Introduction: Cycling is known to have substantial health benefits1, can be a sport of choice for non-impact exercise or a mode of transport for survivors of stroke. A rapid literature review and benchmarking has revealed that there are no existing guidelines to streamline clinical decision making in relation to safe return to cycling after stroke. The aim of our project was, therefore, to develop an evidence informed procedure to streamline clinical decision making when supporting patients who were previously able to ride a bike and wish to resume this after stroke.
Methods: Our project commenced with a rapid literature review and benchmarking with Barwon Health and The Royal Melbourne Hospital as they both have an established return to cycling program. Resources were adapted to create a procedure which outlined indications, contraindications and precautions for return to cycling after stroke.
Results: Our procedure includes a medical clearance letter and suggested neuropsychologist input. The physiotherapy assessment form includes prompts to assess for cervical spine range of movement, a vestibular and visual field assessment, a balance assessment and an assessment for range and power in bilateral upper and lower limbs. Additionally, our procedure includes a pre riding safety checklist, some basic starting techniques and a range of mounting, dismounting and stopping techniques.
Conclusion: An evidence informed procedure to guide decision making for return to cycling after stroke has successfully been developed at Western Health. A copy of the Western Health return to cycling procedure can be shared with other health services upon request.