Getting seniors back on their bicycle; a pretest-posttest case-control study on the improvement of bicycle balance control

Abstract This paper quantifies the effectiveness and generalizability of an intervention that aims at restoring bicycle balance control skills in seniors that have quit cycling. The intervention increased the difficulty of the bicycle balance control task in a stepwise fashion, gradually approaching the difficulty of bicycle balance control on the public roads. The intervention involved three components: (1) training on an exercise bicycle, (2) balance control training on a bicycle simulator, and (3) cycling on the public roads with a safe start-and-stop technique that was practiced on the bicycle simulator. The experimental group consisted of 23 community-dwelling senior citizens that had quit cycling (N=19) or that were on the verge of doing so (N=4). The effectiveness of the intervention was evaluated by comparing balance control skill and confidence between a post-and a pre-intervention measurement. To control for a possible spontaneous recovery, the same comparison was also performed in a matched control group that did not participate in the intervention. The intervention produced a very large improvement (Cohen’s d = 1.5, t(16)=6.0, p<.001) in balance control skills and confidence on the public roads. Bicycle balance control skills and confidence can thus be restored over a short period of time. In the Discussion section, I argue that this very large improvement does not rule out the importance of the slower process of acquiring a sufficient lower body strength. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was funded by the Radboud Center Social Sciences Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics Committee of the faculty of Social Sciences (ECSS) of the Radboud University (ECSS-2020-132) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes This revision contains the changes made in response to reviews of a peer-reviewed journal. These reviews mainly involved requests for additional information and did not affect the results and the conclusions. Data Availability All data produced in the present study are available upon reasonable request to the authors