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Advancing pediatric cycling: A 3D-printed adaptive device for congenital upper limb deficiency-case report
Amanda Thomas1, Jaclyn Bulluck1, Patricia Diaz1
1Florida International University, Miami, FL, USA.
Background:
Pediatric patients with congenital upper limb differences often experience challenges in performing daily activities such as bike riding. This skill supports physical activity, social participation, and independence, yet adaptive devices are often costly and lack personalization.
Purpose:
This case study describes the impact of a custom 3D-printed adaptive device on bike riding skills, muscular strength and endurance, and motivation in a child with a congenital upper limb difference.
Study Design:
Case study.
Methods:
A single case study was conducted with a pediatric patient with a right congenital upper limb difference. The adaptive device was designed using 3D printing software and lightweight polylactic acid (PLA) filament based on the patient's needs and bike handle dimensions. The participant completed pre- and post-assessments surrounding a two-week bike riding protocol (5 sessions per week, 30 minutes each). Motivation toward bike riding was assessed using the intrinsic motivation subscale of the Behavioral Regulations in Exercise Questionnaire-3 (BREQ-3), and perceived competence was evaluated with the Pictorial Scale of Perceived Movement Skill Competence. Core muscular endurance was measured using the FitnessGram curl-up and trunk extension tests, and shoulder strength was measured via handheld dynamometry (flexion, abduction, horizontal abduction, and adduction). Bike riding ability was analyzed using observational criteria from the Special Olympics Cycling Manual.
Results:
Post-assessment results demonstrated increased motivation (BREQ-3: 4.67 to 5.0), improved core endurance (curl-ups: 33 to 39; trunk lift: 11.5 to 12.5 in.), and bilateral shoulder strength gains, most notably in right abduction (+8.6 lbs) and left horizontal abduction (+8.1 lbs). Observable skill gains included improved stopping, dismounting, and steering.
Conclusion:
A personalized 3D-printed adaptive device enhanced motivation, perceived competence, strength, and bike riding ability in a child with a congenital upper limb difference. Future studies with larger samples are recommended to validate these findings.
