Can you drive the motorcycle with a prosthetic leg?At Williams Occupational Therapy, we are often asked to assess a rider with a prosthetic leg to see if he can get back on his motorbike. And more often than not, this question is due to the amputation of one of the rider’s legs.

In a previous post, we discussed if you can drive with a prosthetic arm/hand and use it for steering. If you want to recap you can read it here.

So can you ride a motorbike with a prosthetic leg? 

The answer could be yes.
Let’s unpack that a little bit more.

As a driver trained occupational therapist we look at the functional implications of a medical disability on someone’s ability to drive. Some of us, like the staff at Williams OT, have gained extra qualifications in assessing motorbike riders and their ability to ride. So what do we look for?

• First, a rider needs to be able to get on his ride. Our assessment looks at whether the rider can mobilise to and from their bike and get on and off of it safely. We look at the ability to fill up the tank without sitting on the bike and general mobility for things like getting into the petrol station to pay for fuel. More than likely due to difficulties with taking a walking stick, crutches or a wheelchair with you on a motorcycle, most riders need to be competent on using a prosthetic leg.

• The next part of the assessment is looking at sitting balance on the bike. If you are a rider, you would know there is a large difference in sitting positions between something like a Harley Davidson where the legs are in front of the body, often with the feet on side plates (rather than pegs),  and a road/street bike, or  dirt bike where the legs are tucked up under the body and the feet rest on little pegs. Riders need to be able to hold their prosthetic leg in place while they ride or we need to look an alternative to hold the foot in place. Therefore, the rider needs a well-fitting prosthetic leg and good adduction of the hips (that movement of squeezing your legs together).
• I know, if you are a rider you want to know about gear selection or braking (depending on what leg we are talking about) but first, as assessors of function, we need to look at walking the bike and manoeuvring the kickstand. This can be trickier than first expected. Without extensive movement of the ankle in the prosthetic leg, both in forwards and backwards movements (plantarflexion and dorsiflexion) and the rolling of the foot from side to side (inversion and eversion), the rider is quite often balancing themselves and the bike on the toe or heel of the prosthetic foot. Unless the rider is very comfortable balancing on a small part of the prosthetic, moving the bike slowly could be tricky.
• And that kickstand. If the kickstand is on the opposite side to the amputation, the rider needs to balance themselves and the weight of their ride while they kick up the stand. Again, balance and strength is the key here. If the prosthetic is on the side of the stand, the process a rider use to use may not be functional any longer. Without movement of the ankle, rotating the ball of the foot under the bike is impossible. As an assessor, we look at the alternatives such as using the heel and if the prosthetic leg has the reach, stability and strength to do this. Otherwise, we look at using the hand or adapting the kickstand.

If any of these things are issues or have the potential to be an issue, especially if the consideration is for an above-knee amputation, then consideration for a three-wheel bike may need to be considered. This can include a trike, Spyder, or sidecar. There are also kits available that can convert some bikes into trikes or Spyders. This can take all the worry out of the above issues while still allowing that freedom that many of our riders are looking for.

All of that to be considered and we haven’t even started riding the bike yet.

For this next bit, we need to know a little bit about how a bike works. Now, I am not a motorbike rider or mechanic, so I expect and welcome any comments from the like to teach me and the readers a thing or two about bikes.

As OTs, we look at the function and the main functions we need to consider when riding a motorcycle is gear selection or braking when we are considering riding with an amputated leg.

• On the right side of the bike, the right foot does rear brake application. On most bikes, this is done with ankle movements to press down the foot on the brake lever. Occasionally, on bikes like a Harley, it can be more like a plate to press rather than a peg like a lever. This can make a huge difference to functional outcomes when there is no ankle movement. I know what experienced riders are going to say, “if you use your rear brake, you going to kill yourself and slide the bike.” We know as assessors that the majority of braking is done with the hand operated brake for the front wheel and that this the best way to brake. But, we are not allowed to promote that this the only way to brake. In an emergency especially, a rider will need to apply the rear brake. Therefore we need to have a safe and efficient system in place. Depending on the bike and the function of the prosthetic limb and the riders abilities, this might be functional. But more often than not we need to explore alternative methods. This comes in the form of a double handled brake lever for the right hand. This has one lever for the front brake, and one for the rear and the levers are activated by different fingers of the hand. If the rider has a sound right-hand function,  these are a great adaptation and can really assist a rider with a right leg amputation get back on the road.
• And what about the left leg. What if that has had an amputation? The left side of the bike has the gear selector. This is usually activated by left ankle movements to move the forefoot up and down depending on whether the gears need to go up or down. Occasionally, like on a Harley Davidson Deluxe as one example, the gear selector lever has a double ended lever that can be activated by the heel or toe and ankle movements are not required. But more often than not, even with a Deluxe setup (due to decreased sensations in the lower limb and the need to look at the foot when they change gears), the rider needs a gear selector adaptation. There are devices available that offer thumb operated up and down gear selection for the left hand. This involves squeezing in the clutch with the left fingers and press up or down as required with the thumb, so that function of the left-hand needs to be appropriate.

If you are a rider with a lower leg amputation or a lower leg issue, and you want to get back in your ride,  or you have a client with a prosthetic lower limb, Williams Occupational Therapy may be able to help. If you want to know how Williams OT could help you with driving, give us a call on 0466 529 891, or write us an email at admin@williamsot.com

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