Can I learn to Cycle? Opportunities for all children to ach - PowerPoint Presentation

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Can I learn to Cycle? Opportunities for all children to achieve cycling- voices from research and practice

Child’s World- Next Steps,

International Conference Aberystwyth University

Gabriela Todd and Dawn Pickering

26th June

2014Slide2

Objectives Context of practice and researchCycling, Race runningChildren’s voicesFuture Slide3

United Nations Convention on the Rights of the Child 23 Children with disabilities 28 Right to Education29 Goals of Education

31 Leisure play and cultureSlide4

BackgroundPhysiotherapy clinical practice with Cerebral Palsy (CP)

Lack of participation opportunities for CP

Fowler et al, 2009;

Fauconnier

et al, 2009;

McConachie

et al, 2006;

Mihaylovat

et al 2004

Choice of activities limited- requires some adaptation and supportSlide5

Cerebral Palsy- consensus definitionRosenbaum et al 2007‘….describes a group of permanent disorders of thedevelopment of movement and posture causing

activity limitations

that are attributed to non-progressive

disturbances that occurred in the developing

fetal

or

i

nfant brain. The motor disorders of cerebral palsy are

often accompanied by disturbances of sensation,

perception, cognition, communication and behaviour, by

epilepsy and

by secondary musculoskeletal problems

.’Slide6

Palisano et al, 1997; Reid et al, 2011Slide7

Adapted cycling research 2009-2012(Nancie Finnie Charitable Trust )

Diane’s drawing aged 10

Muscle strength and length

Participation opportunities

2 groups:

Cycling (17),

non

cycling (18)

Diary of physical activities

Interview adapting Mosaic methods

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Cycle routeSlide9

What did physiotherapists understand participation meant? Pickering et al, 2012

Medical modelSlide10

Non cycling group analysis- physical activities + cycling Pickering et al in press 2014

Wheel of Participation

Social model

VoiceSlide11

AspirationsPeter’s Mum

:

“

Gabriela put him on the Tom Cat

trike

, strapped his feet in and

it was the first time ever he pedalled and he couldn’t stop it. Everybody got so emotional, fantastic

. It just shows if you’ve got the tools for the job, the right equipment, you can do it…This year we cycled from Bristol towards Windsor because we could hire the special

trike

….

I think completely independently he cycled not far off 40 miles

…”

“I did cycling and it was wicked!”

Peter aged 7 years

Diplegia

, High tone, GMFCS ISlide12

Diane’sDiary entry-cycling skillsSlide13

Andrew’s cycling skillsAndrew was able to describe his cycling experiences: ‘…when I pedal it’s like I’m

there

and I am

enjoying

it…we cycle in

the park and I go

down

the slope…and

then I

change

it…. you know…

I put into 3

(gears) and it makes me

fast

…’

Dad describes his progress ‘…

he loves

biking,

obviously it gives him that

independence

…they’ve taken the

footplates away..’

Andrew progressed to going cycling

with a carer (

Bethan

)

Dad: ‘…

Bethan

actually cycles with

Andrew and

they now do four circuits

rather than the one or two he did

before….’

Andrew 17 years and GMFCS level II with

diplegia

,

athetosis

and autism

Recumbent

Trike

steered from sideSlide14

Children unable to self reportJulia, 14 years, GMFCS IVRachel, 8 years, GMFCS IV

“

You can just see

the joy

in her face when she’s on her bike yeah!....Um, I mean if it’s straight, you know, you can virtually sort of let go and she’ll just go by herself until she starts veering off course……

she definitely enjoys it

…”

“

Throughout the cycling sessions I feel that

Rachel’s confidence has

improved

. She is so happy when she is cycling and it gives her the

freedom and independence

she needs…..”Slide15

FatigueSlide16

Cycling at schoolBecky (GMFCS III) attended mainstream schoolDiary entry, written by mum: “…It’s bike day at school. All of the children are taking their bikes…Apparently she had another good session, cycling enthusiastically and proudly on her bike ( not sure how long-should think it was a good hour)….” Slide17

May’s diary entry

May is GMFCS II and has underdeveloped organs, dystonia and hemiplegia due to

prematurity

and having a strokeSlide18

May’s Cycling AmbitionsMay ‘s own Diary entry (aged 10 years) Today I had a 20

mins

bike ride with my

sister and brother to RK secondary

school car park there are loads of bends,

curbs, bays and car spaces.

I have come

on really well considering me and my

family all thought I wouldn’t be able to

achieve such a brilliant

opertinity

, we

also thought I am going to be doing a

bike

prefishinsiy

test after

easter

so we

have been practising

weving

in and out

and signalling left and right the right is

really easy for me but the left is what I

find tricky. and I am also learning that I

have to ride on the left on the road.

May

Interview

:

Int

:… So assuming you pass your

cycling proficiency test, what do you

hope to do with your cycling?

M:..

to get better and better at it.

Int

: Where would you like to go with

your bike?

M: H Forest

Int

: Have you been there already?

M: Yeah but I had to go on

a ‘stupid

tandem’

because my teacher kind of

forced me…another Dad pedalled..

Mum: …It was sort of an ice cream

basket on the back..

Int

: So you didn’t do any pedalling at all?

M: No which was

really, really, really

disappointing…

cos

all my other friends were

like riding a bike and I was lonely….Slide19

Change in behaviour11 of the 18 children started cycling during or after the study was completedSlide20

Implications for practiceQuality of life - The children who participated in adapted cycling told us they enjoyed this experience and it improved their sense of well being, independence, achievement and confidence.

Some children chose other activities to participate in, fatigue was a factor in this.

Policy makers

should consider offering adapted cycle hire within a 50 mile radius.Slide21

Follow on from researchThis research has led to the development of some after school cycling clubs and the exploration of a competitive sport:

Race

running bikesSlide22

Imogen on her racerunner

Children were curious

5 pilot sessions in athletic stadium

Great excitement

Physiotherapy Student volunteers keen to help

Requested FundingSlide23

RacerunningSpeed- without worrying about fallingSpace is open- freedom to move - Sociable

- being with others is fun

Spring-loaded

- easy to turn or to keep straight

Sporty

- fun to race my friends

Stand

- I can just stand still and stretch, chat or rest!Slide24

BeginningOUTCOME

What Gareth did

Parents want their children to have a go

invite an expert speaker

Assessment arranged at cycle charity

Cycle together session follow-up

Funding for 4 after school sessionsSlide25

Imogen on her bikeSlide26

Kissing gates were created to keep animals in, not children out

Radar key Slide27

Making leisure activities accessible for allAccessible spaceOpportunities Personal adjustments

Adult services cannot simply be made “smaller”

Cost of bespoke anything is high- seek fundingSlide28

6 week after school cycling clubHelp children to be physically active for one hour after school (well-being)Work on pre-cycling skillsProgress children or let them try out different cycles and chose what they like- if safe

H

elp children focus as routine builds up

R

educe the burden for parents to go out again after school when they are tiredSlide29

Department of Education June 2013Evidence on physical education and sport in schools:“The barriers include: inaccessible facilities and equipment; staff without adequate training; and inadequate, non-compliant or otherwise inaccessible programs and curricula

(

Auxter

, et al, 2010;

Rimmer

, 2008;

Rimmer

and Rowland, 2007;

Stanish

, 2010)”Slide30

Imogen’s digital storyConsent obtained 28th April 2014:Imogen now aged 8 years reported that she

“

enjoys horse riding- especially when I’m trotting, bike riding and Brownies” Slide31

Three ‘E’s we need to flourish

Expectations

Equality

Empathy

Wheelchairs

Medical prognosis

Treatments

The sky is the limit

How do those words make me feel?

Hours in the day

Whole family aspirations, constraints and challenges

Children have rights too

“Yes, we can!”Slide32
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Questions ?Dawn Pickering, Senior Lecturer,

Cardiff University’s School of Healthcare Sciences;

pickeringdm@cf.ac.uk

Twitter: @

DawnMPickering

Gabriela Todd, Community Children’s Physiotherapist, NHS; and

BBC Children in Need

funded @ Cardiff Pedal Power

gabriela.todd@yahoo.co.uk

;

physio@cardiffpedalpower.org