therapist, Rifton 0114 285 3376 hello@jiraffe.org.uk www.jiraffe.org.uk Jiraffe are the exclusive distributors of Rifton products in the UK.
¹Armstrong, E.L., Spencer, S., Kentish M.J., Horan, S.A., et al. (2019) Efficacy of cycling interventions to improve function in children and adolescents with cerebral palsy: a systematic review and meta-analysis. Clinical Rehabilitation. 33(7):1113-1129. Abstract https://www.ncbi.nlm.nih.gov/pubmed/?term=30935240 Photo ©2020 by Rifton Equipment. Used by permission.