Physical Activity with Spina Bifida

Therapeutic exercise is important for people with Spina Bifida and helps improve health and quality of life.

Aerobic exercise is important, as is muscle strengthening activities.  Whilst nervous system damage can make some types of physical activity challenging for those with Spina Bifida, cycling with the right support in place, can fulfil both these functions.

Cycling for Spina Bifida

The symptom most commonly associated with Spina Bifida is weakness of the legs.  This will vary from mild through to total paralysis depending upon the individual’s condition and means that the cycling solution best suited to the individual’s needs will also vary.  

Using the legs as nature intended is always the preferred option, as the exercise this provides both strengthens and tones the leg muscles, whilst similarly benefitting the digestive system which can also be adversely affected by Spina Bifida.  Legs are better designed for propulsion purposes than arms as they have larger, stronger muscles and greater range of movement.  Also, steering and propelling a trike at the same time can be more of a challenge.  However, if legs are a poor option or not an option at all, hand propulsion or hand and foot propulsion, will provide an excellent compromise.

In the case of full paralysis of the legs, only hand propulsion is possible – however, all Tomcats hand propelled trikes can be power assisted to level the playing field with leg propulsion, or to take the effort out of manual propulsion.  

Many of our trikes can be built with “hand propelled” power assistance to 28kph (15.5mph) or Tomcat’s Bionic Buddy™  – an electric motor which is limited to a brisk walking speed (3mph) and does not need pedal or hand crank assistance to propel the trike.  Consequently, it is an ideal solution for Carer Controlled™ trikes of any kind.  

In between these two distinctly different propulsion options is the option of a hand and foot propelled trike. This is a good choice where there is mild or moderate strength in the legs, a wish to exercise the legs, or to provide general health benefits.  

Care has to be taken over the design geometry of hand and foot propelled trikes as it is possible to have collisions between legs and arms when both are in motion, but with our knowledge of the issues and our custom building ability, this can be avoided.

The final factor with hand propulsion which is not always understood, is that it is not just the arms that provide the cycling action; the spine plays an important part too!  For that reason, when we fit a back support, we like to place it in the area of the lower thoracic vertebrae T10 to T12 as this allows the spine to flex as part of the cycling process.  As the arms extend, so the spine straightens and the shoulders reach forward whilst the exact opposite happens when the arms contract.  In this way, all the muscles and joints in the arms and spine are being put through their paces to the benefit of the entire upper body, and the bowels.  It is possible to hand crank with higher back support and a harnessed thorax, but that usually requires very careful consideration.

From a practical perspective, hand propelled trikes have traditionally had transport limitations.  Whilst it is possible to fold a machine for transport, this does nothing to reduce weight and very little for the overall footprint – however, Tomcat is renowned for its transportation features, where the frame can be split and the seat and wheels can be removed in just a few seconds.  Our new Connect™ system is of particular interest as it provides the automatic division and reassembly of essential control functions such as braking, gear changing, motor controls and many more electrical or mechanical functions besides. This means that critical controls such as the rear brake’s ‘stationary start’ button and power control can all be fitted to the hand cranks where they belong.    

In conclusion, providing suitable bikes for Spina Bifida, though complex, is entirely possible – particularly with Tomcat’s manual and power assisted options.  It just needs to be the right machine, with the right features and accessories to suit the individual.