Adaptive bikers get moving with the Tour de Shrine.

The recreation therapy department at Shriners Hospitals for Children, Chicago has always been focused on providing excellent care to patients while they are in the hospital. Several years ago they began asking what happens when the children return home? Shriners Hospitals offers a series of summer workshops that introduce patients to a variety of adaptive sports. It was because of one of these patients that the hospital took this vision to the next level.

Biking is an aerobic activity enjoyed by many, but the world of adaptive bikes is not as common. They began taking patients to Creative Mobility in St. Charles, Ill. This bike shop had adaptive bicycles from a variety of venders for participants to experiment with, but one of the patients was looking for something more. She wanted something bigger, something she could train for; she wanted a biking marathon. The recreation therapy department was unable to locate such a program in the area, so it decided to create its own. Thus the Tour de Shrine overnight 60-mile bike trip was born.

Cost is a question when beginning any new program. Shriners Hospitals provides free medical services to its patients, so finding funding for programs is key. The Medinah Motorcorps are a group of Shriners known for their motorcycle appearances in many parades. With the biking connection, the sponsorship unfolded.

Given the challenge and distance of this program, teenage patients were targeted as having the stamina and drive to best participate. Six participants are selected each year. Each participant rides an adaptive bicycle. Patients with paraplegia or limited use of their lower extremity are fitted with a hand-propelled bike for the trip.

Ambulatory patients can use an adaptive foot-propelled bike. While the foot-propelled bikes are powered much like a regular bike, they often have three wheels and a full seat with back support for balance. Participants can also be outfitted with footplates so their feet can be attached to the pedals. The hospital found that participants who use braces and/or assisstive devices to ambulate actually succeed better on a hand-propelled bike.

The Shriners Hospitals' trip takes place along the I&M canal trail with a 1:1 or 1:2 staff to participant ratio. This allows participants the ability to ride at their own pace increasing their potential to last longer. If two or more participants ride at similar speeds they can act as a support system and inspire each other to keep going. Teenagers possess a competitive edge and often will not slow down or take a break if another participant is still going.

The therapists have observed the great rewards that have resulted from the completion of this challenge. Alliances and friendships are created when participants are working towards a common goal. While not all participants are biking collectively, they are all coming together at the end to marvel in their accomplishment and share the stories of their travels.

Participants are required to be independent in all of their care. On this trip they learn to think outside the box when they must make adjustments to their bathroom and showering routine when using facilities at the campground or along the trail. One teen learned to get dressed in her wheelchair for the trip since she was unaware of what the camping facilities would be like. For some teens this is their first overnight opportunity away from home. The independence gained from this event will help prepare them for college and adult responsibilities.

This experience allows patients to participate at their own pace with an ultimate goal in mind. Many of the participants have gone to the next level and have purchased adaptive bikes for their personal use at home. Biking is becoming more and more popular as a recreation activity. The recreation therapy department is privileged to be able to introduce this activity to other patients. This trip is something they will remember for years to come.