Demands of Simulated Commuting Using an Electrically Assisted Bicycle Effect of E-Bike Versus Bike Commuting on Cardiorespiratory Fitness in Overweight Adults: A 4-Week Randomized Pilot Study Effects of electric stimulation-assisted cycling training in people with chronic stroke. Long-term intensive electrically stimulated cycling by spinal cord-injured people: effect on muscle properties and their relation to power output. Easy rider wheelchair biking. A nursing-recreation therapy clinical trial for the treatment of depression. Effects of hybrid cycling versus handcycling on wheelchair-specific fitness and physical activity in people with long-term spinal cord injury: a 16-week randomized controlled trial Cycling Induced by Electrical Stimulation Improves Motor Recovery in Postacute Hemiparetic Patients: A Randomized Controlled Trial Effect of pedaling technique on muscle activity and cycling efficiency Active-assisted cycling improves tremor and bradykinesia in Parkinson's disease. FES-cycling training in Spinal Cord Injured patients Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial A randomised study of home-based electrical stimulation of the legs and conventional bicycle exercise training for patients with chronic heart failure. The Effect of Electrical Passive Cycling on Spasticity in War Veterans with Spinal Cord Injury Pedelecs as a physically active transportation mode The working mechanisms of an environmentally tailored physical activity intervention for older adults: a randomized controlled trial Critical Care Cycling Study (CYCLIST) trial protocol: a randomised controlled trial of usual care plus additional in-bed cycling sessions versus usual care in the critically ill The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort
The American College of Sports Medicine ( ACSM ) recommends adults participate in weekly aerobic activity for a minimum of 30 minutes moderate intensity exercise 5 days per week or 20 minutes of vigorous activity 3 days per week . The electrically assisted bicycle may help individuals achieve the ACSM ’s aerobic recommendations and introduce inactive individuals to physical activity . To compare the physiological requirements of riding a bicycle with electric pedal assist versus non-assist among healthy active young adults . 6 males and 6 females completed two r and omized cycling trials using electric pedal assist ( PAB ) and non-assist ( NON ) . Cycling trials were completed over a 3.54 km course with varying terrain . Time to completion was faster in the PAB ( 12.5 ± 0.3 min ) than the NON ( 13.8 ± 0.3 min , p=0.01 ) . Rating of Perceived Exertion ( RPE ) was lower in the PAB ( 12.0 ± 0.4 ) than the NON ( 14.8 ± 0.5 , p < 0.001 ) . There was no difference in mean VO2 between PAB ( 2.3 ± 0.1 L·min−1 ) and NON ( 2.5 ± 0.1 L·min−1 , p=0.45 ) . There was no difference in mean power output when comparing PAB ( 115 ± 11 Watts ) to NON ( 128 ± 11 Watts , p=0.38 ) . There was no difference in heart rate between PAB ( 147 ± 5 bpm ) and NON ( 149 ± 5 bpm , p=0.77 ) . Recreationally active younger ( college age ) individuals may self-select a similar physiological intensity of physical activity regardless of mechanical assistance , result ing in quicker completion of a commuting task with PAB . Both the PAB and NON exercise bouts met ACSM criteria for vigorous exercise Objective : To assess if active commuting with an electrically assisted bicycle ( e-bike ) during a 4-week period can induce increases in cardiorespiratory fitness measured as peak oxygen uptake ( V[Combining Dot Above]O2peak ) in untrained , overweight individuals , and if these changes are comparable with those induced by a conventional bicycle . Design : Four-week r and omized pilot study . Setting : Controlled laboratory . Participants : Thirty-two volunteers ( 28 men ) participated . Seventeen { median age 37 years [ interquartile range ( IQR ) 34 , 45 ] , median body mass index [ BMI ] 29 kg/m2 [ IQR 27 , 31 ] } were r and omized to the E-Bike group and 15 [ median age 43 years ( IQR 38 , 45 ) , median BMI 28 kg/m2 ( IQR 26 , 29 ) ] to the Bike group . Interventions : Participants in both groups were instructed to use the bicycle allocated to them ( e-bike or conventional bicycle ) for an active commute to work in the Basel ( Switzerl and ) area at a self-chosen speed on at least 3 days per week during the 4-week intervention period . Main Outcome Measures : V[Combining Dot Above]O2peak was assessed before and after the intervention in an all-out exercise test on a bicycle ergometer . Results : V[Combining Dot Above]O2peak increased by an average of 3.6 mL/(kg·min ) [ SD 3.6 mL/(kg·min ) ] in the E-Bike group and by 2.2 mL/(kg·min ) [ SD 3.5 mL/(kg·min ) ] in the Bike group , with an adjusted difference between the 2 groups of 1.4 mL/(kg·min ) [ 95 % confidence interval , −1.4 - 4.1 ; P = 0.327 ] . Conclusions : E-bikes may have the potential to improve cardiorespiratory fitness similar to conventional bicycles despite the available power assist , as they enable higher biking speeds and greater elevation gain OBJECTIVE To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance , aerobic capacity , muscle strength , and functional performance and to determine if electric stimulation ( ES ) to the contralateral ( paretic ) leg during cycling has additional effects over cycling without ES . DESIGN A r and omized controlled trial , with a partial double-blind design . SETTING A rehabilitation center . PARTICIPANTS Twelve stroke patients ( range , 18 - 70 y ) , more than 5 months poststroke , with lower-extremity hemiparesis . INTERVENTION Subjects were r and omly assigned to groups that performed cycling exercise , one with ES evoking muscle contractions and a control group with ES not evoking muscle contractions . Subjects , blinded for group assignment , trained twice a week for 6 weeks . MAIN OUTCOME MEASURES Changes in aerobic capacity and maximal power output , functional performance , and lower-limb muscle strength . RESULTS Aerobic capacity and maximal power output significantly increased by 13.8%+/-19.1 % and 38.1%+/-19.8 % , but muscle strength was not significantly enhanced after training . Functional performance improved ( ie , scores on the Berg Balance Scale increased by 6.9%+/-5.8 % ( P=.000 ) and the six-minute walk test improved by 14.5%+/-14.1 % ( P=.035 ) . There was no significant effect on the Rivermead Mobility Index ( P=.165 ) . Training-induced changes were not significantly different between the 2 groups . Changes in cycling performance and aerobic capacity were not significantly related to changes in functional performance . CONCLUSIONS This study showed that a short cycling training program on a semirecumbent cycle ergometer can markedly improve cycling performance , aerobic capacity , and functional performance of people with chronic stroke . The use of ES had no additional effects in this specific group of subjects with chronic stroke Inactivity and muscular adaptations following spinal cord injury ( SCI ) result in secondary complications such as cardiovascular disease , obesity , and pressure sores . Functional electrically stimulated ( FES ) cycling can potentially reduce these complications , but previous studies have provided inconsistent results . We studied the effect of intensive long-term FES cycle training on muscle properties in 11 SCI subjects ( mean + /- SEM : 41.8 + /- 2.3 years ) who had trained for up to 1 hour/day , 5 days/week , for 1 year . Comparative measurements were made in 10 able-bodied ( AB ) subjects .  Quadriceps maximal electrically stimulated torque increased fivefold ( n = 5 ) , but remained lower than in AB individuals . Relative force response at 1 HZ decreased , relaxation rate remained unchanged , and fatigue resistance improved significantly . Power output ( PO ) improved to a lesser extent than quadriceps torque and not to a greater extent than has been reported previously . We need to underst and the factors that limit PO in order to maximize the benefits of FES cycling Depression is a common condition among long-term care residents with limited treatment options available . There are few nonpharmacological interventions available to this population . This study examined the use of a prescribed , therapeutic recreation-nursing intervention , wheelchair biking , for treatment of symptoms of depression in older adults in a long-term care setting . A classical experimental design was used and was guided by the Roy Adaptation Model . Forty residents were pretested for depression and r and omly assigned to two groups . A 2-week trial of biking therapy was provided to the treatment group . All participants were posttested . Findings indicated there was a statistically significant improvement in depression scores for the treatment group and no significant change for the control group . This study contributes to the body of knowledge of nursing regarding options for the treatment of depression in older adults , and is an encouraging indicator that psychosocial interventions may be effective in reducing depression Study design : This is an open r and omized controlled trial . Objective : The objective of this study was to investigate the effects of a 16-week hybrid cycle versus h and cycle exercise program on fitness and physical activity in inactive people with long-term spinal cord injury ( SCI ) . Setting : The study was conducted in two rehabilitation centers with a specialized SCI unit . Methods : Twenty individuals ( SCI⩾8 years ) were r and omly assigned to a hybrid cycle ( voluntary arm exercise combined with functional electrical stimulation (FES)-induced leg exercise ) or a h and cycle group . During 16 weeks , both groups trained twice a week for 30 min at 65–75 % heart rate reserve . Outcome measures obtained before , during and after the program were fitness ( peak power output , peak oxygen consumption ) , submaximal VO2 and heart rate ( HR ) , resting HR , wheelchair skill performance time score ) and physical activity ( distance travelled in wheelchair and Physical Activity Scale for Individuals with Physical Disabilities ( PASIPD ) score ) . Changes were examined using a two-factor mixed- measures analysis of variance . Results : For all fitness parameters , except for submaximal VO2 , no interaction effects were found . The hybrid cycle group showed a decrease in VO2 over time in contrast to the h and cycle group ( P=0.045 ) . An overall reduction in HRrest ( 5±2 b.p.m . ; P=0.03 ) and overall increase in PASIPD score ( 6.5±2.1 ; P=0.002 ) were found after 16 weeks of training . No overall training effects were found for the other fitness and activity outcome measures . Conclusion : In the current study , hybrid cycling and h and cycling showed similar effects on fitness and physical activity , indicating that there seem to be no additional benefits of the FES-induced leg exercise over h and cycle training alone Background and Purpose — This study assessed whether cycling induced by functional electrical stimulation ( FES ) was more effective than passive cycling with placebo stimulation in promoting motor recovery and walking ability in postacute hemiparetic patients . Methods — In a double-blind , r and omized , controlled trial , 35 patients were included and r and omized to receive FES-induced cycling training or placebo FES cycling .  The 4-week treatment consisted of 20 sessions lasting 25 minutes each . Primary outcome measures included the leg subscale of the Motricity Index and gait speed during a 50-meter walking test . Secondary outcomes were the Trunk Control Test , the Upright Motor Control Test , the mean work produced by the paretic leg , and the unbalance in mechanical work between paretic and nonparetic legs during voluntary pedaling . Participants were evaluated before training , after training , and at 3- to 5-month follow-up visits . Results — No significant differences were found between groups at baseline . Repeated- measures ANOVA ( P<0.05 ) revealed significant increases in Motricity Index , Trunk Control Test , Upright Motor Control Test , gait speed , and mean work of the paretic leg after training and at follow-up assessment s for FES-treated patients . No outcome measures demonstrated significant improvements after training in the placebo group . Both groups showed no significant differences between assessment s after training and at follow-up . A main effect favoring FES-treated patients was demonstrated by repeated- measures ANCOVA for Motricity Index ( P<0.001 ) , Trunk Control Test ( P=0.001 ) , Upright Motor Control Test ( P=0.005 ) , and pedaling unbalance ( P=0.038 ) . Conclusions — The study demonstrated that 20 sessions of FES cycling training significantly improved lower extremity motor functions and accelerated the recovery of overground locomotion in postacute hemiparetic patients . Improvements were maintained at follow-up The purpose of this study was to examine the acute effect of talocrural joint position on muscle activity and gross mechanical efficiency ( GE ) . Eleven trained cyclists participated in three r and omized 6-min cycling bouts at ∼80 % of maximal aerobic capacity on an electromagnetically braked cycle ergometer  while oxygen consumption and muscle activity ( EMG )  were monitored during the subject ’s self-selected pedaling technique ( control ) and while using a dorsi- and plantarflexed pedaling technique . The mean differences in range of motion of the dorsi- and plantarflexed technique from the control position were 7.1 ± 4.4 and 6.9 ± 5.4 ° , respectively . Gastrocnemius EMG activity was higher with the dorsiflexion technique than when using the self-selected control position ( 33.2 ± 13.0 and 24.2 ± 8.4 μV s , respectively ; P < 0.05 ) . Moreover , GE was 2.6 % lower while riding with the dorsiflexion technique than the control position ( 19.0 ± 1.2 and 19.5 ± 1.3 % , respectively ; P < 0.05 ) . The data suggested that introducing more dorsiflexion into the pedal stroke of a trained cyclist  increases muscle activity of the gastrocnemius lateralis and decreased GE when compared to the self-selected pedal stroke OBJECTIVES To develop a rapid cadence cycling intervention ( active-assisted cycling [ AAC ] ) using a motorized bike and to examine physiological perimeters during these sessions in individuals with Parkinson 's disease ( PD ) . A secondary goal was to examine whether a single session of AAC at a high cadence would promote improvements in tremor and bradykinesia similar to the on medication state . DESIGN Before-after pilot trial with cross-over . SETTING University research laboratory . PARTICIPANTS Individuals with idiopathic PD ( N=10 , age 45 - 74y ) in Hoehn and Yahr stages 1 to 3 . INTERVENTION Forty minutes of AAC . MAIN OUTCOME MEASURES Heart rate , pedaling power , and rating of perceived exertion were recorded before , during , and after a bout of AAC . Functional assessment s included tremor score during resting , postural , and kinetic tremor . RESULTS This AAC paradigm was well tolerated by individuals with PD without excessive fatigue , and most participants showed improvements in tremor and bradykinesia immediately after a single bout of cycling . CONCLUSIONS This paradigm could be used to examine changes in motor function in individuals with PD after bouts of high-intensity exercise Among the objectives of spinal cord injury ( SCI ) rehabilitation , ( i ) prevention of bony , muscular and joint trophism and ( ii ) limitation of spastic hypertone represent important goals to be achieved . The aim of this study is to use functional electrical stimulation ( FES ) to activate pedaling on cycle-ergometer and analyse effects of this technique for a rehabilitation training in SCI persons . Five spinal cord injured subjects were recruited and underwent a two months FES-cycling training . Our results show an increase of thigh muscular area and endurance after the FES-cycling training , without any increase of spasticity . This approach , which is being vali date d on a larger pool of patients , represents a potential tool for improving the rehabilitation outcome of complete and incomplete SCI persons Background Important health benefits can be derived when low-cost ( e.g. , computer-tailored ) physical activity interventions for older adults demonstrate sustained effects . Purpose The purpose of the study was to conduct in-depth analysis on the long-term efficacy of two tailored physical activity interventions for older adults . Methods A r and omized controlled trial ( n = 1,971 ) with two computer-tailored interventions  and a no-intervention control group was conducted . The two tailored interventions consisted of three tailored letters , delivered during 4 months . The basic tailored intervention targeted psychosocial determinants alone , while the environmentally tailored intervention additionally targeted environmental determinants , by providing tailored environmental information .  Self-reported behaviors ( i.e. , total physical activity , transport walking and cycling , leisure walking and cycling , and sports ) were measured at baseline and 12 months . Additionally , potential personal , health-related , and psychosocial moderators of the intervention effects were examined . Results The environmentally tailored intervention was effective in changing total physical activity , leisure cycling , and sports compared with the basic intervention and control group . No intervention effects were found for the basic intervention . Moderation analysis revealed that participants with a higher age , lower body mass index , and higher intention were unresponsive to the interventions . Conclusions Providing environmental information is an effective intervention strategy for increasing physical activity behaviors among older adults , especially among certain “ at-risk ” subgroups such as lower educated , overweight , or insufficiently active participants . Moderation analysis was perceived as a promising method for identifying meaningful subgroups that are unaffected by an intervention , which should receive special attention in future interventions AIMS Recent guidelines recommend regular exercise in the management of patients with chronic heart failure ( CHF ) . This study was design ed to compare the safety and efficacy of conventional bicycle exercise and functional electrical stimulation ( FES ) of the legs as forms of home-based exercise training for patients with stable CHF . METHODS AND RESULTS Forty-six patients ( 38 male ) with stable NYHA Class II/III heart failure underwent a 6-week training programme using either a bicycle ergometer or electrical stimulation of the quadriceps and gastrocnemius muscles . In the bike group , significant increases were seen in 6-min walk ( 44.6 m , 95 % confidence interval ( CI ) 29.3 - 60.9 m ) , treadmill exercise time ( 110 s , 95 % CI 72.2 - 148.0 s ) , maximum leg strength ( 5.32 kg , 95 % CI 3.18 - 7.45 kg ) , and quadriceps fatigue index ( 0.08 , 95 % CI 0.04 - 0.12 ) following training . In the stimulator group , similar significant increases were seen following training for 6-min walk ( 40.6 m , 95 % CI 28.2 - 53.0 m ) , treadmill exercise time ( 67 s , 95 % CI 11.8 - 121.8s ) , maximum leg strength ( 5.35 kg , 95 % CI 1.53 - 9.17 kg ) , and quadriceps fatigue index ( 0.10 , 95 % CI 0.04 - 0.17 ) . Peak VO(2)did not change in either group following training , indicating a low-intensity regime . Quality of life scores improved following training when the bicycle and stimulator groups were considered together , but not when considered separately ( -0.43 , 95 % CI -8.13 to -0.56 ) . CONCLUSIONS FES produces beneficial changes in muscle performance and exercise capacity in patients with CHF . Within this study , the benefits were similar to those observed following bicycle training . FES could be offered to patients with heart failure as an alternative to bicycle training as part of a home-based rehabilitation programme Introduction : Muscle atrophy , spasticity , and deformity are among long term complication of spinal cord injury ( SCI ) veterans . There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people , but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs  in individuals with SCI . Aims : To evaluate the effect of electrical passive cycling on passive range of movement spasticity and electrodiagnostic parameters in SCI veterans . Methods : Sixty-four SCI veterans referred to two clinical and research center in Tehran were recruited in this prospect i ve clinical trial . The subjects were divided into two groups according to electrical passive cycling usage : ( 1 ) patients who did not use pedal exercise ( control group ) , ( 2 ) patients used Electrical passive cycling up to optimal level ( intervention group ) . Main outcome measures included hip , knee , and ankle range of motion , spasticity scale , and electrodiagnostic parameters including F-Wave Consistency , F-Wave Amplitude , H/M Ratio , F/M Ratio , H-Reflex Onset Latency , and H-Reflex Amplitude . Data were recorded at the time of receiving and 1 year after pedal exercise usage . Results : Sixty-four SCI patients including 95.3 % male , 4.7 % female with mean age 43 years old were included in this study . All patients except one suffered from complete SCI . The involved spinal levels were cervical ( 17.2 % ) , upper thoracic ( 34.4 % ) , lower thoracic ( 45.3 % ) , and lumbar ( 3.1 % ) . Spasticity scale decreased significantly after passive cycling in group 2 . Also hip , knee , and ankle ROM in group 2 were significantly improved after pedal exercise . There was a significant difference in H max/M max ( RT < ) and F/M ratio after versus before electric passive cycling system in group 2 . Conclusion : These findings suggest that passive rhythmic leg exercise can lead to decrease in spasticity , increase in passive ROM of lower limbs and improvement in electrodiagnostic parameters of spasticity in patients with SCI Introduction Pedelecs are bicycles that provide electric assistance only when a rider is pedaling and have become increasingly popular . Purpose Our purpose was to quantify usage patterns over 4 weeks of real-world commuting with a pedelec and to determine if pedelec use would improve cardiometabolic risk factors . Methods Twenty sedentary commuters visited the laboratory for baseline physiological measurements [ body composition , maximum oxygen consumption ( $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ) , mean arterial blood pressure ( MAP ) , blood lipid profile , and 2-h oral glucose tolerance test ( OGTT ) ] . The following 4 weeks , participants were instructed to commute using a pedelec at least 3 days week−1 for 40 min day−1 while wearing a heart rate monitor and a GPS device . Metabolic equivalents ( METS ) were estimated from heart rate data . Following the intervention , we repeated the physiological measurements . Results Average total distance and time were 317.9 ± 113.8 km and 15.9 ± 3.4 h , respectively . Participants averaged 4.9 ± 1.2 METS when riding . Four weeks of pedelec commuting significantly improved 2-h post-OGTT glucose ( 5.53 ± 1.18–5.03 ± 0.91 mmol L−1 , p < 0.05 ) , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ( 2.21 ± 0.48–2.39 ± 0.52 L min−1 , p < 0.05 ) , and end of $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max test power output ( 165.1 ± 37.1–189.3 ± 38.2 W , p < 0.05 ) . There were trends for improvements in MAP ( 84.6 ± 10.5–83.2 ± 9.4 mmHg , p = 0.15 ) and fat mass ( 28.6 ± 11.3–28.2 ± 11.4 kg , p = 0.07 ) . Conclusion  Participants rode a pedelec in the real world at a self-selected moderate intensity , which helped them meet physical activity recommendations . Pedelec commuting also result ed in significant improvements in 2-h post-OGTT glucose , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max , and power output . Pedelecs are an effective form of active transportation that can improve some cardiometabolic risk factors within only 4 weeks Background The aim of this study was to explore the working mechanisms of a computer tailored physical activity intervention for older adults with environmental information compared to a basic tailored intervention without environmental information . Method A clustered r and omized controlled trial with two computer tailored interventions and a no-intervention control group was conducted among 1971 adults aged ≥ 50 . The two tailored interventions were developed using Intervention Mapping and consisted of three tailored letters delivered over a four-month period . The basic tailored intervention targeted psychosocial determinants alone , while the environmentally tailored intervention additionally targeted environmental determinants , by providing tailored environmental information . Study outcomes were collected with question naires at baseline , three and six months and comprised total physical activity ( days/week ) , walking ( min/week ) , cycling ( min/week ) , sports ( min/week ) , environmental perceptions and use and appreciation of the interventions . Results Mediation analyses showed that changes in cycling , sports and total physical activity behaviour induced by the environmentally tailored intervention were mediated by changes in environmental perceptions . Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour . Compared with the basic tailored intervention , the environmentally tailored intervention significantly improved cycling behaviour ( τ = 30.2 ) . Additionally , the tailored letters of the environmentally tailored intervention were better appreciated and used , although these differences did not mediate the intervention effect . Discussion This study gave some first indications of the relevance of environmental perceptions as a determinant of changing physical activity behaviours and the potential effectiveness of providing environmental information as an intervention strategy aim ed at enhancing physical activity behaviour among older adults Introduction  In-bed cycling with patients with critical illness has been shown to be safe and feasible , and improves physical function outcomes at hospital discharge . The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy , and associations with physical and cognitive function are unknown . Methods and analysis A single-centre r and omised controlled trial in a mixed medical-surgical intensive care unit ( ICU ) will be conducted . Adult patients ( n=68 ) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be r and omly allocated into either ( 1 ) a usual care group or ( 2 ) a group that receives usual care and additional in-bed cycling sessions . The primary outcome is change in rectus femoris cross-sectional area at day 10 in comparison to baseline measured by blinded assessors . Secondary outcome measures include muscle strength , incidence of ICU-acquired weakness , h and grip strength , time to achieve functional milestones ( sitting out of bed , walking ) , Functional Status Score in ICU , ICU Mobility Scale , 6 min walk test 1 week post-ICU discharge , incidence of delirium and quality of life ( EuroQol Five Dimensions question naire Five Levels scale ) . Quality of life assessment s will be conducted post-ICU admission at day 10 , 3 and 6 months after acute hospital discharge . Participants in the intervention group will complete an acceptability of intervention question naire . Ethics and dissemination Appropriate ethical approval from Metro South Health Human Research Ethics Committee has been attained . Results will be published in peer- review ed publications and presented at scientific conferences to assist planning of future multicentre r and omised controlled trials ( if indicated ) that will test in-bed cycling as an intervention to improve the physical , cognitive and health-related quality of life outcomes of patients with critical illness . Trial registration number This trial has been prospect ively registered on the Australian and New Zeal and Clinical Trial Registry ( ACTRN12616000948493 ) ; Pre- results Objectives To investigate associations between modest levels of total and domain-specific ( commuting , other utility , recreational ) cycling and  mortality from all causes , cardiovascular disease and cancer . Design Population -based cohort study ( European Prospect i ve Investigation into Cancer and Nutrition study -Norfolk ) . Setting Participants were recruited from general practice s in the east of Engl and and attended health examinations between 1993 and 1997 and again between 1998 and 2000 . At the first health assessment , participants reported their average weekly duration of cycling for all purpose s using a simple measure of physical activity . At the second health assessment , participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity question naire . Participants Adults aged 40–79 years at the first health assessment . Primary outcome measure All participants were followed for mortality ( all-cause , cardiovascular and cancer ) until March 2011 . Results There were 22 450 participants with complete data at the first health assessment , of whom 4398 died during follow-up ; and 13 346 participants with complete data at the second health assessment , of whom 1670 died during follow-up . Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9 % reduced risk of all-cause mortality ( adjusted HR 0.91 , 95 % CI 0.84 to 0.99 ) . Using the more precise measures of cycling available from the second health assessment , all types of cycling were associated with greater total moderate-to-vigorous physical activity ; however , there was little evidence of an association between overall or domain-specific cycling and mortality . Conclusions Cycling , in particular for utility purpose s , was associated with greater moderate-to-vigorous and total physical activity . While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality , further research is required to confirm how much cycling is sufficient to induce health benefits
There was moderate evidence that  e-cycling provided physical activity of at least moderate intensity , which was lower than the intensity elicited during conventional cycling , but higher than that during walking .
There was also moderate evidence that  e-cycling can improve cardiorespiratory fitness in physically inactive individuals .
Evidence of the impact of e-cycling  on metabolic and psychological health outcomes was inconclusive .
Conclusion E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness .
As such , e-bikes offer a potential alternative to conventional cycling .
Background Electrically assisted bicycles ( e-bikes ) have been highlighted as a method of active travel that could overcome some of the commonly reported barriers to cycle commuting .
The objective of this systematic review was to assess the health benefits associated with e-cycling .