{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T18:48:53Z","timestamp":1767034133247,"version":"3.41.2"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:p>- Durable medical equipment (DME) policies require that the equipment be medically necessary; however, adaptive cycling equipment (bicycles and tricycles) are usually not deemed medically necessary.<\/jats:p><jats:p>- Individuals with neurodevelopmental disabilities (NDD) are at high risk for secondary conditions, both physical and mental, that can be mitigated by increasing physical activity.<\/jats:p><jats:p>- Significant financial costs are associated with the management of secondary conditions.<\/jats:p><jats:p>- Adaptive cycling can provide improved physical health of individuals with NDD potentially reducing costs of comorbidities.<\/jats:p><jats:p>- Expanding DME policies to include adaptive cycling equipment for qualifying individuals with NDD can increase access to equipment.<\/jats:p><jats:p>- Regulations to ensure eligibility, proper fitting, prescription, and training can optimize health and wellbeing.<\/jats:p><jats:p>- Programs for recycling or repurposing of equipment are warranted to optimize resources.<\/jats:p>","DOI":"10.3389\/fresc.2023.1160948","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T04:45:55Z","timestamp":1685940355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Policy brief: adaptive cycling equipment for individuals with neurodevelopmental disabilities as durable medical equipment"],"prefix":"10.3389","volume":"4","author":[{"given":"Mary E.","family":"Gannotti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret E.","family":"O\u2019Neil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Fragala-Pinkham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"George E.","family":"Gorton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel G.","family":"Whitney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e20190811","DOI":"10.1542\/peds.2019-0811","article-title":"Prevalence and trends of developmental disabilities among children in the United States: 2009\u20132017","volume":"144","author":"Zablotsky","year":"2019","journal-title":"Pediatrics"},{"key":"B2","first-page":"57","article-title":"Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment\u2013United States, 2003","volume":"53","year":"2004","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1111\/jir.12554","article-title":"High health care costs among adults with intellectual and developmental disabilities: a population-based study","volume":"63","author":"Lunsky","year":"2019","journal-title":"J Intellect Disabil Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.jpeds.2020.08.084","article-title":"Disability, hospital care, and cost: utilization of emergency and inpatient care by a cohort of children with intellectual and developmental disabilities","volume":"229","author":"Lindgren","year":"2021","journal-title":"J Pediatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"469","DOI":"10.2147\/CLEP.S205839","article-title":"Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy","volume":"11","author":"Whitney","year":"2019","journal-title":"Clin Epidemiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1017\/S0033291720001981","article-title":"Psychological morbidity among adults with cerebral palsy and spina bifida","volume":"51","author":"Peterson","year":"2021","journal-title":"Psychol Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1097\/PHM.0000000000001787","article-title":"Psychological, cardiometabolic, and musculoskeletal morbidity and multimorbidity among adults with cerebral palsy and spina Bifida: a retrospective cross-sectional study","volume":"100","author":"Peterson","year":"2021","journal-title":"Am J Phys Med Rehabil"},{"key":"B8","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1111\/j.1467-789X.2012.01052.x","article-title":"Chronic disease risk among adults with cerebral palsy: the role of premature sarcopoenia, obesity and sedentary behaviour","volume":"14","author":"Peterson","year":"2013","journal-title":"Obes Rev"},{"key":"B9","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1177\/1362361320953652","article-title":"Increased prevalence of non-communicable physical health conditions among autistic adults","volume":"25","author":"Weir","year":"2021","journal-title":"Autism"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1002\/jbmr.3694","article-title":"Adults with cerebral palsy have higher prevalence of fracture compared with adults without cerebral palsy independent of osteoporosis and cardiometabolic diseases","volume":"34","author":"Whitney","year":"2019","journal-title":"J Bone Miner Res"},{"key":"B11","first-page":"50","article-title":"Adults with down's syndrome: the prevalence of complications and health care in the community","volume":"57","author":"Henderson","year":"2007","journal-title":"Br J Gen Pract"},{"key":"B12","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1002\/ajmg.a.38512","article-title":"Co-occurring medical conditions in adults with down syndrome: a systematic review toward the development of health care guidelines","volume":"176","author":"Capone","year":"2018","journal-title":"Am J Med Genet A"},{"key":"B13","doi-asserted-by":"publisher","first-page":"6","DOI":"10.12927\/hcq.2018.25521","article-title":"The mental health of adults with developmental disabilities in Ontario: lessons from administrative health data","volume":"21","author":"Lunsky","year":"2018","journal-title":"Healthc Q"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.18553\/jmcp.2020.26.9.1153","article-title":"Polypharmacy among privately insured adults with cerebral palsy: a retrospective cohort study","volume":"26","author":"Whitney","year":"2020","journal-title":"J Manag Care Spec Pharm"},{"key":"B15","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1089\/aut.2018.0004","article-title":"Health care service utilization and cost among adults with autism Spectrum disorders in a U.S. Integrated health care system","volume":"1","author":"Zerbo","year":"2019","journal-title":"Autism Adulthood"},{"key":"B16","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.healthpol.2010.09.010","article-title":"Prevalence and lifetime healthcare cost of cerebral palsy in South Korea","volume":"100","author":"Park","year":"2011","journal-title":"Health Policy"},{"key":"B17","doi-asserted-by":"publisher","first-page":"665","DOI":"10.2147\/CEOR.S370311","article-title":"The cost of neurodevelopmental disability: scoping review of economic evaluation methods","volume":"14","author":"Kularatna","year":"2022","journal-title":"Clinicoecon Outcomes Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"Lee","year":"2012","journal-title":"Lancet"},{"key":"B19","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/S0140-6736(12)60898-8","article-title":"The pandemic of physical inactivity: global action for public health","volume":"380","author":"Kohl","year":"2012","journal-title":"Lancet"},{"volume-title":"Physical activity guidelines for Americans","year":"2018","key":"B20"},{"key":"B21","doi-asserted-by":"publisher","first-page":"100888","DOI":"10.1016\/j.dhjo.2020.100888","article-title":"Physical activity types among US adults with mobility disability, behavioral risk factor surveillance system, 2017","volume":"13","author":"Hollis","year":"2020","journal-title":"Disabil Health J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e005263","DOI":"10.1161\/CIRCOUTCOMES.118.005263","article-title":"Physical activity guidelines for Americans from the US department of health and human services","volume":"11","author":"Piercy","year":"2018","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B23","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s12966-022-01312-1","article-title":"Physical activity and mental health in children and adolescents with intellectual disabilities: a meta-analysis using the RE-AIM framework","volume":"19","author":"Yang","year":"2022","journal-title":"Int J Behav Nutr Phys Act"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.2522\/ptj.20060116","article-title":"Promotion of physical fitness and prevention of secondary conditions for children with cerebral palsy: section on pediatrics research summit proceedings","volume":"87","author":"Fowler","year":"2007","journal-title":"Phys Ther"},{"key":"B25","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1098\/rsbl.2009.0474","article-title":"Predictive motor activation during action observation in human infants","volume":"5","author":"Southgate","year":"2009","journal-title":"Biol Lett"},{"key":"B26","doi-asserted-by":"publisher","first-page":"106065","DOI":"10.1016\/j.ypmed.2020.106065","article-title":"Differences in perceived neighborhood environmental supports and barriers for walking between US adults with and without a disability","volume":"134","author":"Omura","year":"2020","journal-title":"Prev Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.amepre.2004.02.002","article-title":"Physical activity participation among persons with disabilities: barriers and facilitators","volume":"26","author":"Rimmer","year":"2004","journal-title":"Am J Prev Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1097\/NPT.0b013e318291bbf6","article-title":"Building the crossroad between inpatient\/outpatient rehabilitation and lifelong community-based fitness for people with neurologic disability","volume":"37","author":"Rimmer","year":"2013","journal-title":"J Neurol Phys Ther"},{"key":"B29","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.dhjo.2011.12.002","article-title":"Built environment instruments for walkability, bikeability, and recreation: disability and universal design relevant?","volume":"5","author":"Gray","year":"2012","journal-title":"Disabil Health J"},{"key":"B30","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1111\/dmcn.15446","article-title":"Impact of adapted bicycle riding on outcomes for children and adolescents with disabilities: a systematic review","volume":"65","author":"Thevarajah","year":"2023","journal-title":"Dev Med Child Neurol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1111\/jar.12840","article-title":"Evidence of continued reduction in the age-at-death disparity between adults with and without intellectual and\/or developmental disabilities","volume":"34","author":"Landes","year":"2021","journal-title":"J Appl Res Intellect Disabil"},{"key":"B32","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1080\/10400435.2021.1934607","article-title":"On the road again! tricycle adaptation with the design of a universal rig","volume":"35","author":"Hoskin","year":"2023","journal-title":"Assist Technol"},{"key":"B33","first-page":"355","article-title":"\u201cBiking? Let\u2019s make it happen!\u201d: cycling intervention to enhance motor skills, social interaction and inclusion of pupils with autism and other special needs","volume-title":"Physical education and sport for children and youth with special needs: Researches\u2014best practices\u2014situation","author":"Caniz Castillo","year":"2021"},{"key":"B34","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1111\/j.1365-2214.2011.01338.x","article-title":"The \u201cF-words\u201d in childhood disability: i swear this is how we should think!","volume":"38","author":"Rosenbaum","year":"2012","journal-title":"Child Care Health Dev"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.2522\/ptj.20110061","article-title":"Physical activity benefits of learning to ride a two-wheel bicycle for children with down syndrome: a randomized trial","volume":"91","author":"Ulrich","year":"2011","journal-title":"Phys Ther"},{"key":"B36","first-page":"35","article-title":"Benefits of learning to ride a two-wheeled bicycle for adolescents with down syndrome and autism spectrum disorder","volume":"31","author":"Hauck","year":"2017","journal-title":"Palaestra"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1111\/jir.12275","article-title":"The effects of assisted cycling therapy (ACT) and voluntary cycling on reaction time and measures of executive function in adolescents with down syndrome","volume":"60","author":"Ringenbach","year":"2016","journal-title":"J Intellect Disabil Res"},{"key":"B38","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1111\/jar.12061","article-title":"Assisted cycling exercise improves fine manual dexterity in persons with down's syndrome","volume":"27","author":"Chen","year":"2014","journal-title":"J Appl Res Intellect Disabil"},{"key":"B39","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1007\/s10882-019-09706-z","article-title":"Assisted cycling therapy (ACT) improves adaptive behaviors in adolescents with down syndrome","volume":"32","author":"Ringenbach","year":"2020","journal-title":"J Dev Phys Disabil"},{"key":"B40","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s10803-019-04224-5","article-title":"Accelerating motor skill acquisition for bicycle riding in children with ASD: a pilot study","volume":"50","author":"Hawks","year":"2020","journal-title":"J Autism Dev Disord"},{"key":"B41","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.pedneo.2016.02.004","article-title":"Gross motor profile and its association with socialization skills in children with autism Spectrum disorders","volume":"57","author":"Pusponegoro","year":"2016","journal-title":"Pediatr Neonatol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1590\/1809-2950\/18011026012019","article-title":"Cycle ergometer in the improvement of gross motor function of children with cerebral palsy: a systematic review with meta-analysis","volume":"26","author":"Catelli","year":"2019","journal-title":"Fisioterapia e Pesquisa"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1111\/jpc.12289","article-title":"\u2018Every picture tells a story': interviews and diaries with children with cerebral palsy about adapted cycling","volume":"49","author":"Pickering","year":"2013","journal-title":"J Paediatr Child Health"},{"key":"B44","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1080\/01942638.2020.1862384","article-title":"Efficacy of lower extremity cycling interventions for youth with intellectual disabilities: a systematic review","volume":"41","author":"Fragala-Pinkham","year":"2021","journal-title":"Phys Occup Ther Pediatr"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1177\/0269215519837582","article-title":"Efficacy of cycling interventions to improve function in children and adolescents with cerebral palsy: a systematic review and meta-analysis","volume":"33","author":"Armstrong","year":"2019","journal-title":"Clin Rehabil"},{"key":"B46","doi-asserted-by":"publisher","first-page":"367","DOI":"10.2522\/ptj.20080364","article-title":"Pediatric endurance and limb strengthening (PEDALS) for children with cerebral palsy using stationary cycling: a randomized controlled trial","volume":"90","author":"Fowler","year":"2010","journal-title":"Phys Ther"},{"key":"B47","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1177\/0269215512453061","article-title":"Can a six-week exercise intervention improve gross motor function for non-ambulant children with cerebral palsy? A pilot randomized controlled trial","volume":"27","author":"Bryant","year":"2013","journal-title":"Clin Rehabil"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.ridd.2012.01.017","article-title":"Muscle strength enhancement following home-based virtual cycling training in ambulatory children with cerebral palsy","volume":"33","author":"Chen","year":"2012","journal-title":"Res Dev Disabil"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1007\/s00198-012-2137-0","article-title":"Efficacy of home-based virtual cycling training on bone mineral density in ambulatory children with cerebral palsy","volume":"24","author":"Chen","year":"2013","journal-title":"Osteoporos Int"},{"key":"B50","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1111\/j.1469-8749.2007.00522.x","article-title":"Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non-ambulant","volume":"49","author":"Williams","year":"2007","journal-title":"Dev Med Child Neurol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1055\/s-0032-1321803","article-title":"Aerobic training in children with cerebral palsy","volume":"34","author":"Nsenga","year":"2013","journal-title":"Int J Sports Med"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.16965\/ijpr.2015.161","article-title":"Comparision of dynamic cycling vs static cycling on endurance, balance, and walking ability of children with cerebral palsy","volume":"3","author":"Mohanty","year":"2015","journal-title":"Physiother Res Int"},{"key":"B53","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1177\/1545968317718631","article-title":"Task-Specific and functional effects of speed-focused elliptical or motor-assisted cycle training in children with bilateral cerebral palsy: randomized clinical trial","volume":"31","author":"Damiano","year":"2017","journal-title":"Neurorehabil Neural Repair"},{"key":"B54","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.ejmhg.2014.02.008","article-title":"Effect of arm cycling on gait of children with hemiplegic cerebral palsy","volume":"15","author":"Hussein","year":"2014","journal-title":"Egyptian Journal of Medical Human Genetics"},{"key":"B55","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1002\/jor.24515","article-title":"Low-Trauma fracture increases 12-month incidence of cardiovascular disease for adults with cerebral palsy","volume":"38","author":"Whitney","year":"2020","journal-title":"J Orthop Res"},{"key":"B56","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/jir.12790","article-title":"Cause of death in adults with intellectual disability in the United States","volume":"65","author":"Landes","year":"2021","journal-title":"J Intellect Disabil Res"},{"year":"","key":"B57"},{"year":"2023","key":"B58"},{"key":"B59","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1152\/japplphysiol.01361.2010","article-title":"Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy","volume":"111","author":"Zhao","year":"2011","journal-title":"J Appl Physiol"},{"year":"","key":"B60"},{"volume-title":"Medicare coverage determination process","year":"2023","key":"B61"},{"year":"","key":"B62"},{"volume-title":"The CHRONIC care act of 2018: advancing care for adults with Complex needs","year":"2018","author":"Tumlinson","key":"B63"},{"key":"B64","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1123\/jpah.2020-0656","article-title":"Delivering physical activity strategies that work: active people, healthy nation","volume":"18","author":"Schmid","year":"2021","journal-title":"J Phys Act Health"},{"key":"B65","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1111\/dmcn.13737","article-title":"The risk, burden, and management of non-communicable diseases in cerebral palsy: a scoping review","volume":"60","author":"Ryan","year":"2018","journal-title":"Dev Med Child Neurol"},{"key":"B66","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/j.jadohealth.2007.05.005","article-title":"Obesity and secondary conditions in adolescents with disabilities: addressing the needs of an underserved population","volume":"41","author":"Rimmer","year":"2007","journal-title":"J Adolesc Health"},{"key":"B67","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1001\/jamapediatrics.2014.210","article-title":"Costs of autism spectrum disorders in the United Kingdom and the United States","volume":"168","author":"Buescher","year":"2014","journal-title":"JAMA Pediatr"},{"key":"B68","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ridd.2018.01.011","article-title":"Health care expenditures of overweight and obese U.S. adults with intellectual and developmental disabilities","volume":"75","author":"Li","year":"2018","journal-title":"Res Dev Disabil"}],"container-title":["Frontiers in Rehabilitation Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2023.1160948\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T04:46:01Z","timestamp":1685940361000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2023.1160948\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,5]]},"references-count":68,"alternative-id":["10.3389\/fresc.2023.1160948"],"URL":"https:\/\/doi.org\/10.3389\/fresc.2023.1160948","relation":{},"ISSN":["2673-6861"],"issn-type":[{"type":"electronic","value":"2673-6861"}],"subject":[],"published":{"date-parts":[[2023,6,5]]},"article-number":"1160948"}}