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

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 (Cohens 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.