Advice

The World Health Organisation defines Disability as follows: "Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions.

Of course there are those who have a disability who can ride any and all types of bicycles. Quest 88's range of cycles is aimed at those who may require 3 wheels and those who need encouragement and supervision whilst riding. When we mention disability and disabled in the context of this website we are referring to those interested in cycling but who generally need more physical or cognitive support or have impaired balance or confidence issues. Disabilities such as:

Cerebral Palsy, Spina Bifida, Spinal Muscular Atrophy, Muscular Dystrophy, Multiple Sclerosis, Learning disabilities, Autistic Spectrum Disorders, Angelman Syndrome, Prader Willi Syndrome, Stroke Survivors, Head and Spinal injuries.

The following information has been written and collated to help parents, end-users and those involved with inclusive cycling. It is not a definitive guide as each cyclist is completely individual. However we do hope that the advice below can help you in some way.

Inclusive means "to include or encompass everything and everyone". As far as inclusive cycling is concerned, total inclusion is an ambition, a goal, to enable everyone to participate in cycling, together.

With imagination, engineering knowhow and determination, children and adults with a varied range of abilities and disabilities can be enabled to participate in cycling activities with their able bodied peers, to enjoy exercise, fresh air and fun.

Cycling has the power to connect community and integrate those with disabilities into society.

Case Study 1:

Haus Munstertal is a residential respite and rehabilitation centre for children with disabilities and their families, situated in the Black Forest, Germany. One mile away from Haus Munstertal is the town of Staufen. For many years the residential centre and the town have led a disconnected existence, just barely aware of each other. When a cycle rental scheme was introduced at the Haus by Draisin, families began to take leisure excursions and shopping breaks into the town. This has now sparked a new relationship between the town and the respite centre and this having a mutual benefit for both parties. This means there is now more local support for Haus Munstertal , and an economic benefit for local businesses and residents.

Case Study 2:

Telford Social Services Day Services approached Quest88 in 2008, as they wanted to purchase some bikes to begin a cycle project in the Telford Town Park. They now run 2 cycling projects, one from a local day centre with access to cycle paths, and one in the heart of the town park. Day service users now cycle regularly in the community as part of their weekly activity program. Cycling is working to pacify those with more challenging behaviours. This improves the service user's sense of well-being and makes the job of the carer a little easier.

You will see similar cycles to those shown on our website, described as 'adapted bikes'. This is misleading. The word 'adapted' suggests a regular bicycle or tricycle which has been adapted to suit someone who is disabled. If these were adapted bikes, you would be forgiven for thinking these bikes are expensive just for the sake of a few adaptions. The bikes supplied by Quest 88 are specialist bikes; manufactured in low volumes but designed for purpose, to make pedalling easier, to address posture and with built-in features to enable adjustment for riders with different needs. This being said Quest 88 do manufacture accessories and components which, if suitable, maybe used to adapt regular 2 wheelers and other manufacturers of tricycle - such as footplates and calf supports.

Where to begin?

There are so many weird and wonderful contraptions available. You can learn a lot from looking through this website and reading through the advice given. Then the next step is up to you. Quest 88 offer a free demonstration service and also run road-shows around the country so that you can come and try any number of cycles, tricycles and companion bikes.

In recent years inclusive cycling has emerged as a vehicle for social inclusion and general fitness. Sometimes the therapeutic benefits can be overlooked. The symmetrical exercise offered by cycling, when combined with Physiotherapy, can produce great results and in some cases accelerate developmental progress.

As well as designing and selling inclusive cycling products, Quest 88 is also a leading designer and manufacturer of therapy and rehabilitation equipment and we carry a lot of what we know about physiology, position and posture into the design of our cycles and their accessories. Our clinical understanding is what sets Quest 88 and our products apart from those who would simply try and adapt a tricycle or cycle for a disabled rider.

Fixed Wheel

A fixed-gear cycle (or fixed-wheel cycle) is a cycle that has no freewheel, meaning it cannot coast. The pedals are always in motion when the bicycle is moving. This can greatly assist children and adults with little strength or low muscle tone as it greats an assistive momentum. A fixed wheel tricycle is useful for children who have limited space as they can reverse the tricycle for manouvering.

Even if a child or adult does not have the strength to pedal independently, by pushing or pulling them along, a child still benefits from passive exercise on a fixed wheel cycle. They can also enjoy the fact that they have their own cycle.

Freewheel (back pedal brake)

This is the most common place form of transmission for a cycle and it allows the rider to coast, "freewheel" without the chainwheel rotating whilst the cycle is in motion. Many children and adults with low muscle tone can find freewheel transmissions difficult as their ability to continue the full pedal rotation is inhibited.

Switchable

Quest 88 provide, through the Draisin range of cycles, both fixed wheel and free wheel on the same cycle which makes them ideal for training riders to pedal forwards and ultimately progress towards freewheel.

Gears

Most of the cycles developed for disabled riders have a limited range of gears, normally upto 7 or 9. This is generally due to the types of terrain that are suitable for disabled cyclists. Some riders will not be able to operate gears because of physical impairment or lack of cognitive skill or coordination problems. In this situation the parent or carer will need to select the gear in advance. For the more enthusiastic rider who may not have much spatial awareness, it may be necessary to select a high gear to reduce resistance and restrict speed.

For children and adults with Cerebral Palsy a fixed wheeled tricycle is a good place to start. Footplates and ankle foot orthoses may help the rider to maintain efficient pedalling.

Some of the Draisin companion cycles in our range have opt out gearing, which means the co-rider can rest whilst the parent or carer continues to pedal. Similarly these cycles can be switched over to connect the co-rider and carers drive. The co-rider can then benefit from passive exercise as the carer turns their charges' legs.

Electric motors and pedal assist.

All of the Draisin range of cycles we supply can be fitted with a hub motor and pedal assist technology. This is normally operated by a twist throttle and works when the rider meets resistance and pedalling becomes difficult or when they become tired.

Footplates, toe clips & Ankle Foot Orthoses (keeping feet on pedals)

Quest 88 manufacture two kinds of footplate: the standard footplate features ankle and foot straps to secure the child's foot to the pedals; the advanced footplate uses the straps in the same way, but can be used in-conjunction with ankle-foot orthoses (calf supports).

The ankle-foot orthosis is a "splint" type device which controls the child's ankle and foot relationship. This prevents the toes from dropping to the point where it is hard to maintain pressure through the pedals to drive the tricycle and keep up momentum. The ankle-foot orthosis also controls the position of the knees and influences the hip adductors/abductors. In effect, this removes the need for a pommel or wedge to space the child's knees apart.

Saddles, Hips and the upper body (supporting the upper body and posture)

Hip and upper body supports can be used to either:

1. Support those with very little sitting balance and/or upper body control, to enable them to sit on a cycle. (for those with more complex needs)

Hip supports work as a foundation for controlling stability further up the trunk, thoracic, chest supports and a head support can be added for better positioning and control. Belts are used to secure the rider and to fix their position.

The rider's position and posture is further enhanced when they are holding the handlebar, enabling them to extend the arms and push back their shoulders.

2. Give riders with moderate balance problems a sense of security and confidence whilst riding. (for those with moderate disability, learning disabilities or confidence issues)

For this category of rider, the hip support is not there to control positioning or posture as such, but is there to give the rider more comfort and confidence. The position or height of the support is less critical. Belts can be used but are not always necessary. It is important to remember that if you require footplates with straps for riding, then it is imperative that you are secured at the waist via a belt through either a full hip support or half moon support. If for any reason a tricycle is tipped it is highly dangerous for the feet to be attached to the bike but the rest of the body dislodged!

Steering, hands and handlebars

There is a broad range of handlebar sizes and styles to choose from. The double or "twin" grip style allows the child to move their hands between the inner and outer grips to assist in the steering of the tricycle. Another style available is the "forearm gutter" style which offers support for the arms and features vertical hand grips.

Mainly developed for children and often referred to as "push/pull rods" or "steer rods", these are devices which help put the parent or carer in control of the child's speed and/or direction. Each manufacturer has their own unique system, some more complex than others, although they generally achieve the same goals.

Push rods can be used to assist the child's pedalling whilst they steer according to where they want to go. This is great for developing independence and improving spatial awareness as the child gains an understanding of cause and effect whilst steering. The push rod is also useful when a child is tiring or as a confidence builder in the first few days/weeks of using a new tricycle.

Pull rods are used to lead the tricycle from the front. The main advantage is that the parent/carer is able to engage and encourage the child face to face. One disadvantage however, is that the parent or carer is having to walk sideways- on or sometimes backwards.

Rear steer systems are available from most manufacturers and are available on or Draisin Neon and Laser models. The rear steer system is especially useful for assisting children who do not have the awareness or ability to steer independently and who are unlikely to in the future because of the nature of their disability. Rear systems are more expensive than the much simpler push and pull rods and should only be considered where it is highly unlikely that a child can develop their own steering skills over time with training.

Gripping & Gripping Aids

These are designed for children and adults who have low muscle tone or weakness in the lower arm and hand and who want to participate more fully in leisure or DIY activities.

The Gripmit® from Quest 88 can be used to assist with the gripping of walking aids and tricycle handlebars, particularly where the user has a tendency to release handles spontaneously. Important: In this situation the Gripmit® must be prescribed and used responsibily and should not be simply relied upon at the expense of training and encouraging the individual to grip independently.

We have more to learn than to share here. The biggest thing we have learned at Quest 88, is that never make assumptions about who is able or unable to use different cycles. Through experience the Quest 88 specialists are usually able to match up an individual with the right cycle, however we saw one example of a young man who arrived at a roadshow in a parapet walker, his walking was very limited and his arm movements were very erratic and yet when a carer tried him in a semi recumbent, he was a natural. His ability to steer and pedal took us all by surprise. The secret is to just try things.

An assumption some people make, is that if someone arrives in a wheelchair, that they either require a hand-cycle or a wheelchair tandem. Sometimes such people are looking to use their legs to retard muscle weakness or ease stiffness, or for many children, to assist physical development. Whilst some children cannot yet walk independently, they may be using a standing frame and making steady progression towards greater weight bearing and eventually walking in a walker. In such cases they need to use their legs. Hand-cycling is fun too, so mix it up a bit.

Finally, Quest 88 want to assist you, by providing great equipment, but also by helping you to network, by sharing experiences and through training. Please contact us and find out ways we can help you with your cycling project

The following is not an exhaustive list but represents some of the areas you may wish to consider when assessing risk either as a parent/guardian or as a group organiser.

The user / passenger / service user
Personal safety equipment - helmet, harness, tendancy towards seizures, joint restrictions, orthoses, appropriate clothing, general health.

The carer (companion cycles)
Familiarity with the cycles handling, General fitness, patient handling experience, use of hoists, training and experience with cycles, general cycling proficiency, visability, cycling helmet suitable clothing.

The environment
A tricycle needs 3 points of contact with the riding surface. Slopes, uneven surfaces, cambers and curbs are all potential hazards to the rider, especially if the rider needs securing to the saddle and pedals. The rider's steering skills, ability to operate and understand braking and gear control are all factors in deciding the suitability of a location.

On the whole, a flat firm surface is best, free from traffic or parked vehicles and with appropriate supervision.

Cycling paths and country parks may be suitable, but it is always advisable to assess the route first to determine possible hazards such as streams and pot holes. Cycles with a lower centre of gravity offer the rider more control such as the Relaxino and Twister.

Appropriate supervision is always paramount.

Other environmental factors to be considered: Local knowledge and familiarity with route, weather considerations, pedestrians, pets, rivers or pools, ground under repair and embankments, designated cycle lanes and access restrictions.

The cycle

Tyre pressure and balance, (puncture resistant fluid?), fully functioning brakes, gears, motor operation and battery charge level, steering/performance characteristics. visibility/lights.

You can minimise these risks greatly if you remember the following:

Familiarise yourself with the cycles' braking and handling. Use the bike in a secure area several times before embarking on longer journeys and especially public byways and roads.

Even If you are familiar with the cycle - there is just as much reason to remain vigilant and alert.

Ensure that tyres are fully and evenly inflated before starting your journey or session. Tyre pressures should be indicated on the tyre walls.

Remember many adapted cycles and tricycles do not behave like conventional bicycles. Most require 3 points of contact. You cannot influence a tricycle by leaning in a counter direction in order to avoid a hazard. THEREFORE - Adjust speed by braking well in advance of making a turn or other manouvres. READ THE ROUTE. Braking whilst turning the cycle is a major contributor to instability and tipping.

Children and adults with congenital disabilities may not have the saving reflexes or balance reactions of an able bodied rider and so appropriate supervsion will be required. Some riders with learning disabilities and poor spatial awareness will require closer supervision or may be better suited to a companion cycle or tandem.

Be observant and read the terrain ahead, adjust speed accordingly. If you are planning to accompany someone into the community, you could ride the planned route beforehand without a passenger and mentally note potential risks such as pedestrians, other activities sharing the route, intersections, terrain, traffic etc.

This is a crucial part of cycling and yet so often ignored. All cycles and tricycles need some TLC.

Always make sure that your cycle is in good working order. Keep hold of your user manuals and observe them. Make copies and share them around with everyone who needs to be better informed, whether it is grandparents or colleagues.

Plan a maintenance and safety check schedule. If something is a amiss with your cycle or bicycle, address the issue quickly, don't postpone your actions. It is amazing how the condition of a cycle can deteriorate through neglect and then when you need to use the cycle, it is not functional.

This kind of equipment is manufactured in low volumes, specialist in nature and therefore more expensive than bicycles found on the high street or retail park. Thankfully there are a number of charities who can offer financial help. Our Funding support leaflet is regularly reviewed and whilst we cannot guarantee a successful funding application every time, we do contact the charities listed to make sure that our information is up to date and that they still actively support the purchasing of cycles. Making a personal contribution towards the cost of the cycle may assist with the success of your application and the speed at which your application is processed.

All our quotations include VAT in the totals, although in most cases VAT will not be charged providing we receive a valid, completed VAT exemption certificate which you will find included in this pack. Local government agencies will be required to pay VAT.

 

Having well-trained, equipped staff is often what differentiates between successful, motivated cycling initiatives and those that just muddle on. There is also a direct link between a lack of training and a rapid deterioration in the condition of bikes.

From January 2012,Quest 88 are distributing 100 vouchers, redeemable against British Cycling Disability Coaching Workshops, which cover 50% of the course fees. For more information please email: robert.henshaw@quest88.com

Inclusive cycling initiatives: If you would like product and maintenance training and Quest 88 are personally delivering equipment to you, it is an advantage if the relevant personnel are made available for a couple of hours on the planned delivery day. Alternatively, we provide equipment advice sheets and are available for advice over the phone or via email.

Quest 88 provides expert advice for existing and planned inclusive cycling schemes. We can offer advice on marketing, sustainability, route planning, safety and access, risk assessments and equipment storage. Full project surveys and reports are also available. Charges for surveys may be redeemable in part against cycle purchases.