Daily Outdoor Cycling by Older Adults Preserves Reactive Balance Behavior: A Case-Control Study

in Journal of Aging and Physical Activity

Click name to view affiliation

Shani Batcir Schwartz Rehabilitation and Movement Analysis Laboratory, Physical Therapy Department, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Be’er Sheva, Israel

Search for other papers by Shani Batcir in
Current site
Google Scholar
PubMed Close
https://orcid.org/0000-0003-2840-6339
and
Itshak Melzer Schwartz Rehabilitation and Movement Analysis Laboratory, Physical Therapy Department, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Be’er Sheva, Israel

Search for other papers by Itshak Melzer in
Current site
Google Scholar
PubMed Close
*
DOI:
https://doi.org/10.1123/japa.2021-0378
Keywords:
unexpected perturbations; outdoor bicycling; reactive stepping; reactive balance control
First Published Online:
13 May 2022
In Print:
Volume 31: Issue 1
Page Range:
7–17
Restricted access

We examined whether older adults who cycle outdoors regularly have better reactive balance control than noncycling older adults. Sixteen cyclist older adults and 24 age-, sex-, and health-matched controls who did not cycle (noncyclists) were exposed to unannounced perturbations of increased magnitudes in standing. We evaluated the strategies and kinematics employed at each perturbation magnitude. We found that cyclists exhibited a significantly higher stepping threshold, lower probability of stepping at each perturbation magnitude, and lower number of trials in which the participant needed to make a step to retain their balance. Cyclists also tended to recover balance using unloaded leg strategies in the first recovery step rather than a loaded leg strategy; they showed faster swing phase duration in the first recovery step, better controlling the displacement of center of mass than noncyclists. Older adults who cycle regularly outdoors preserve their reactive balance functions, which may reduce fall risks.

Batcir https://orcid.org/0000-0003-2840-6339

Melzer (itzikm@bgu.ac.il) is corresponding author.

Supplementary Materials

    • Supplementary Table S1 (PDF 185 KB)
  • Collapse
  • Expand

Journal of Aging and Physical Activity

Cover Journal of Aging and Physical Activity

  • Bair, W.N., Prettyman, M.G., Beamer, B.A., & Rogers, M.W. (2016). Kinematic and behavioral analyses of protective stepping strategies and risk for falls among community living older adults. Clinical Biomechanics, 36, 74–82. https://doi.org/10.1016/j.clinbiomech.2016.04.015

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Batcir, S., & Melzer, I. (2018). Daily bicycling in older adults may be effective to reduce fall risks: A case-control study. The Journal of Aging and Physical Activity, 26(4), 570–576. https://doi.org/10.1123/japa.2017-0263

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Batcir, S., Shani, G., Shapiro, A., Alexander, N., & Melzer, I. (2020). The kinematics and strategies of recovery steps during lateral losses of balance in standing at different perturbation magnitudes in older adults with varying history of falls. BMC Geriatrics, 20(1), 249. https://doi.org/10.1186/s12877-020-01650-4

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Batcir, S., Sharon, H., Shani, G., Levitsky, N., Gimmon, Y., Kurz, I., Shapiro, A., & Melzer, I. (2018). The inter-observer reliability and agreement of lateral balance recovery responses in older and younger adults. Journal of Electromyography & Kinesiology, 40, 39–47. https://doi.org/10.1016/j.jelekin.2018.03.002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Boufous, S., Beck, B., Macniven, R., Pettit, C., & Ivers, R. (2021). Facilitators and barriers to cycling in older residents of New South Wales, Australia. Journal of Transport & Health, 21, Article 101056. https://doi.org/10.1016/j.jth.2021.101056

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Carty, C.P., Cronin, N.J., Nicholson, D., Lichtwark, G.A., Mills, P.M., Kerr, G., Cresswell, A.G., & Barrett, R.S. (2015). Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults. Age and Ageing, 44(1), 109–115. https://doi.org/10.1093/ageing/afu054

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Centers for Disease Control and Prevention. (2020). National center for injury prevention and control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. https://www.cdc.gov/injury/wisqars/index.html

    • Search Google Scholar
    • Export Citation

  • Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Haley, S.M., Jette, A.M., Coster, W.J., Kooyoomjian, J.T., Levenson, S., Heeren, T., & Ashba, J. (2002). Late life function and disability instrument: II. Development and evaluation of the function component. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(4), M217–M222. https://doi.org/10.1093/gerona/57.4.m217

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Handelzalts, S., Steinberg-Henn, F., Levy, S., Shani, G., Soroker, N., & Melzer, I. (2019). Insufficient balance recovery following unannounced external perturbations in persons with stroke. Neurorehabil Neural Repair, 33(9), 730–739. https://doi.org/10.1177/154596839862565

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hartog, J.J., Boogaard, H., Nijland, H., & Hoek, G. (2011). Do the health benefits of cycling outweigh the risks? Ciencia & Saude Coletiva, 16(12), 4731–4744. https://doi.org/10.1590/s1413-8123201100130002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Harvey, S., Rissel, C., & Pijnappels, M. (2018). Associations between bicycling and reduced fall-related physical performance in older adults. The Journal of Aging and Physical Activity, 26(3), 514–519. https://doi.org/10.1123/japa.2017-0243

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hilliard, M.J., Martinez, K.M., Janssen, I., Edwards, B., Mille, M.L., Zhang, Y., & Rogers, M.W. (2008). Lateral balance factors predict future falls in community-living older adults. The Archives of Physical Medicine and Rehabilitation, 89(9), 1708–1713. https://doi.org/10.1016/j.apmr.2008.01.023

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Jones, T., Chatterjee, K., Spinney, J., Street, E., Van Reekum, C., Spencer, B., Jones, H., Leyland, L., Mann, C., Williams, S., & Beale, N. (2016). Cycle BOOM design for lifelong health and wellbeing—Summary of key findings and recommendations. Oxford Brookes University. https://www.cycleboom.org/wp-content/uploads/2016/09/cB_Summary_Report_Sept2016_Digital.pdf

    • Search Google Scholar
    • Export Citation

  • Kelly, P., Kahlmeier, S., Götschi, T., Orsini, N., Richards, J., Roberts, N., Scarborough, P., & Foster, C. (2014). Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship. The International Journal of Behavioral Nutrition and Physical Activity, 11, 132. https://doi.org/10.1186/s12966-014-0132-x

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Klein, P.J., & DeHaven, J.J. (1995). Accuracy of three-dimensional linear and angular estimates obtained with the ariel performance analysis system. The Archives of Physical Medicine and Rehabilitation, 76(2), 183–189. https://doi.org/10.1016/s0003-9993(95)80028-x

    • Crossref
    • Search Google Scholar
    • Export Citation

  • League of American Bicyclists. (2016). Where we ride: Analysis of bicycle commuting in American cities. Report on 2016 Analysis of bicycle commuting in American cities. https://bikeleague.org/sites/default/files/LAB_Where_We_Ride_2016.pdf

    • Search Google Scholar
    • Export Citation

  • League of American Bicyclists. (2018). Bicycling and walking in the United States: 2018 benchmarking report (6th ed.). https://bikeleague.org/sites/default/files/Benchmarking_Report-Sept_03_2019_Web.pdf

    • Search Google Scholar
    • Export Citation

  • Leyland, L.A., Spencer, B., Beale, N., Jones, T., & van Reekum, C.M. (2019). The effect of cycling on cognitive function and well-being in older adults. PLoS One, 14(2), Article e0211779. https://doi.org/10.1371/journal.pone.0211779

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Maki, B.E., Edmondstone, M.A., & McIlroy, W.E. (2000). Age-related differences in laterally directed compensatory stepping behavior. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55(5), M270–M277. https://doi.org/10.1093/gerona/55.5.m270

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Maki, B.E., & McIlroy, W.E. (1997). The role of limb movements in maintaining upright stance: The “change-in-support” strategy. Physical Therapy, 77(5), 488–507. https://doi.org/10.1093/ptj/77.5.488

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Maki, B.E., & McIlroy, W.E. (2006). Control of rapid limb movements for balance recovery: Age-related changes and implications for fall prevention. Age and Ageing, 35(Suppl. 2), ii12–ii18. https://doi.org/10.1093/ageing/afl078

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Mason, J., Fulton, L., & McDonald, Z. (2015). Transport matters blog. A global high shift cycling scenario, the potential for dramatically increasing bicycle and E-bike use in cities around the world, with estimated energy, CO2, and cost impacts. https://www.itdp.org/a-global-high-shift-cycling-scenario/

    • Search Google Scholar
    • Export Citation

  • Melzer, I., Kurz, I., Sarid, O., & Jette, A.M. (2007). Relationship between self-reported function and disability and balance performance measures in the elderly. Journal of Rehabilitation Research and Development, 44(5), 685–691. https://doi.org/10.1682/jrrd.2006.10.0133

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Mille, M.L., Johnson-Hilliard, M., Martinez, K.M., Zhang, Y., Edwards, B.J., & Rogers, M.W. (2013). One step, two steps, three steps more . . . Directional vulnerability to falls in community-dwelling older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68(12), 1540–1548. https://doi.org/10.1093/gerona/glt062

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Mille, M.L., Rogers, M.W., Martinez, K., Hedman, L.D., Johnson, M.E., Lord, S.R., & Fitzpatrick, R.C. (2003). Thresholds for inducing protective stepping responses to external perturbations of human standing. Journal of Neurophysiology, 90(2), 666–674. https://doi.org/10.1152/jn.00974.2002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Nachmani, H., Shani, G., Shapiro, A., & Melzer, I. (2020). Characteristics of first recovery step response following unexpected loss of balance during walking: A dynamic approach. Gerontology, 66(4), 362–370. https://doi.org/10.1159/000505649

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Nashner, L.M. (1976). Adapting reflexes controlling the human posture. Experimental Brain Research, 26(1), 59–72. https://doi.org/10.1007/BF00235249

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Nashner, L.M. (1977). Fixed patterns of rapid postural responses among leg muscles during stance. Experimental Brain Research, 30(1), 13–24. https://doi.org/10.1007/BF00237855

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Nashner, L.M. (1980). Balance adjustments of humans perturbed while walking. Journal of Neurophysiology, 44(4), 650–664. https://doi.org/10.1152/jn.1980.44.4.650

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Ogilvie, D., Egan, M., Hamilton, V., & Petticrew, M. (2004). Promoting walking and cycling as an alternative to using cars: Systematic review. The BMJ, 329(7469), 763. https://doi.org/10.1136/bmj.38216.714560.55

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Oja, P., Titze, S., Bauman, A., de Geus, B., Krenn, P., Reger-Nash, B., & Kohlberger, T. (2011). Health benefits of cycling: A systematic review. Scandinavian Journal of Medicine & Science in Sports, 21(4), 496–509. https://doi.org/10.1111/j.1600-0838.2011.01299.x

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Pai, Y.C., & Patton, J. (1997). Center of mass velocity-position predictions for balance control. Journal of Biomechanics, 30(4), 347–354. https://doi.org/10.1016/s0021-9290(96)00165-0

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Pai, Y.C., Rogers, M.W., Patton, J., Cain, T.D., & Hanke, T.A. (1998). Static versus dynamic predictions of protective stepping following waist-pull perturbations in young and older adults. Journal of Biomechanics, 31(12), 1111–1118. https://doi.org/10.1016/s0021-9290(98)00124-9

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Parkkari, J., Kannus, P., Palvanen, M., Natri, A., Vainio, J., Aho, H., Vuori, I., & Järvinen, M. (1999). Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: A prospective controlled hip fracture study with 206 consecutive patients. Calcified Tissue International, 65(3), 183–187. https://doi.org/10.1007/s002239900679

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Patton, J.L., Hilliard, M.J., Martinez, K., Mille, M.L., & Rogers, M.W. (2006). A simple model of stability limits applied to sidestepping in young, elderly and elderly fallers. Conference Proceedings—IEEE Engineering In Medicine And Biology Society, 2006, 3305–3308. https://doi.org/10.1109/IEMBS.2006.260199

    • Search Google Scholar
    • Export Citation

  • Pucher, J., & Buehler, R. (2008). Making cycling irresistible: Lessons from the Netherlands, Denmark and Germany. Translation Review, 28, 495–528. https://doi.org/10.1080/01441640701806612

    • Search Google Scholar
    • Export Citation

  • Pucher, J., & Buehler, R. (2017). Cycling towards a more sustainable transport future. Transport Reviews, 37(6), 689–694. https://doi.org/10.1080/01441647.2017.1340234

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Rissel, C., Passmore, E., Mason, C., & Merom, D. (2013). Two pilot studies of the effect of bicycling on balance and leg strength among older adults. Journal of Environmental and Public Health, 2013, Article 686412. https://doi.org/10.1155/2013/686412

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sakurai, R., Kawai, H., Yoshida, H., Fukaya, T., Suzuki, H., Kim, H., Hirano, H., Ihara, K., Obuchi, S., & Fujiwara, Y. (2016). Can you ride a bicycle? The ability to ride a bicycle prevents reduced social function in older adults with mobility limitation. Journal of Epidemiology, 26(6), 307–314. https://doi.org/10.2188/jea.JE20150017

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Saunders, L.E., Green, J.M., Petticrew, M.P., Steinbach, R., & Roberts, H. (2013). What are the health benefits of active travel? A systematic review of trials and cohort studies. PLoS One, 8(8), Article e69912. https://doi.org/10.1371/journal.pone.0069912

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Schulz, B.W., Ashton-Miller, J.A., & Alexander, N.B. (2005). Compensatory stepping in response to waist pulls in balance-impaired and unimpaired women. Gait & Posture, 22(3), 198–209. https://doi.org/10.1016/j.gaitpost.2004.09.004

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Shapiro, A., & Melzer, I. (2010). Balance perturbation system to improve balance compensatory responses during walking in old persons. Journal of NeuroEngineering and Rehabilitation, 7, 32. https://doi.org/10.1186/1743-0003-7-32

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Stevens, J.A., Mahoney, J.E., & Ehrenreich, H. (2014). Circumstances and outcomes of falls among high risk community-dwelling older adults. Injury Epidemiology, 1(5), 5. https://doi.org/10.1186/2197-1714-1-5

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sturnieks, D.L., Menant, J., Delbaere, K., Vanrenterghem, J., Rogers, M.W., Fitzpatrick, R.C., & Lord, S.R. (2013). Force-controlled balance perturbations associated with falls in older people: A prospective cohort study. PLoS One, 8(8), Article e70981. https://doi.org/10.1371/journal.pone.0070981

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tajeu, G.S., Delzell, E., Smith, W., Arora, T., Curtis, J.R., Saag, K.G., Morrisey, M.A., Yun, H., & Kilgore, M.L. (2014). Death, debility, and destitution following hip fracture. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(3), 346–353. https://doi.org/10.1093/gerona/glt105

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tsunoda, K., Kitano, N., Kai, Y., Tsuji, T., Soma, Y., Jindo, T., Yoon, J., & Okura, T. (2015). Transportation mode usage and physical, mental and social functions in older Japanese Adults. Journal of Transport & Health, 2, 44–49. https://doi.org/10.1016/j.jth.2014.10.003

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Wagenaar, R.C., Holt, K.G., Kubo, M., & Ho, C.-L. (2002). Gait risk factors for falls in older adults: A dynamic perspective. Journal of the American Society on Aging, 26(4), 28–32. https://www.jstor.org/stable/26555174

    • Search Google Scholar
    • Export Citation

  • World Health Organization [WHO]. (2017). Physical activity .http://www.who.int/mediacentre/factsheets/fs385/en/

  • Yang, F., & Pai, Y.C. (2014). Can sacral marker approximate center of mass during gait and slip-fall recovery among community-dwelling older adults? Journal of Biomechanics, 47(16), 3807–3812. https://doi.org/10.1016/j.jbiomech.2014.10.027

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing, 34(6), 614–619. https://doi.org/10.1093/ageing/afi196

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Zander, A., Passmore, E., Mason, C., & Rissel, C. (2013). Joy, exercise, enjoyment, getting out: A qualitative study of older people’s experience of cycling in Sydney, Australia. Journal of Environmental and Public Health, 2013, Article 547453. https://doi.org/10.1155/2013/547453

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1697 1138 98
Full Text Views 92 61 4
PDF Downloads 131 82 7