Adaptive Cycling

Adaptive Cycling

Cycling provides a fun way to enjoy the outdoors while getting some exercise. People with disabilities can enjoy para-cycling with different types of cycles, depending on the type of disability. Para-cycling can be done for fun, recreation, and fitness. There are local, regional, national, and international competitions for those cyclists who are looking for greater challenges. Local riding groups and international competitive teams are available for cyclists of various skill levels.
Child on a Tandem Bike

Tandem Cycle image use covered by Adaptive Cycling
The tandem cycle is a bicycle built for two. Tandem cycles allow a visually-impaired person to ride with a sighted person. The visually-impaired person, as the stoker, rides on the back seat. The captain rides on the front seat and pilots the cycle. The team, with practice, learns to coordinate pedaling, shifting gears, and maneuvering different road conditions. Tandem cycle riders should take care to find a tandem cycle that fits their size. Many upright tandem cycles are built for children or females to sit in the rear/stoker position. Tandem cycles with recumbent seats and multiple wheels (3 or 4) are also available so that the cyclist can sit in a reclining or upright position that offers more support than a traditional bicycle seat. This type of cycle reduces the chance of falling and reduces the need for balancing. See the Wikipedia Tandem Bicycle page for further information.

allow individuals with lower-body disabilities to pedal using their hands and arms. These cycles are usually recumbent cycles: the rider sits lower to the ground in a chair rather than on an upright seat. Handcycles are available for recreational and competition use and should be chosen based on the size of the rider and the intended use. For more information, see the Wikipedia Handcycle page.

Adaptive Foot-Powered Tricycle image use covered by
MOST - Stories from the Heart
Teen on an Adative Cycle
Tricycles offer greater stability for individuals with balance difficulties, such as those with brain injuries. Tricycles are available in both recumbent and upright styles. They are available for children, off-road, racing, and other uses. See the Wikipedia Tricycle page for further information.
Finally, some individuals with various disabilities can ride regular bicycles. Jaye Milley, a quadruple amputee and competitive cyclist, provides some pretty fantastic inspiration. See the Canadian Paralympic Jaye Milley page for further information.

Assessment and Evaluation: Getting Started

Since cycling places the rider at a high risk for injury, the rider’s primary care clinician should provide anticipatory guidance for a regular exercise/training routine. The clinician, as well as other cyclists, should also recommend proper safety equipment, including helmet, gloves, elbow, and knee pads. [American: 2001] [Van: 2012] Additional safety precautions may include using sunscreen or wearing long clothing, such as arm warmers and coolers, to protect against the sun and weather.
Cyclists should be assessed for possible discomfort as a result of incorrect size or positioning of the seat, pedals, or other cycle components. Injuries and pressure points can occur on the hands, knees, elbows, feet, back, sacrum, and any contact point for prosthetic devices.
Cyclists that are riding for recreational purposes should be evaluated at regular chronic-care and well-care visits. However, the cyclist's condition may require closer observation by the primary care clinician or cycling partner. For example, individuals with traumatic brain injuries may have difficulty regulating their body temperature and may need to be monitored by a cycling partner throughout and after the cycling experience to prevent overheating.
Boy and Mom on a Tandem Bike

Buddy Bike image use covered by Adaptive Cycling
Many cyclists will enjoy riding for recreation and fitness, but for those who wish for an even greater challenge, there are various levels of competitive cycling. When a cyclist chooses to participate in competitions, the primary care clinician should provide documentation according to the rules noted by the cycling organization. Usually the documentation is required as the cyclist applies to participate in competitions.
The documentation may include clearance to participate and medical history with an indication of the severity of the disability. The cyclist is usually classified according to the type of cycle to be used and the severity of the disability. The diagnosis or type of disability is usually less important, but still helpful in determining the class, since the focus is on the functional ability of the cyclist. Testing processes are usually used by the governing organization to ensure that cyclists with similar functional abilities are placed in the same class in order to provide a more fair competition. An example of the classifications can be found at Para-cycling Classification. This example is provided as a sample reference since the classification rules may vary for different governing organizations.
When prescribing medications or offering treatment options, the primary care clinician should be aware of the implications in terms of the functional ability of the cyclist, the World AntiDoping Code, and the possible lack of medical services available for the cyclist while traveling. [Van: 2012]
Cyclists that are competing with organized groups, such as paralympic teams, are evaluated periodically by the medical staff of the governing organization to ensure the cyclists are in the correct classification. See Team USA Paralympic Cycling Performance Pipeline. The cyclist may or may not have further access to the medical staff of the governing organization or the cycling team's medical staff.

Use and Care

As with other recreational and sport activities, cyclists should contact the medical home with any changes in the primary condition or unexpected effects from the activity such as injuries.
For recreational use, the cycle should be maintained similarly to other bicycles by periodically checking the chain and other hardware, and checking tire pressure and brakes before each ride. For competitive use, help with this kind of maintenance may come from the organization providing the cycle. The primary care clinician should ask the cyclist about the proper fit and usefulness of the cycle as the rider changes in age, size, or functional ability.

Funding and Costs

Commercial cycles are available at local stores that sell bicycles, while custom cycles are available from specialized businesses. Prices vary and insurance does not often cover the cost of the cycle. Organizations that provide recreational opportunities for people with disabilities may offer scholarships or discounted rates for use of equipment. The medical home may refer patients to organizations that provide recreational opportunities for individuals with disabilities.


Information & Support

For Professionals

USA Paralympics Cycling Classification
The USA Classification Policies and Procedures – Cycling cover sport-specific classification information including classifier prerequisites, current classifiers and their authorization levels, classification panel composition for the sport, and any sport criteria for athletes who present for classification assessment.

Para-cycling Classification
Para-cycling classification is the disability cycling process governed by the Union Cycliste Internationale (UCI) covering 4 functional disability types.

For Parents and Patients

AbleData Product Categories
AbleData classifies the products listed in their database of assistive technology by each product's intended function or any special features it possesses. The products are classified by type.

U.S. Blind Tandem Cycling Connection
The U.S. Blind Tandem Cycling Connection endeavors to increase the participation of individuals who are visually impaired or blind in the exhilarating sport of tandem cycling.

Orange County Bike Camp
Video describing the Orange County Bike Camp in California.

Paralympics 2012 Cycling Promo
YouTube Video of 2012 Paralympics Cycling Events.

London 2012 Paralympic Games
YouTube video of Paralympic Cycling at the London 2012 Paralympic Games.

Paralympic Cyclists Preparing for London
YouTube video of paralympic cyclists preparing for the 2012 Paralympic Games.

Channel 4 Paralympics -- Meet the Superhumans
YouTube video of the 2012 London Paralympic competitors.

Paralympian Cyclists Train
YouTube video of paralympian cyclists training for world championships.

Team USA Paralympic Cycling Performance Pipeline
The USA Paralympic Cycling Performance Pipeline Table.

UCI Introduction to Para-Cycling
YouTube video that explains the classifications for paralympian cyclists.


Disability Related Sports

See all Disability Related Sports services providers (49) in our database.

For other services related to this condition, browse our Services categories or search our database.

Authors & Reviewers

Initial Publication: January 2013; Last Update: March 2016
Current Authors and Reviewers (click on name for bio):
Author: Alfred N. Romeo, RN, PhD

Page Bibliography

American Academy of Pediatrics.
Bicycle helmets.
Pediatrics. 2001;108(4):1030-2. PubMed abstract

Van de Vliet P.
Paralympic athlete's health.
Br J Sports Med. 2012;46(7):458-9. PubMed abstract