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Adjustable Bicycle Stabilisers
muscle weakness and postural deformities - can provide clues to the likely effect upon rising from sitting. The spinal jacket provides an example. A patient may be supplied with a rigid polypropylene jacket to support the spine. If, however, his method of rising previously necessitated full trunk flexion, he may find that he is unable to rise when wearing the jacket, since adequate trunk motion can no longer be achieved. The patient may, unknown t o the clinician, abandon the jacket, when provision of a chair with a higher seat might have resolved the problem.
Conclusion Two important management principles emerge from 1 h e illustrations given. The first, of overwhelming importance, is preverifio? d joint contractures so that progressively weakening miiaclr?s may continue effectively t o provide a balance of moments Care should be taken that contractures are prevented iri all joints, not only those of the lower limbs. The second principle is that both therapists and clinicians should develop an understanding and awareness of the compensatory mechanisms that may be used in rising from sitting. These mechanisms can then be considered in the overall management plan and not inadvertently eradicated without provision of a substitute. ACKNOWLEDGMENTS This study was inspired by Mr G K Rose OBE FRCS, formerly director of ORLAU, whose guidance the authors gratefully acknowledge. They also express sincere thanks to Mr M R McClelland, formerly Medical Research Fellow, ORLAU; Dr S Khodadadeh, bio-engineer, ORLAU; and Mrs N Thompson, research physiotherapist, ORLAU, for their help and advice.
MANY handicapped children become frustrated by their inability to master riding a bicycle. They feel isolated from their peer group. Stabilisers may enable them to ride, but are a constant fixture; there is no way of varying the degree of support to enable a child to learn to balance gradually. Good's adjustable bicycle stabilisers solve this problem by enabling the support to be reduced in small stages, so that the rider can learn balancing skills over a period of time. The supporting wheels swivel from a position distant from the bicycle wheel to a situation very close to it.
Physiotherapy, August 1991, vol77, no 8 .
REFERENCES Bajd, T, Kralj, A and Turk, R (1982). 'Standing up of a healthy subject and a paraplegic patient', Journal of Biomechanics, 15,
1, 1-10.
Uurdett, R G, Habasevich, R, Pisciotta, J and Simon, S R (1985). 'Biomechanical comparison of rising from t w o types of chairs', Physical Therapy, 65, 8, 1177-83. Ellis, M I, Seedhom, B B and Wright, V (1984).'Forces in the knee joint whilst rising from a seated position', Journal of Biomedical Enginegring, 6, April, 113-120. Gowers, W R (1879). Pseudo-hypertrophic Muscular Paralysis. A clinical lecture, J and A Churchill, London. Kerr, K M, White, J A, Mollan, R A B and Baird, H E (1991).'Rising from a chair: 1 review of the literature', Physiotherapy, 77, 1, 1 5 -- 1 9. Khonadadeli. S, McClelland, M R, Patrick, J H, Edwards, R H T and Evans, G A (1986). 'Knee moments in Duchenne muscular dystronhy', The t.anret, September 6, 544.- 545. bluntor!. J S, Ellis, M I and Wright, V (1984). 'Use of electtomyograptiy t o 3tudy leg muscle activity in patients with arthritis and in normal subjects during rising from a chair', Annals of the flheumati.; Diseases, 43, 63-65. Nuzit, S, Lamb, Ft, Vdrisant, A and Hirt, S (1986). 'Sit to stand movement pattern', Physical Therapy, 66, 11, 1708-13. Hodosky, M W, Andrlai:,;i, T P and Anderson, G B J (1989).'The influence of chair height on lower limb mechanics during rising', Journal of Orthopaedic Research, 7. 2, 266-271. Scott, 0 M, Hyde, S A, Goddard, C and Dubowitz, V (1981). 'Prevention of deformity in Duchenne muscular dystrophy', Physiotherapy, 67, 6, 177-180. Wheeler, J, Woodward, C, Vcovich, R L, Perry, J and Walker, J (1985). 'Rising from a chair - The influence of age and chair design', Physical Therapy, 65, 1, 23-26. Yoshida, K, Iwakura, H and Inoue, F (1983).'Motion analysis in the movements of standing up from and sitting down on a chair', Scandinavian Journal of Rehabilitation Medicine, 15, 133-140.
They were developed by the father of twin boys, one of whom was hemiplegic. Using them, the handicapped child learned to ride independently in a few months. We have tried them with other physically and/or mentally handicapped children who had been struggling to learn this skill, with very good results. I think they are an excellent piece of equipment and recommend them to staff and parents.
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Conclusion Two important management principles emerge from 1 h e illustrations given. The first, of overwhelming importance, is preverifio? d joint contractures so that progressively weakening miiaclr?s may continue effectively t o provide a balance of moments Care should be taken that contractures are prevented iri all joints, not only those of the lower limbs. The second principle is that both therapists and clinicians should develop an understanding and awareness of the compensatory mechanisms that may be used in rising from sitting. These mechanisms can then be considered in the overall management plan and not inadvertently eradicated without provision of a substitute. ACKNOWLEDGMENTS This study was inspired by Mr G K Rose OBE FRCS, formerly director of ORLAU, whose guidance the authors gratefully acknowledge. They also express sincere thanks to Mr M R McClelland, formerly Medical Research Fellow, ORLAU; Dr S Khodadadeh, bio-engineer, ORLAU; and Mrs N Thompson, research physiotherapist, ORLAU, for their help and advice.
MANY handicapped children become frustrated by their inability to master riding a bicycle. They feel isolated from their peer group. Stabilisers may enable them to ride, but are a constant fixture; there is no way of varying the degree of support to enable a child to learn to balance gradually. Good's adjustable bicycle stabilisers solve this problem by enabling the support to be reduced in small stages, so that the rider can learn balancing skills over a period of time. The supporting wheels swivel from a position distant from the bicycle wheel to a situation very close to it.
Physiotherapy, August 1991, vol77, no 8 .
REFERENCES Bajd, T, Kralj, A and Turk, R (1982). 'Standing up of a healthy subject and a paraplegic patient', Journal of Biomechanics, 15,
1, 1-10.
Uurdett, R G, Habasevich, R, Pisciotta, J and Simon, S R (1985). 'Biomechanical comparison of rising from t w o types of chairs', Physical Therapy, 65, 8, 1177-83. Ellis, M I, Seedhom, B B and Wright, V (1984).'Forces in the knee joint whilst rising from a seated position', Journal of Biomedical Enginegring, 6, April, 113-120. Gowers, W R (1879). Pseudo-hypertrophic Muscular Paralysis. A clinical lecture, J and A Churchill, London. Kerr, K M, White, J A, Mollan, R A B and Baird, H E (1991).'Rising from a chair: 1 review of the literature', Physiotherapy, 77, 1, 1 5 -- 1 9. Khonadadeli. S, McClelland, M R, Patrick, J H, Edwards, R H T and Evans, G A (1986). 'Knee moments in Duchenne muscular dystronhy', The t.anret, September 6, 544.- 545. bluntor!. J S, Ellis, M I and Wright, V (1984). 'Use of electtomyograptiy t o 3tudy leg muscle activity in patients with arthritis and in normal subjects during rising from a chair', Annals of the flheumati.; Diseases, 43, 63-65. Nuzit, S, Lamb, Ft, Vdrisant, A and Hirt, S (1986). 'Sit to stand movement pattern', Physical Therapy, 66, 11, 1708-13. Hodosky, M W, Andrlai:,;i, T P and Anderson, G B J (1989).'The influence of chair height on lower limb mechanics during rising', Journal of Orthopaedic Research, 7. 2, 266-271. Scott, 0 M, Hyde, S A, Goddard, C and Dubowitz, V (1981). 'Prevention of deformity in Duchenne muscular dystrophy', Physiotherapy, 67, 6, 177-180. Wheeler, J, Woodward, C, Vcovich, R L, Perry, J and Walker, J (1985). 'Rising from a chair - The influence of age and chair design', Physical Therapy, 65, 1, 23-26. Yoshida, K, Iwakura, H and Inoue, F (1983).'Motion analysis in the movements of standing up from and sitting down on a chair', Scandinavian Journal of Rehabilitation Medicine, 15, 133-140.
They were developed by the father of twin boys, one of whom was hemiplegic. Using them, the handicapped child learned to ride independently in a few months. We have tried them with other physically and/or mentally handicapped children who had been struggling to learn this skill, with very good results. I think they are an excellent piece of equipment and recommend them to staff and parents.
525