This article has been fact checked by a Board Certified Pediatric Nurse Practitioner. Sources of information for the article are listed at the bottom.
For any content issues please Contact Us.
Riding a bicycle or tricycle is a beloved pastime and a beneficial way for children to have fun with peers while getting exercise. Children with cerebral palsy may not be able to ride a traditional bicycle, but they can still enjoy the freedom of bike riding with the help of adaptations.
An adaptive bike is a bicycle that’s modified to accommodate people with disabilities. The modifications can vary, depending on each child’s needs. These bikes and trikes come in different sizes and varieties.
Therapy trikes are designed specifically for children with disabilities by offering three wheels for stability, along with adjustable handlebars and pedals. A therapy trike, also known as an assisted tricycle, is not only designed to help mobility-challenged children enjoy riding, but it also promotes muscle strength and tone.
Adaptive tricycles aren’t just for young children. They come in different sizes to accommodate toddlers, elementary-aged kids, teenagers, and adults. Some trikes come with a standard bicycle seat while others come equipped with wheelchair-style seating.
Most therapy trikes will have wrists straps and self-leveling pedals. Handlebars can be modified for easier control.
A handcycle is a three-wheeled tricycle that’s powered by hand cranks. These types of cycles are ideal for children who have limited or no mobility in their legs. As with other types of adaptive bikes, handcycles can be modified to each person’s needs.
For example, some handcycles allow foot pedaling while using hand cranks at the same time. This helps increase the child’s range of motion while stimulating movement. It also helps build coordination by encouraging the arms and legs to work together.
Other handcycles are powered solely by the arms and hands. The brakes on most arm-powered handcycles are located on the handlebars.
Handcycling has become so popular since its invention that it has become a major way for disabled people to compete in sports. Handcycling is now considered an official sport at the Paralympic Games.
Adaptive Stationary Bikes
A stationary bike may not be as fun as riding outdoors on sunny days with friends, but it offers countless benefits to children with cerebral palsy. A stationary bike is primarily used as a pediatric therapy exercise option and improves cardiovascular fitness while targeting specific needs.
According to the U.S. National Institutes of Health, previous statements that “effortful exercises” would harm children with cerebral palsy have been unfounded. Instead, a study carried out by numerous pediatricians entitled “PEDALS Project” showed that stationary biking is beneficial for kids with CP. 
“Stationary cycling programs can provide progressive resistance exercise for lower extremity musculature,” the study reads.
Stationary bikes are adjustable and can be modified to each child’s needs. For example, the seat can be widened and reclined and the pedals adjusted for size. Most adapted stationary bikes come with a restraint system to support the upper body and/or ankle straps and braces.
Recumbent bikes allow a child to ride an adaptive bike with a reclining seat that helps with weight distribution, which in turn makes cycling easier.
Recumbent bikes typically have two wheels in the back and a larger wheel in the front of the bicycle. The extra front wheel helps children with stability while riding. Sometimes, recumbent bikes have two wheels in the front and one in the back.
Recumbent bikes can help address physical problems many children with CP will experience in the neck, back, and arms such as stiffness, spasticity, and weakness.
Work with your child’s pediatrician to determine which type of recumbent bike would work best for your child. In general, recumbent bikes with one front-wheel sit higher from the ground than those with two front wheels.
One front-wheel recumbent bikes are easier when getting on and off the bike, but the two front-wheeled recumbent bikes usually have better stability when making turns.
Tandem bikes allow someone else to ride with a disabled child, often an adult who pedals while the child enjoys the ride.
Tandem bikes have different designs, but for children with cerebral palsy, the most common choice is the bike that allows the child to sit in a front seat attached to the front of the bike, while the other person sits on the back seat of the bike, while pedaling and steering.
Tandem bikes can come with pedals in the back, as well as pedals in the front. The front pedals are lifted up to the level of the child so they can help pedal. If the child needs a break from pedaling, they can stop while the person in the back seat of the bike continues.
Another type of tandem bike includes a side-by-side tandem tricycle that lets two people pedal at the same time, at their own rate. Both types of tandem bikes allow disabled children to take breaks when needed while still enjoying a bike ride.
Adaptive Bike Prices
The cost of an adaptive bike varies, depending on the type of bike and the number of modifications.
Typically, adaptive bikes can range roughly anywhere from $100 to $5,000. The costs of caring for a child with cerebral palsy can be demanding on parents and caregivers, and adding an additional cost of a bike can be daunting.
There are several options to consider if you need funding for an adaptive bike.
Some medical insurance providers cover the price of an adaptive bike if it falls within qualifications.
Medicaid may cover the expenses under specialized medical equipment and supplies if the bike is deemed medically necessary. Most states require you to submit a claim, under “HCPCS Code E1399 DME Miscellaneous,”  which should be filled out by the child’s doctor.
Most states also require the child’s doctor to prescribe the need for a bike and deem it necessary before insurance will cover the cost. East state has different rules and regulations, however, so it’s important to understand what your own state’s laws entail.
Keep in mind that Medicare will generally pay for the most basic or cost-effective type of bike, which may mean additional modifications will not be covered.
State Financial Loan Programs
Each state also offers financial loan programs. In California, for instance, a program called “California Foundation for Independent Living Centers” offers families affordable assistance. New York offers the “Technology Related Assistance for Individuals with Disabilities (TRAID).” 
Contact your child’s pediatrician or caseworker for more information on financial loan programs. You can also check with the Rehabilitation Engineering Society of North America (RESNA) for contact information for each state.
Fundraising is another option. However, before starting any fundraising event for a disabled child, it’s important to first consult with a cerebral palsy attorney, who can help set up a trust for any funds earned.
Another option is obtaining a grant. Charitable organizations such as the Make-A-Wish Foundation, Easter Seals, United Way, and many more may be able to help you afford an adaptive bike for your child.
- Pediatric endurance and limb strengthening for children with cerebral palsy (PEDALS) – a randomized controlled trial protocol for a stationary cycling intervention. (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1838902/
- E1399 - HCPCS code for durable medical equipment, miscellaneous. (n.d.). HCPCS Codes Level II - 2020 Complete Reference.
Retrieved from: https://hcpcs.codes/e-codes/E1399/
- The technology related assistance for individuals with disabilities (TRAID) program. (n.d.). New York State Department of Health.
Retrieved from: https://www.health.ny.gov/publications/0548/the_triad_program.htm