A SYSTEMATIC REVIEW OF THE IMPACT OF ADAPTED BIKE RIDING ON OUTCOMES FOR CHILDREN AND ADOLESCENTS WITH DISABILITIES

A. Thevarajah¹, M. Wallen¹, C. Imms², C. Lonsdale¹, J. Carey², E. Froude¹

¹Australian Catholic University, Sydney, Australia, ²University of Melbourne, Melbourne, Australia

Background: Participation of children with disabilities in the community can involve taking part in leisure activities, engaging in recreation and play, and developing social relationships with others. Bike riding promotes opportunities to engage in physical activity and enables social connections with peers and family members. Children and youth with intellectual and physical disabilities are less likely than their typically developing peers to participate in bike riding. Access to bike riding for children with disabilities can be enabled through the provision of an adapted bike which can be customised to suit the individual’s needs. Additional supports may also be needed to develop competence and promote participation in the community. Outcomes for children with disabilities using an adapted bike have not been explored in previous reviews.

Purpose: The primary objective of this systematic review was to evaluate the effects of adapted bike riding on body structures and functions, activity, participation, and quality of life in children aged 4 to 18 years with disabilities. The secondary objectives were to i) investigate the impact of adapted bike riding for children aged 4 to 18 years with disabilities on their family’s participation in social and recreational activities and ii) identify any interventions that effectively supported the implementation of adapted bike riding for children and adolescents aged 4 to 18 years with disabilities.​

Methods: Nine electronic databases were searched for studies including participants aged 4 to 18 years old with a permanent childhood or developmental disability and the provision of a dynamic adapted bike. Outcomes were reported under the International Classification of Functioning, Disability and Health domains of body structure and function, activity, and participation. Risk of bias assessments were completed according to study design. A narrative synthesis integrated the findings of included studies. Certainty of evidence was synthesised using the GRADE approach.

Results: Ten studies were included with 234 participants. Five studies reported outcomes at the body structures/function level including strength, height, weight, body mass index, cardiorespiratory fitness, motor coordination, balance, gait quality, locomotor endurance, peak cycling resistance and muscle activity. Ten studies reported activity level outcomes, including gross motor function, sit-to-stand capacity and social communication goals. Two studies reported participation-related outcomes - participation in life activities and mean level of enjoyment. No studies assessed quality of life or family participation in social and recreational activities.

Conclusions: Adapted bike riding interventions may improve gross motor function, enhance lower limb muscle strength, and promote physical activity; however certainty of evidence was rated very low using GRADE. Further research is required to understand the impact of adapted bike riding on the participation outcomes of children and adolescents with disabilities and on family participation in social and recreational activities.

Implications: Adapted bike riding interventions may improve motor functions and physical activity. There is limited evidence about participation outcomes following adapted bike riding. The review findings will inform the development of an adapted bike riding intervention for children aged 4 to 18 years with disabilities. Research on adapted bike riding interventions in natural settings and participation outcomes is needed.

Funding acknowledgements: PhD scholarship jointly funded by the Technical Aid to the Disabled and the Australian Government Research Training Program (RTP).

Keywords:
Disability
Adapted bike riding
Children

Topics:
Paediatrics
Disability & rehabilitation
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Reason: Ethics approval was not required as this is a systematic review.