Nelson Marquez, PT, EdD, Physical Therapy Editor

Nelson Marquez, PT, EdD, Physical Therapy Editor

I have had a peculiar history with bicycles. I first learned how to ride one when I graduated from sixth grade. The bicycle was a graduation gift from my parents. Because there were no training wheels, my father steadied the bicycle as I pedaled through the streets in our neighborhood. The most difficult maneuver for me was turning. It challenged my equilibrium and postural mechanisms quite a bit, and I had to put at least one foot down to keep the bicycle balanced as I made a turn. Disaster struck when — because of my fear of turning — I pedaled straight through the neighbor’s wooden fence and came face to face with their bulldog. Our neighbors predicted I would be the last one to learn how to ride a bike.

I proved them wrong. Avoiding neighborhoods with fenced houses, I kept practicing at night, when the streets were no longer busy. Months later, I was able to keep my equilibrium, while making turns, even with my brother riding on the bike with me.

As we outgrew our neighborhood, my parents began taking me and my brothers to bike around a cultural facility in the Philippines on the weekends. I recall enjoying the bike rides, varying my speeds along quiet roads around the facility, without any fear of getting off-balance. However, despite my confidence, disaster struck once more when, during a turn, I saw a taxi cab headed in my direction. My eyes were so glued on the taxi that, instead of staying in my lane, I steered the bike toward the cab. I wasn’t aware wherever your eyes are directed, your body will follow — I learned it later during my neuro class in PT school. Fortunately, the cab stopped before we collided, with the driver asking whether I was trying to kill myself. That was the last time I rode a bike.

As a PT, I have had many bicycle encounters over the years. But instead of using it for recreation, I use the bike as a device to address my patients’ needs: to strengthen weakened muscles, facilitate increase of lower extremity range of motion, improve their functional endurance and — drawing from my issues turning a bicycle — facilitate and improve patients’ balance and postural control.

I also have some PT friends who have taken up cycling as a hobby. Some of them own multiple bikes, some of which cost $1,000 or more. Several of them ride in groups on the weekends as part of their exercise regimen. As a PT, I help them recover by treating their sore muscles, shin splints and sprained ankles and wrists, and most of all, reinstating their confidence in riding again by telling them what happened to me when I rode through my neighbor’s fence.

Recently, I got involved with a group of students from Harvard University in a fundraising campaign that involves bicycles: World Bicycle Relief. Just when I thought bicycles were meant only for recreation, sports or PT purposes, the campaign gave me a new perspective about how this simple vehicle can be an economic driver and influence delivery of healthcare in rural parts of Africa.

Health workers in this part of the world spend more time walking than caring for their patients. They also cannot carry medical supplies with them. On average, they can visit and treat only two to three patients per day. Whenever a patient needs to be transported to a clinic several miles from home, the caregiver or patient has to rent a bike. What a way to provide home healthcare! In contrast, for home health visits in the U.S., we use cars — sometimes high-end cars — which can be loaded with exercise equipment. For some of us, that car is for home health work only, and we own others for personal use.

With a bike funded through donations and provided by the Chicago-based World Bicycle Relief Organization, a health worker is able to visit and treat about eight patients per day. The healthcare provider is able to spend more time with each patient, providing quality care. Also, a form of transportation is available for the patient, if the person needs to go to a clinical facility.

To help increase awareness of this campaign, I posted a link to a website created by my Harvard student teammate on Facebook. However, I was surprised to see after almost a month, I had only a handful of “Likes” for the post. In contrast, some Facebook friends post pictures of their lunch and they generate countless “Likes” and multiple “Shares.”

In the past, I have written several articles about my volunteer and charitable efforts, asking at the end of each article: “What about you, what have you done lately?”

This time, I ask how difficult is it to press the “Like” button on Facebook to indicate awareness that our counterparts on the other side of the world do not drive a high-end car to provide home care? That they do not own expensive bicycles? All they ask is for a bicycle worth $147 to save lives.

So, I ask again: “What have you done, lately?” My answer will not be that I rode my bike. Instead, I helped put a colleague on a bike!

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