It’s Summer! Let’s Go Ride A Bike!

By: Josephine Hipolito, Physical Therapist

Summertime is approaching, and around this time, caregivers often ask me to work on bike riding with their kids as one of their goals. As an avid cyclist, it’s one of my favorite things to teach because of the joy and freedom children feel when they learn to ride. Let’s start with a few tips on teaching children bike riding.

Things to Consider When Starting

1. Determine whether the child knows how to pedal.  If they do, skip the next section and go to the balance section to work on the balance aspect of bike riding .
2.  Remember you don’t have to follow this step by step. It’s more of a guide to see where your child is in the bike riding process and then proceed.

 Teaching Children Pedaling:  

1. Start with teaching “Air Cycling.” Most kids don’t understand the concept of extending one leg while the opposite leg is relaxed if they have never pedaled before. Their usual instinct if you tell them to push with their legs is to have both legs push simultaneously, so they usually get stuck when on a tricycle.
   
2. To practice the motion of pedaling, place your hands at the bottom of their feet and tell them to push against it on their bent leg. Use a little resistance when you do this. On a tricycle, kids often stop pedaling and move backward when they encounter resistance, so you want them to get used to resistance.

3. Once they master air cycling, start them on a tricycle with a pedal block (a device that holds their feet on the pedals) or strap their feet on the pedals using an ace wrap or velcro straps. Children usually tend to over-push with their feet at first, so their feet slip off the pedals. Wrapping their feet will keep them on the pedals. You can also get commercially available pedal straps like this one.

4. Once they master the pedal block, take off the straps so they can learn to control their leg movement and keep their feet on the pedals.

5. Make sure they master pedaling with a tricycle so that it becomes second nature to them when they graduate to a bicycle.

Balance Bike Versus a Bike with Training Wheels 

I often tell families ready to progress their children from a tricycle to a bike, to start with a balance bike. A balance bike is simply a bike without pedals where children use their legs instead of pedals to move.

Skip the step of learning with training wheels because children can get dependent on leaning on them for balance. The Balance Bike enables the child to learn to find their center of balance on their own  

NOTE: Not everyone will be able to get a balance bike and a bike with training wheels, so I recommend taking the training wheels AND the pedals off of a bike to convert it to a balance bike. 

 Biking with Training Wheels

The problem with a bike with training wheels is the braking system.  They use coaster brakes which means pedaling backward to activate the brakes. 

Kids tend to start pedaling backward when they encounter resistance which activates the brakes. It’s always difficult for kids with motor planning issues to figure this out. That’s why you ensure they master the pedaling part of bike riding before moving on.

Keep an eye out for the following:  

1. Some kids tend to push with their legs while pulling on the handlebars, which causes the bikes to turn – as a PT, this signals to me that they need core strengthening 
2. Some kids will over push with their legs causing them to slip backward on the bike seat – I put a dycem (non-slip pad) or tie a theraband on the seat to prevent this .

 Tips to Use a Balance Bike 

1. Start with having the child walk with their legs while sitting on the saddle. See if they have the control to keep the bike from tipping or even recognize that the bike is tipped while they are riding it. They need to integrate this part. Children with body awareness issues will not even recognize that they are tilted when propelling a balance bike.
2. Watch out for kids who walk the bikes, but they are standing and not sitting on the seat. I sometimes use an ace wrap to secure their pelvis on the seat to prevent this 
3. Once they master keeping the bike upright, work on gliding .
4. Gliding – have them take three steps: 1, 2, 3, then bring their feet up to glide. Challenge them and ask them to see how far they can glide before they put their feet down.
5. I sometimes use floor markings like chalk on the surface to mark a certain point. Children can work on balancing better if they have a visual cue on how far to glide.
6. Once a child can glide for 10-20 feet consistently, I move them to a bike with two wheels (or put the pedals back on the bike).

Steps to Help Children Ride a Standard Bike 

1. Work in a parking lot of a school or a park early in the morning so that it will be empty and there are no distractions – avoid the sidewalks or hallways because the child needs to worry about staying within the confines of the space (it can become too stressful for them).
2. Try to find a parking lot with a little downward incline to help them get a little momentum to balance.
3. Let your child walk the bike out to the parking lot while holding the handlebar. This way, they learn to handle the bike and how to motor plan to keep it balanced.
4. Work on pedaling forward first.  Worry about turns later.
5. Have a gait belt (or Dad’s belt) around their trunk, so you have something to grab onto when they are riding (if they are not using a bike with a parent’s handle).
6. Give them a little push to start them up – they will usually start slow because they are apprehensive but what children don’t realize yet is they need momentum to be able to balance.  
7. Give them frequent breaks, and maybe bring a snack, as bike riding can be stressful while learning. Let them know that they have to do 2-3 laps then they can take a break. Break for 1-2 mins, get a drink or snacks, then return to bike riding. Use a timer so they know break time is over when it rings. This way, they may be more cooperative when they know they have a break.
8. Once they master going straight, you can work on turning – put cones on each end of the parking lot and ask them to turn around the cones. This way, they can practice tight turns.
9. Once they master turning,  work on tighter areas (e.g. a hallway, sidewalk) to narrow their space.  
10. Once they master tight areas, work on going up inclines.

Biking From a Complete Stop  

1. Determine the child’s balance leg – it’s usually the first leg they put down when they stop.  
2. Once that’s determined, the balance leg is the leg that will stay on the ground and will be pushing to get the bike going.  The other leg goes on the pedal (pedal leg).  
3. Teach the child to position the pedal (pedal leg side) in front of their shin so they can easily put their foot on it.  
4. Ask them to have the balance leg push on the ground while the pedal leg is pushing down on the pedal to start the bike .

Cycling Benefits

I hope this blog has been helpful wherever your child is on their cycling journey! Teaching children to cycle has numerous benefits to their development, including improving motor skills, strength and balance. It’s also a fun exercise that can be enjoyed with a sibling or friend!

if you ever have concerns about your child’s mobility, strength, or motor skills, Easterseals DuPage & Fox Valley is here to help! Learn more about our physical therapy services by visiting:
https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.

We also invite your family to join our annual Bike for the Kids in Elgin!

Cyclists of all ages and abilities are welcome to ride distances ranging from 12 miles – 50 miles or join us in reaching a 100-mile goal throughout the summer on the Strava app. Adapted bikes and trailers are welcome. All ages and abilities are encouraged to participate.

We are excited to take this ride to the Fox River Trail and celebrate together at Festival Park in Elgin with food, refreshment, entertainment and more!

Learn more and register here: https://www.givegab.com/campaigns/bikeforthekids2022

Growing A Family’s Health

By: Laura Basi, PT, MPT

Physical fitness is important for everyone, including children and adolescents with developmental disabilities.  Running is a great weight-bearing aerobic activity. It promotes cardiovascular and respiratory endurance, bone health, lower extremity strength and endurance, symmetry of movement in both upper and lower extremities, and emotional regulation.  Wheelchair racing promotes cardiovascular and respiratory endurance, upper extremity strength and endurance, and upper body symmetry.  These are all areas that children with developmental delays and disabilities can improve on. 

“Gross motor skills like jumping and running, and object control skills like throwing and catching, are the building blocks upon which more complex physical activity can be learned as children grow, so the sooner kids work on being active, the better.” From parents modeling physical activity help kids with developmental disabilities improve motor skills).

Our community program, Hustle for Your Health, helps children reach their fitness goals. Each week includes an outdoor aerobic activity in the form of running and walking or wheelchair propulsion, basic strengthening exercises, and stretching to cool-down. At the end of the program, children will be prepared to complete our Run for the Kids: Superhero Hustle to run or walk a 5k distance and are encouraged to participate in other local races too.

I have heard from countless families that are amazed at their child’s commitment to health during and after the 10-week program. Below, I share some tips to help all children grow their enthusiasm for wellness.

Growing a Child’s Love of Physical Fitness

1. Make it fun. Choose activities your kids like. Some kids enjoy walking, running, and biking, but others may get more out of obstacle courses, climbing trees, hopscotch, rollerblading, dancing or a game of kickball in the yard.  The goal is to promote a love of movement.
2. Variety is the spice of life. To prevent boredom, change things up. Tour the neighborhood using different modes of transport – walking, scootering, biking, skating; you can even make a walk feel different by bringing a ball to dribble while walking or by challenging your child to run to the next tree, skip to the next fire hydrant, leap across the next driveway, etc.
3. When building endurance, add in activities for “active rest.” Lengthen a jog or a bike ride by bringing along a frisbee so that you can take a break in the middle of your run/ride to toss a frisbee before heading back home. Your child will have maintained being active for a longer period of time and be able to handle a longer distance with a built-in break.
4. Stuck inside?  Get your body moving by:
   • Making up a dance routine.
   • Setting up an indoor obstacle course
   • Creating movement themed minute challenges. How many times can you…. in a minute? 
     • I.E: Run up and down the stairs, do sit-ups, do jumping jacks, push a basket of laundry across a room, run laps throughout your house.

Growing your child’s fitness and love for activities like running, biking or yoga, has a positive impact on their overall body health but also improves attention, mood and more. But one of the biggest factors in growing a child’s fitness was parent modeling according to a recent study published in the Disability and Health Journal. Caregivers and parents that model physical activity helped encourage their children to be active and created a supportive environment for children with developmental delays and disabilities. The study also mentions that starting this early, around preschool age, takes advantage of the fact that younger children are already spending significant time watching and copying parents.

During the State of Illinois’ stay-at-home order, children have more opportunities to spend time with their caregivers and model their activities. There are plenty of fitness activities the family can do together. Our annual Run for the Kids: Superhero Hustle helps many children at Easterseals make a goal to cross the finish line with their first independent steps, with a walker, or after reaching a new distance. Their goals help inspire other family members to join in their training and reach new levels of health. The new Superhero Hustle date is August 1, which gives participants three months to work on a new wellness goal.

Our goal is to help you reach yours! Set your intention for the next 3 months. What will your family accomplish by August 1? Will you run a 5K for the first time? Do 100 jumping jacks? Start each day with mindfulness and yoga? Tell us! To get started: 

1. Register today at eastersealsdfvr.org/runforthekids.
2. Set your wellness and fundraising goals.
3. Share your progress with family and friends and encourage their support
4. Make plans to “cross the finish line” on August 1 

One of my personal goals as a physical therapist for children with developmental delays and disabilities is to not only help improve their physical health but the entire families. Our Run for the Kids and Bike for the Kids events are opportunities to grow our family’s fitness with a very supportive community group.

All About Adaptive Bikes

By: Bridget Hobbs, PT, DPT

Want to see pure joy in a child’s face?  Put him on a bike!  Children of all abilities love the freedom, weightlessness and fun that bicycles (and tricycles) provide.  Just like children, bicycles come in all varieties and can be adapted for children with special needs.

Bicycle riding provides not only the physical benefits such as leg strengthening, increased balance, coordination and endurance, but also the social benefits of riding with family and peers.  Below are just a few examples of modified cycles that are made to assist children with special needs in their bike riding goals.

Adaptive tricycle: The three wheels on this tricycle provide a wide base for increased stability which helps children feel safe not only when riding the bike, but when getting on and off it as well.  The high back and seat belt also provide proper trunk support to help a child stay upright and midline.  There are also Velcro foot holders to prevent feet from sliding forward.

Tandem bicycles: Tandem bicycles allow for a parent to propel the bicycle with the option to turn the child’s pedals on or off, which enables a child to rest and enjoy the ride when they are tired. The tandem bicycle also allows for communication while simultaneously enjoying the benefits of exercise.

Bicycle Trailer: A bicycle trailer is a good option for longer family bike rides where everyone in the family can be included.  The bicycle trailer allows for a lot of leg room and a child or adult can be easily transferred in and out of the trailer and positioned in many different ways.

Hand and Foot Cycle: A hand and foot cycle can be used for children who have lower extremity weakness, spina bifida, cerebral palsy or low muscle tone. This type of tricycle has the ability to be propelled with either arms and/or legs.   A benefit of this type of tricycle is that children can increase their range of motion in their arms as well as work on a reciprocal motor pattern of their upper extremities.

Your child’s physical or occupational therapist is a great resource to help you and your child learn what kind of bicycle or tricycle would be good for your child.   A few companies/websites that may be helpful in adapted cycles are below:

• The Bike Rack
• AmTryke
• Rifton Adapive Tricycles
• Freedom Concepts Therapy Bikes

Thanks to a generous donor, we are pleased to launch the Jonathan Goers Bike Club at Easter Seals DuPage & Fox Valley. This program was established to share Jonathan’s joy of biking with children who have developmental delays and/or disabilities and may not otherwise have the opportunity to ride or own a bicycle. The program will provide a child with an adapted bicycle free of charge.

Any family of a child with a developmental delay or disability is eligible to apply to this program. The bike must be returned to Easter Seals DuPage & Fox Valley if the child outgrows or no longer uses the bike. This will allow another child to enjoy the benefits of biking. Speak with your Easter Seals DuPage & Fox Valley therapist for more information on the application.

The first bike giveaway will be at our 2nd Annual Bike for the Kids event on September 17 in Elgin. Adapted bikes and trailers are welcome and all ages and abilities are encouraged to participate. Choose your distance from 100 Miles to the 2.5 Mile family ride. Learn more at www.EasterSealsDFVR.org/BikeForTheKids.

Begin to Bike

By: Cassidy McCoy PT, DPT

Summer is a great time of year to get back on your bike.  Here are a few key concepts to help your child ditch the training wheels!

The key to learning how to balance and ride on a two-wheeled bike is to ensure proper stability at the trunk, allowing your child to move their arms and legs freely for steering and pedaling.  Here are some tips to help bring the physical components of bike riding all together.

1. Balance bike
   1. A balance bike is a bike with no pedals. A balance bike can be purchased, or you can simply remove the pedals from your child’s current bike until they get the hang of it.
   2. First, start with having your child sit on the bike, lower the seat so their feet touch the ground. Have them walk the bike with their feet to begin to learn how to balance without training wheels.
   3. As this gets easier, progress to using both feet at the same time to push the bike and pick their feet up off the floor to glide while maintaining their balance.
2. Catching themselves
   1. Another way to work on balance is to teach your kids how to catch themselves by placing their foot down when they feel like they are tipping over. Hold the bike stationary for you child as they place both feet on the pedals. Let go of the bike, allowing it to fall to one side or the other. Your child should place their foot down in order to catch their balance.
3. Steering
   1. Using cones or other objects, set up a pattern for your child to steer around. This can be done with a balance bike while scooting/walking it through or with pedaling if your child has mastered their balance.
4. Start to Pedal
   1. When your child is ready to pedal, have them start standing with their feet flat on the floor. Have them lift one foot onto the pedal that is lifted at around 2-3 o’clock. As they push down on the pedal to get the bike going, they will lift their other foot onto the other pedal and push down to maintain momentum. If needed, you can help steady the bike by gently placing your hands on your child’s shoulder or the bike seat.

 

Bonus Pro Tip:

Avoid the discomfort of hunching over to push young riders along on their tricycles. Lace a sturdy rope around the bike’s structure, careful to avoid the spokes and pedals.  This allows you to help pull the trike along, adjusting the resistance to match the child’s ability.

 

Remember to always practice safe cycling. Wear a helmet, and obey the rules of the road.

 

Help your child develop their cycling skills at Easter Seals DuPage & Fox Valley’s Bike for the Kids on Sunday, September 17 in Elgin, IL.  This long-distance bike ride includes a 2.5 mile family ride, pedal parade and kid-friendly entertainment!

To learn more about Physical Therapy programs to improve strength, balance and coordination at at Easter Seals DuPage & Fox Valley visit:
http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.html

 

Tips For Fitness-Focused Activities: Run, Golf, Bike & More

Fitness-focused activities are a great complement to a child’s therapy sessions, and an opportunity to work on therapy goals while also participating in an athletic or recreational activity.  By encouraging involvement in new activities for children of all abilities, they are learning the importance of health and wellness at a young age.

The benefits of fitness-focused activities are far-reaching and can impact a child in many ways.

“We all need to challenge ourselves in order to reach our potential. Our job as therapists is to to see that potential in others and encourage kids to try activities that are outside their comfort zones, so they will truly be all they can be.  Any fitness or recreational activity that interests a child is worth pursuing for the benefits it provides physically as well as emotionally, cognitively and socially.”  – Laura Znajda, PT, C/NDT

Physical Wellness
Children of all abilities should participate in athletic and/or recreational activities as physical fitness is important for ALL.  Physical fitness, as defined by the American Physical Therapy Association, is “a dynamic physical state – comprising of cardiovascular/pulmonary endurance; muscle strength, power, endurance and flexibility; relaxation; and body composition – that allows optimal and efficient performance of daily and leisure activities.”

Just because as individual has a disability, does not mean that physical fitness is any less important.

Building Confidence
Participating in activities outside of a child’s comfort zone help support their emotional development.  Trying something new can be intimidating and challenging. Keep the focus on what makes the activity fun and avoid getting caught up in the competition. Every child approaches new activities differently, but it’s ok to remind them that no one is good at everything.  No one!  You can help temper frustration by celebrating every improvement – no matter how small, and sharing your own example of a time that practice and persistence led to success.

Socialization

Physical activities take many forms and are a great opportunity to increase peer interactions, build friendships and promote health and wellness for the whole family. Embrace a child’s interests and find ways to involve friends and family.

Setting Goals and Staying Motivated
Community based therapy programs and special recreation can target individualized therapy goals. For example, a child with hemiparesis might be working on running in order to use both sides of her body more fluidly, as needed for natural arm swing while walking. A child with sensory processing challenges might be building the strength needed for wall climbing so that he can include this activity in his weekly routine to assist with state regulation.

Motivation comes from finding ways to turn therapy activities into games with friendly competition, involving the whole family and plenty of cheering!

“Therapy activities include dynamic warm-ups which may include animal walks, relay races, and jumping games; a progressive walk/run/bike program building up to increased time running/biking and increased overall distance; client-specific strengthening and agility tasks to target weak muscle groups and to promote the symmetry of movement required to efficiently run or ride a bike; and stretching to promote muscle flexibility and adequately cool our bodies down.”
– Laura Basi, Physical Therapist

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How to Get Involved

Look for organized activities in your community that help bridge the gap between individual therapy and daily life.  Here are some examples of upcoming events at Easter Seals DuPage & Fox Valley that present ways for skills to carry over into home, school and the community.

May 6, 2017              
Run for the Kids: Superhero Hustle 5K Run/2 Mile Walk
Easter Seals DuPage & Fox Valley, Villa Park, IL
This superhero themed run/walk is a family-friendly event for all ages and abilities.
Register here

• Set a goal to run the race, roll or drive the distance in a wheelchair or take a few unassisted steps across the finish line.

  Participants of the Hustle for Health community based therapy program are training to run all 3.1 miles of the race independently.  The Hustle for your Health program began because many children struggled with the 1-mile run in their school P.E. class. A 10-12 week training program is intended to target running pattern and cardiovascular endurance so that participation in community run/walk events becomes a reality.

Rich Howe Photography

Rich Howe Photography

June 9, 2017              
Golf Outing in Partnership with Freedom Golf Association
Cog Hill Golf & Country Club, Lemont, IL
Enjoy 18 holes of golf and help bring the joy of golf to children with disabilities.
Register here

• Try something new by learning the game of golf in an adapted golf clinic.

  The golf clinic welcomes children of all abilities to participate in the fun with adapted clubs and equipment and 1:1 training from expert golf coaches from Freedom Golf Association.

  To register for this golf clinic email spike@eastersealsdfvr.org by May 1.

September 17, 2017               
2nd Annual Bike for the Kids
Easter Seals DuPage & Fox Valley, Elgin, IL
Choose a cycling distance ranging from 12 – 100 miles or participate in a 2.5 mile family ride.  Adapted bicycles and trailers welcome!
Register here

• Go on regular bike rides and train as a family throughout the summer.

All proceeds from these events support infants, children and adults with developmental delays and disabilities at Easter Seals DuPage & Fox Valley. For a complete list of upcoming events visit here.

Taking off the Training Wheels: Transitioning to a Two-Wheeler

Blog by: Bridget Hobbs, PT, DPT

Photo by Ann Mehrman

Spring is here and bike riding season is upon us!  Since May is national bike month (#bikemonth) I want to shed some light on biking, which is a fun activity the whole family can enjoy.   Taking off the training wheels can be a big step, so here are a few tips that will ease the transition to a two-wheeler.

First, always make sure the child’s bike is in good condition.  Inflated tires, working brakes and an oiled chain help to ensure safety.   In order to properly assess if the bike is a proper height for your child, have them stand on the ground and adjust the seat so it is just under their bottom.  Practicing getting on and off the bike before riding will also help them feel more independent and comfortable with the transition to a two-wheeler. A proper fitting bike helmet is a must as well!  Some children may need comfortable fitting elbow and knee pads for safety.

The ‘run-behind’ method, where Mom or Dad runs behind while holding underneath the bike seat to give the child peace of mind, is a proven technique for beginning the two-wheeler process.  Giving positive feedback such as “keep up the good work” can keep your child from getting discouraged while learning the skill of balancing on two wheels.  Offering  a reward,  such a family bike trip to the ice cream shop will keep your child motivated to succeed.

Photo by Amy Onesti

Learning the balance of a two-wheeled bike is often the hardest part when transitioning from training wheels or a tricycle.  If your child is having difficulty with the balance of a two-wheeler, it might be good to try a Strider Bike.   A Strider Bike is a bike without pedals which can be used by children as young as 18 months to learn the balance, coordination and steering of a two-wheeler.  This bike gives children the confidence they need to ride independently before transitioning to a bike with pedals.

The best way to teach your child to bike ride and enjoy overall fitness is to lead by example.  So, plan some fun family outings to a forest preserve or park trails today!

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.