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8 Ideas for Adapting Trikes and Bikes for Children with Hemiplegia

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January 2016

Learning to ride a tricycle or bike can be challenging for all children, and kids with hemiplegia may benefit from some additional modifications and support when learning to ride.

  1. When looking for a bike for your child, it is important that you have them try a variety of trikes or bikes in a store or bike shop to determine what works best for them. Keep in mind that adjustable features, such as seat height and handlebar height can help you get a more precise fit for your child as they grow.
  2. Make sure that you also have them fitted with appropriate protective equipment, including a helmet to ensure they are safe when they ride.
  3. Younger kids can likely find a tricycle in their size, but as kids get older and graduate to a bicycle, they may need training wheels to maintain their balance. Adult-sized training wheels or adjustable training wheels, such as fat wheels, can provide more support for kids who need it.
  4. To help your child keep his or her foot on the pedals, you can add toe cages, toe clip, custom or home-made Velcro foot straps. This will limit his or her ability to catch his or herself if they fall sideways to their affected side, so walk with them to that side when they are learning to pedal, and stay on level ground as much as possible.
  5. Some children with hand weakness may also need adaptations to help them maintain their grasp on the handlebars. Sticky tape (for example, tape designed for racquet grip) can help with maintaining grasp. Grip-assist gloves are another option to assist with grasping handlebars.
  6. For kids who have trouble keeping their elbow straight enough to reach the handlebars, parents should look for bikes that have handlebars that curve closer to the body. If the reach is still too difficult, extensions can be attached to handlebars.
  7. Most small bicycles are equipped with cruiser brakes that activate with pedaling backwards. Teach kids with hemiplegia who have cruiser brakes that they will have the easiest time to start pedaling if their stronger leg is at the top of the cycle.
  8. Once your child graduates to a bike with a hand brake, you will need to make sure that that brake for the rear wheel is on their stronger side (you can have this switched at a bike shop if your child has left hemiplegia). Using the front brake only is not advised at fast speeds, and can lead to flipping the bike over the handlebars. The gear shifter on multiple speed bikes can also usually be moved to the stronger side as needed.

As you can see, there are many ways that you can modify bikes and trikes for children with hemiplegia. To problem solve the best specific strategies and adaptations for your child, be sure to consult with a physical therapist.

If you have a topic or questions that you would like the Helping Hands blog to address, please email HelpingHands@kennedykrieger.org.

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