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| Inclusion | Exclusion |
|
| (i) 10–18 years of age | (i) Diagnosis of athetoid or ataxic CP |
| (ii) Diagnosis of spastic diplegic or quadriplegic CP | (ii) Significant scoliosis with primary curve >40 degrees |
| (iii) GMFCS level III (walks with assistive device; may use a wheelchair for long distances) or IV (self-mobility with limitations; transported or uses power mobility in the community) | (iii) Spinal fusion extending into the pelvis |
| (iv) Sufficient covering of the femoral head in the acetabulum (MIGR% < 40%) | (iv) Severe tactile hypersensitivity |
| (v) Adequate range of motion of the hips, knees, and ankles to allow pedaling | (v) Joint instability or dislocation in the lower extremities |
| (vi) Sufficient visuoperceptual skills and cognition/communication skills to participate in cycling trials | (vi) Surgery, traumatic or stress fractures in the last year |
| (vii) Seizure-free or well-controlled seizures | (vii) Botulinum toxin injections in the LE muscles in the past 6 months |
| (viii) Willingness to participate in testing at Shriners Hospital for Children, Philadelphia | (viii) Severe spasticity of the leg muscles (e.g., a score of >4 on the Modified Ashworth Scale) |
| (ix) Ability to communicate pain or discomfort with testing procedures | (ix) Joint pain or discomfort during cycling |
| (x) Ability to obtain parent/guardian consent and child assent/consent | (x) Severely limited range of motion/irreversible muscle contractures that prevent the subject from being able to be safely positioned on the cycling |
| (xi) History of pulmonary disease limiting exercise tolerance (Asthma Control Test screen) or history of known cardiac disease (American Heart Association Screen) |
| (xii) Pregnancy |
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