Outdoor cycling competence and balance control in older adults - cross-sectional analysis of the BiPerAge trial.
6 affiliations
- 1Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging, Friedrich- Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany. [email protected].
- 2Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging, Friedrich- Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
- 3Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- 4Department of Mechanical Engineering, Faculty of Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- 5Nursing Department, Faculty of Health Sciences, Ariel University, Ariel, 40700, Israel.
- 6Department of Orthopedic Surgery, Barzilai Medical Center, Ashkelon, Israel.
Abstract
Background
Although cycling offers numerous health benefits, age-related functional decline can increase the risk of accidents. Identifying balance components linked to outdoor cycling competence could inform targeted assessment and training. We aimed to exploratorily investigate the association between outdoor cycling competence and static, dynamic, and reactive balance control in older adults.Methods
In this exploratory cross-sectional analysis of baseline data from a two-center randomized controlled trial, 116 community-dwelling adults aged ≥ 65 years with ≥ 3 errors on a standardized outdoor cycling course completed a balance test battery: Short Physical Performance Battery (SPPB), including gait speed, Modified Balance Error Scoring System (MBESS) and Four Square Step Test (FSST). Cycling-specific trunk balance was assessed with the Perturbation Stationary Bicycle Robotics (PerStBiRo) system, which delivers unannounced angular-tilt perturbations during stationary cycling. We derived mediolateral (ML) trunk sway during unperturbed cycling (UPC) and trunk time-to-peak angle (s) and trunk sway (°) during perturbed cycling (PC). Spearman correlations and multivariable models adjusted for age, sex and country were used to examine associations with the number of errors in the standardized outdoor cycling course.Results
Participants (mean age 74.0 ± 5.4 years; 53% women) made 13.1 ± 8.0 errors on the outdoor cycling course. In bivariate analyses, more outdoor cycling errors were weakly associated with more total errors on the MBESS (rs = 0.213, p = 0.022), slower gait speed (rs = -0.203, p = 0.029), greater ML trunk sway during UPC (rs = 0.246, p = 0.009), shorter trunk time-to-peak angle (rs = -0.289, p = 0.002) and lower trunk sway in PC (rs = -0.295, p = 0.002). In multivariable analyses, longer FSST time (B = 1.28 [95% CI 0.39, 2.17], p = 0.005) and greater trunk sway during UPC (B = 2.68 [0.60, 4.77], p = 0.012) were independently associated with more cycling errors.Conclusions
This study shows weak associations between outdoor cycling competence and dynamic balance control during both UPC and FSST. Low trunk sway during UPC on the PerStBiRo is weakly associated with better outdoor cycling competence. These findings could be further evaluated in future studies aiming to improve outdoor cycling competence.Trial registration
This is a retrospective analysis of BiPerAge study data registered at clinicaltrials.gov: NCT06453473 (initial submission: 11/06/2024), link: https://clinicaltrials.gov/study/NCT06453473 .
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BibTeX
@article{rogler2026outdoor,
title = {{Outdoor cycling competence and balance control in older adults - cross-sectional analysis of the BiPerAge trial.}},
author = {Jana Rogler and Sebastian Krumpoch and Ellen Freiberger and Noam Margalit and Roee Zehavi and Itshak Melzer and Sharon Barak and Amir Shapiro and Dikla Judchak Amir and Shira Levi and Omri Lubovsky and Robert Kob},
journal = {BMC geriatrics},
year = {2026},
month = oct,
doi = {10.1186/s12877-026-08491-7},
url = {https://europepmc.org/article/MED/42897509},
note = {CC BY},
}
RIS
TY - JOUR
TI - Outdoor cycling competence and balance control in older adults - cross-sectional analysis of the BiPerAge trial.
AU - Jana Rogler
AU - Sebastian Krumpoch
AU - Ellen Freiberger
AU - Noam Margalit
AU - Roee Zehavi
AU - Itshak Melzer
AU - Sharon Barak
AU - Amir Shapiro
AU - Dikla Judchak Amir
AU - Shira Levi
AU - Omri Lubovsky
AU - Robert Kob
PY - 2026
DA - 2026/10/19
JO - BMC geriatrics
DO - 10.1186/s12877-026-08491-7
UR - https://europepmc.org/article/MED/42897509
AB - Background Although cycling offers numerous health benefits, age-related functional decline can increase the risk of accidents. Identifying balance components linked to outdoor cycling competence could inform targeted assessment and training. We aimed to exploratorily investigate the association between outdoor cycling competence and static, dynamic, and reactive balance control in older adults.Methods In this exploratory cross-sectional analysis of baseline data from a two-center randomized controlled trial, 116 community-dwelling adults aged ≥ 65 years with ≥ 3 errors on a standardized outdoor cycling course completed a balance test battery: Short Physical Performance Battery (SPPB), including gait speed, Modified Balance Error Scoring System (MBESS) and Four Square Step Test (FSST). Cycling-specific trunk balance was assessed with the Perturbation Stationary Bicycle Robotics (PerStBiRo) system, which delivers unannounced angular-tilt perturbations during stationary cycling. We derived mediolateral (ML) trunk sway during unperturbed cycling (UPC) and trunk time-to-peak angle (s) and trunk sway (°) during perturbed cycling (PC). Spearman correlations and multivariable models adjusted for age, sex and country were used to examine associations with the number of errors in the standardized outdoor cycling course.Results Participants (mean age 74.0 ± 5.4 years; 53% women) made 13.1 ± 8.0 errors on the outdoor cycling course. In bivariate analyses, more outdoor cycling errors were weakly associated with more total errors on the MBESS (rs = 0.213, p = 0.022), slower gait speed (rs = -0.203, p = 0.029), greater ML trunk sway during UPC (rs = 0.246, p = 0.009), shorter trunk time-to-peak angle (rs = -0.289, p = 0.002) and lower trunk sway in PC (rs = -0.295, p = 0.002). In multivariable analyses, longer FSST time (B = 1.28 [95% CI 0.39, 2.17], p = 0.005) and greater trunk sway during UPC (B = 2.68 [0.60, 4.77], p = 0.012) were independently associated with more cycling errors.Conclusions This study shows weak associations between outdoor cycling competence and dynamic balance control during both UPC and FSST. Low trunk sway during UPC on the PerStBiRo is weakly associated with better outdoor cycling competence. These findings could be further evaluated in future studies aiming to improve outdoor cycling competence.Trial registration This is a retrospective analysis of BiPerAge study data registered at clinicaltrials.gov: NCT06453473 (initial submission: 11/06/2024), link: https://clinicaltrials.gov/study/NCT06453473 .
SN - 1471-2318
ER -