title: Ability of independently ambulant children with cerebral palsy to ride a two-wheel bicycle: a case-control study.
abstract: Limited information exists on the ability of children with cerebral palsy (CP) to ride a two-wheel bicycle, an activity that may improve health and participation. We aimed to describe bicycle-riding ability and variables associated with ability to ride in children with CP (Gross Motor Functional Classification System [GMFCS] levels I-II) compared with children with typical development.
  
  
  
  This case-control study surveyed parents of 114 children with CP and 87 children with typical development aged 6 to 15 years (115 males, mean age 9y 11mo, standard deviation [SD] 2y 10mo). Kaplan-Meier methods were used to compare proportions able to ride at any given age between the two groups. Logistic regression was used to assess variables associated with ability to ride for children with CP and typical development separately.
  
  
  
  The proportion of children with CP able to ride at each level of bicycle-riding ability was substantially lower at each age than peers with typical development (p<0.001). While most children with typical development were able to ride independently by 10 years of age, 51% of children with CP classified as GMFCS level I and 3% of those classified as GMFCS level II had obtained independent riding in the community by 15 years of age. Variables associated with ability to ride for children classified as GMFCS level I were age and parent-rated importance of their child being able to ride.
  
  
  
  Some independently ambulant children with CP can learn to ride a bicycle, in particular if they are classified as GMFCS level I. Variables associated with ability to ride deserve consideration in shaping future efforts for the majority of this population who are not yet able to ride.
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.|Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia.|Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Melbourne, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Toovey
authors.affiliation: Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Reid
authors.affiliation: Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Melbourne, Australia.
authors.forename: Barry
authors.initials: B
authors.lastname: Rawicki
authors.affiliation: Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Department of Developmental Medicine, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Adrienne R
authors.initials: AR
authors.lastname: Harvey
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
authors.forename: Kerrianne
authors.initials: K
authors.lastname: Watt
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001642:Bicycling / Q000502:physiology*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000523:psychology; D016009:Chi-Square Distribution; D002648:Child; D002658:Developmental Disabilities / Q000503:physiopathology*; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D010290:Parents / Q000523:psychology; D012720:Severity of Illness Index