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On your bike! Training bike riding skills in children with cerebral palsy

Written by Rachel Toovey, Principal Investigator

Associate Investigators/Contributing researchers: A/Prof Alicia Spittle (VIBeS), Dr Adrienne Harvey (DDRR), A/Prof Jenny McGinley (UoM), A/Prof Katherine Lee (MCTC), Dr Sophy Shih (Deakin), Charmaine Bernie (DDRR)

Children with cerebral palsy (CP) have problems with movement to varying degrees – some children can walk independently but have difficulties with sports and high level mobility, while other children are medically complex and get around using a wheelchair. 

Across all levels of function, there is a need for evidence-based interventions that are meaningful to children with CP and their families.

Learning to ride a bike is a common childhood activity and is often a goal for ambulant children with CP. Bike riding ticks all the ‘F-words in CP’ boxes, it: is a fun and functional activity, can be done with friends and family, is good for fitness and is a skill that can be used in the future!

Some physiotherapists and occupational therapists teach bike skills to children with CP. Other children with CP learn these skills at home with their families. Overall, there hasn’t been any research to test different approaches to see if they work, or if one way is better than another. The aim of this research is to test two different bike skills training programs in children with CP to determine which method is more effective.

In order to do this, we are now running a randomised controlled trial. Children aged 6-15 years with CP who can walk independently and have goals related to bike skills are randomly placed in either one of two bike skills programs. One program involves a centre-based group bike skills training program. Children in the other program participate in a parent-led home based program. Both programs take place for a week during the school holidays.

Outcomes measured assess not just skill development but also the impacts on the children’s daily lives. While we are primarily interested in the children achieving their bike riding goals, we are also measuring each participant’s level of bike skills, physical activity, self-perception, broader functional skills and participation in bike riding over the study period. Outcomes are measured in the week after and at three months after the programs.

So far more than 50 children have enrolled in the trial, which is taking place in partnership with the Victorian Paediatric Rehabilitation Service at Monash Children’s and the Royal Children’s Hospitals.

From this research, we are aiming to provide evidence-based guidance to clinicians and families to enable children with CP achieve their two-wheel bike riding goals.

This project is part of Rachel Toovey’s PhD at Murdoch Children’s Research Institute and the University of Melbourne. The trial is supported by a Physiotherapy Research Foundation seeding grant.  Rachel is supported by an Australian Government research training program scholarship, the Murdoch Children’s Research Institute and the Centre of Research Excellence in Cerebral Palsy.