Jason, I'm gonna sneak another email out here:

When I was competitively cycling, folks were just beginning to change over
from "toe clips" to shoes that actually mate with the pedals via a lug in
the shoe sole.  Because my left knee rotated around the pedal axis in an
elliptical motion, I had to stay in the toe clips in order that my knee
could flex laterally.  I write this just to warn you to stay away from
anything that "locks" her foot rigidly to the pedals.

A pedaling stroke should involve two actions: "pushing" down on the pedal,
and "pulling" up.  If she is able to perform both in her stroke--no matter
how weak her ability--she will progress quickly towards increased tone.  She
can accomplish this by using a pair of mountain bike toe clips reverse
engineered to fit the trike.  Take the trike to any mountain bike shop and
the mechanics can fix her up, I'm sure.  If you can't find anyone to do the
work, let me know.  The UCPAA folks at University of Connecticut are great
for this sort of thing.  Make sure, too, that the "cranks" (the connectors
from the pedal to the axle on the front wheel) are long enough for her to
get enough torque to start the trike from a dead stop.  It's no big deal to
add 2X4 blocks to the pedals.  This will effectively lengthen the crank.

As far as holding on to the handlebar:  epoxy a light-weight, close-fitting
glove to the hand grip.  Buy a pair of kid's cycling gloves with velcro
closures so you can cinch the glove fairly tight without being
uncomfortable.

Lastly, be careful of the type of trike you buy.  The old, all metal style
have a high center of gravity--easy to tip.  The "Big Wheel" variety, where
the child's bottom is only a couple inches from the ground, are far safer.

Helmets are an absolute must!  Knee, elbow and shin guards are helpful and
you can get them in favorite cartoon character styles.  You might think
about a mouth guard to prevent those new permanent teeth from a chip, too.

Let me know if I can help in any other way, Jason.

-Kyle



-----Original Message-----
From: Jason Kruse PA-C [mailto:[log in to unmask]]
Sent: Friday, April 11, 2003 10:12 AM
To: [log in to unmask]
Subject: Need a special tricycle


Hello all-
Can anyone direct me to a distributor of tricycles that are designed with a
hemiplegic in mind? My 6 yr old is hypotone and mild left hemiplegic. The
main problem is the stregnth to do the alternating feet pedaling, keeping
the feet on the pedals. Keeping the left hand on the handle, and controlled
turning of the handle bars. She want to do it but you can see that she is
starting to avoid them. Since everyone else her age and younger are doing
this already it is now another thing that is excluding her from social play.
Sure do appreciate any leads or anecdotal suggestions..

Thanks a bunch

Jason K