Exploring the factors influencing the use of electrically assisted bikes (e-bikes) by stroke survivors: a mixed methods multiple case study

Abstract

Purpose

E-bikes have the potential to overcome some of the barriers that stroke survivors face with regards to physical activity. This study aims to explore the factors that affect e-bike usage by stroke survivors.

Methods

A mixed methods multiple case studies design, using semi-structured interviews and GPS data. Subject to GP approval, participants loaned an e-bike or e-trike for up to three months. Interviews were undertaken pre and post intervention. The COM-B behaviour change model acted as a framework for analysis. GPS data relating to journey duration and distance travelled was collected fortnightly.

Results

Six participants were recruited; only three loaned an e-bike/e-trike (with adaptations as required). Storage, being unable to get GP approval, and safety were withdrawal reasons. Level of impairment was a factor influencing the type of e-bike used, level of support required and the motivation of the participants.

Conclusion

Stroke survivors can use e-bikes although barriers exist. Electrical assistance was a positive factor in enabling some of the participants to cycle outdoors. Due to the small sample size and the number of participants who were able to loan an e-bike, further research is required to determine whether e-bikes are a feasible and effective intervention to increase physical activity for stroke survivors.

IMPLICATIONS FOR REHABILITATION

• The assistance provided by the e-bike/e-trike could provide stroke survivors the opportunity to cycle outdoors.

• E-bikes/e-trikes could facilitate participation of activities of everyday living such as shopping, hobbies and increase levels of physical activity.

• Rehabilitation could focus on physical impairment, its effects on self-confidence, and knowledge surrounding the e-bike to overcome barriers to cycling.

• Social support, the belief that e-bike was an enjoyable mode of physical activity that was good for their health were reported by the participants as important factors for using the e-bike/e-trike.

Keywords:

• Stroke
• E-bikes
• electrically assisted bikes
• factors
• physical activity
• barriers
• active transportation
• active travel

Acknowledgments

We would like to thank the participants who participated in this study and Ian Gibbs at I-Cycle Electric (1 North Street, Clitheroe, BB7 1PG) who provided training and technical support throughout this study. The views expressed are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research is part funded by the National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC).