Efficacy of Lower Extremity Cycling Interventions for Youth with Intellectual Disabilities: A Systematic Review

Abstract

Purpose

To systematically examine the efficacy of lower extremity cycling interventions for youth with intellectual disability (ID).

Methods

Seven databases were searched from March 2000 to October 2019 for English-language articles on cycling interventions for youth with ID. The American Academy of Cerebral Palsy and Developmental Medicine guidelines were used for assigning levels of evidence and grading study quality.

Results

Eight articles met inclusion criteria. Children and young adults, 7-26 years (n = 229), with diagnoses of Down syndrome, autism spectrum disorder, or unspecified ID participated in the studies. Moderate evidence (one level II single subject design study) suggests that a specific cycling intervention can improve two-wheeled cycling skills in youth with ID. Weak evidence (level II group studies) supports stationary cycling for short-term improvements in cognitive skills and two-wheeled riding intervention for increasing physical activity one-year after intervention.

Conclusions

Moderate to weak evidence exists to support two-wheeled cycling instructional programs or stationary cycling interventions for children and young adults with intellectual disabilities. Therapists can use this information when discussing cycling interventions for individuals with ID. Further research is needed to inform therapists in clinical decision-making related to dosing cycling interventions.

Keywords:

• Bicycle riding
• bicycling
• cycling intervention
• stationary cycling

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

At the time this article was written Maria Fragala-Pinkham and Amy Ball were doctoral students at University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Fragala-Pinkham was partially funded by a Department of Education training grant H325K120310.

Notes on contributors

Maria A. Fragala-Pinkham

Maria A. Fragala-Pinkham, PT, DPT, DSc, is a Physical Therapist and Manager of Research and Quality Improvement at Boston Children's Hospital in the Physical and Occupational Therapy Department. Her clinical and research interests include evaluating the effectiveness of physical therapy interventions and developing adaptive sports programs of cycling, ice skating, and baseball.

Amy L. Ball

Amy L. Ball, OTR/L, is an Occupational Therapist and Clinical Liaison for Mercy Inpatient Rehabilitation Center in Oklahoma City, OK. Her clinic and research interests include development and evaluation of effective tools to aid in aging in place, alongside caregiver support tools.

Lynn M. Jeffries

Lynn Jeffries, PT, DPT, PhD, PCS, is an Associate Professor and Director of Clinical Education in the Department of Rehabilitation Sciences at the University of Oklahoma Health Sciences Center in Oklahoma City, OK, USA.