Adaptive Cycling and The OT Perspective Jack Callahan, OTDS | Doctor of occupational Therapy Program | Huntington University

Project Description

With the large variety of areas that occupational therapists can work in, it can be difficult to make sure that students are aware of every single area in which OTs can be useful. The goal of this project is to elaborate on the area of adaptive bikes, and the role occupational therapy can play. The use of adaptive bikes can broach many areas that we, as OTs are well versed in, such as community mobility, social participation, health management and more. The use of adaptive bikes can have many benefits to clients and promote independence which is many times a goal within occupational therapy. A study done by Hawks et al. stated independent bicycle riding is a valuable skill that may improve adaptive function while encouraging autonomy, self-confidence, and new peer interactions among individuals with ASD. (2019). In this study, Hawks et al. completed a study on children with ASD and investigated their motor skill acquisition on a bicycle. Through adaptive bike interventions, nine of the fifteen participants were able to ride their bikes at least 70 feet (Hawks et al., 2019). In addition to motor skill acquisition, the study also found that social communication was correlated with skill acquisition. This study is one example of how OTs who work with children with ASD can use adaptive bikes for goal attainment and how it can fit into our scope of practice. When it comes to working with individuals with disabilities, OTs have to take into account the entire person and not just their deficits. Many times, deficits from disability can interfere with meaning full life activities such as health management, social participation, and more. A study was done by Wilhite and Shank which involved interviews with persons with disabilities and how sports and activities have been beneficial. From their study they found that sport is a significant mechanism for fostering physical and emotional health and building valuable social connections (Wilhite & Shank, 2009). Using adaptive bikes as part of their intervention, OTs can help individuals with disabilities attain their goals and improve their overall well-being. The objective of this project is to educational materials to provide to occupational therapy students to introduce the world of adaptive bikes. The goal is to educate and demonstrate that using adaptive bikes falls within the scope of OT practice. Educational resources that will be provided for the OT students are meant to help educate them on a field of OT that they can use in the future as practitioners.

Needs Assessment

• Valent et al. (2009) engaged in a a study to evaluate the effects of a structured hand cycle program with individuals with tetraplegia. Results from the study showed significant positive improvements in two primary physical capacity categories (Valent et al., 2009)
• An article written by two occupational therapists Baker and Calhoun demonstrated the role of occupational therapy and how understanding adaptations can aid in occupations. Within this article it is discussed that riding bikes and even adaptive bikes is a vital piece for children as it falls under the occupations of play. By being able to create adaptations to a bike provide the ability for this client to now take part in play participation whereas before it might not have been possible (Baker & Calhoun, 2014).
• King et al. (2003) investigated participation in voluntary recreational activities amongst children with disabilities. Results from this study demonstrated various examples of need for people with disabilities. Children and adults with disabilities were found to be more affected and less likely to engage in leisure activities at home and in the community (King et al., 2003)

Literature Review

• Barriers due to disabilities can be a factor for many people; by using adaptive bikes, steps to work towards lessening these barriers caused by disabilities. Shields and Synnot conducted a qualitative study through focus groups on the barriers for people with disabilities. From this study, areas such as social participation, maintenance of a healthy lifestyle, and mental and physical health were affected by the presence of a disability (Shields & Synnot, 2016).
• Access to activities to participate in is also an important consideration. Studies show that people with disabilities tend to have many barriers, which can lead to limited participation in activities and sports (Heron et al., 2015).
• A study by McManus et al. found that children with CP who participated in activities reported a higher quality of life due to their participation (2008).

Project Mission Statement

To educate and develop resources for occupational therapy students and practitioners in the area of adaptive bikes.

Project Leader

The project leader was responsible for driving the progress of the project, including planning, management, completion of deliverables, and dissemination of the content. The project leader was also involved with communicating with stakeholders throughout the project.

Project Mentors

Maria Besta supported by providing expertise and resources regarding adaptive cycling and knowledge of adaptive sports. Maria also oversaw productivity throughout the course of the project.

Dr. Bergstresser-Simpson provided insight and expertise related to the occupational therapy perspective and oversaw productivity of the project.

Project Outcomes

Deliverable #1 Creation of Adaptive Bike Presentation

Deliverable #2 Creation of a digital resource digital including information on acquiring adaptive cycling

Deliverable #3 Creation of an adaptive bike fitting checklist

Deliverable #4 Documentation of hours observed

Deliverable #5 Creation of adaptive bike case scenarios

Deliverable #6 Create a reflection journal of experiences from the volunteer opportunity

Topic areas for this project are listed below

Education

• Provided education to bike fitting clients on modifications and adaptations that could be made to help improve their cycling experiences.
• Addressed the scope of practice and the role occupational therapy practitioners can engage in relating to adaptive cycling, evidence by a sixty minute presentation to Doctor of Occupational Therapy Students.
• Created an online resource in the form of an Instagram page to allow for people to educate themselves on different aspects of adaptive cycling including benefits, funding and more.
• Created an adaptive bike fit checklist to allow people seeking adaptive bikes to begin their search. This checklist was also created to help practitioners provide insight and information to patients they believe would benefit from adaptive cycling.

Clinical Practice

• Engaged in a week long adaptive bike camp with children with disabilities with iCan Shine bike camp.
• Educated children on riding skills with adaptive bikes and worked on transferable skills to two-wheeled bikes.
• Participated in adaptive bike fittings with Turnstone.
• Aided in measurements and modifications to fit adaptive bikes to clients.
• Educated clients on additional modifications and safety features to be aware of when riding adaptive bikes.

Reflection

The doctoral capstone experience allowed me to expand my personal and professional skills throughout the project with management, clinical practice skills, research, and dissemination skills.

Impact on the Profession

• I was able to educate and inspire future occupational therapy practitioners on the topic of adaptive cycling to allow them to increase their knowledge of the subject.
• By creating and adaptive bike fit checklist I hope that this can allow practitioners who believe their patients would benefit from adaptive cycling can take the first step to understanding what adaptive bikes would work best for them.

Future Direction

My doctoral capstone project I hope is a stepping stone for me as I progress into my career, and I hope that I can expand upon the knowledge gained during this process to be able to implement it into my professional career.

Contact Information

Email: jack.callahan21@gmail.com

References

Baker, S. A., & Calhoun, V. D. (2014). A custom bicycle handlebar adaptation for children with below elbow amputations. Journal of Hand Therapy, 27(3), 258–260. https://doi.org/10.1016/j.jht.2014.02.001

Hawks, Z., Constantino, J. N., Weichselbaum, C., & Marrus, N. (2019). Accelerating Motor Skill Acquisition for Bicycle Riding in Children with ASD: A Pilot Study. Journal of Autism and Developmental Disorders, 50(1), 342–348. https://doi.org/10.1007/s10803-019-04224-5

Heron, N., Kee, F., Cupples, M. E., & Tully, M. A. (2015). Correlates of sport participation in adults with long-standing illness or disability. BMJ Open Sport & Exercise Medicine, 1(1), e000003. https://doi.org/10.1136/bmjsem-2015-000003

King, G., Lawm, M., King, S., Rosenbaum, P., Kertoy, M. K., & Young, N. L. (2003). A Conceptual Model of the Factors Affecting the Recreation and Leisure Participation of Children with Disabilities. Physical & Occupational Therapy in Pediatrics, 23(1), 63–90. https://doi.org/10.1080/j006v23n01_05

Mc Manus, V., Corcoran, P., & Perry, I. J. (2008). Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland. BMC Pediatrics, 8(1). https://doi.org/10.1186/1471-2431-8-50

Shields, N., & Synnot, A. (2016). Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC Pediatrics, 16(1). https://doi.org/10.1186/s12887-016-0544-7

Valent, L. J. M., Dallmeijer, A. J., Houdijk, H., Slootman, H. J., Janssen, T. W., Post, M. W. M., & van der Woude, L. H. (2009). Effects of Hand Cycle Training on Physical Capacity in Individuals With Tetraplegia: A Clinical Trial. Physical Therapy, 89(10), 1051–1060. https://doi.org/10.2522/ptj.20080340

Wilhite, B., & Shank, J. (2009). In praise of sport: Promoting sport participation as a mechanism of health among persons with a disability. Disability and Health Journal, 2(3), 116–127. https://doi.org/10.1016/j.dhjo.2009.01.002