Acceptability and effectiveness of stationary bike intervention on health outcomes among older adults: a systematic review of intervention studies

Promoting physical activity (PA) among older adults is challenging due to physical limitations and varying levels of motivation. Stationary biking is a safe, non-weight-bearing form of exercise that is well-suited to this population. Although several studies have investigated stationary bike (SB) interventions, there is limited synthesis regarding their focus, effectiveness, and acceptability. This study aims to identify the primary focus areas of published SB interventions and evaluate their acceptability and impact on health outcomes in older adults. Following PRISMA guidelines, a comprehensive search of seven databases was conducted up to June 18th, 2023, without restrictions on publication year. After duplicate records were removed, two independent reviewers screened studies in a two-phase process. Eligible studies included original intervention research reporting both baseline and post-intervention outcomes, in which stationary biking was employed either as a health assessment tool or as an intervention modality among individuals aged 60 years or older. Out of 8,022 studies, 47 English-language articles were included: 28 Randomized Controlled Trials (RCTs) and 19 (40.43%) Non-RCTs, including Pretest-post-test and Quasi-Experimental studies. The most common focus points of the included studies were Cognitive function, Motor and Balance, Physiological and Psychological changes, Cardiovascular, and Executive function. The most common study populations had neurological problems (15/47, 31.91% studies). Among the 47 included studies, the highest participants’ acceptance rate was 38% (18/47 studies), while the retention rate was 15% (07/47 studies), the adherence rate was 6% (3/47 studies), and the lowest dropout rate was 13% (06/47 studies). Significant health outcomes after SB intervention included Aerobic capacity (VO2 max), Cycling efficiency, Cognition, Executive function, Quality of life (QOL), and Mobility (Timed up and Go test), mentioned in at least 5 studies. About 25% (12/47) of all included studies used virtual aid (VA)-assisted SB intervention and among them 9 RCTs showed better improvement in cycling efficiency, cognition, and executive function compared to non-VA groups. A review of 47 studies found that stationary biking shows moderate acceptability (38%) and yields significant benefits in VO2 max, cycling efficiency, cognition, executive function, quality of life, and mobility (Timed Up and Go test) in adults aged ≥ 60. Stationary biking especially when combined with VA, shows promise as a low-risk intervention to enhance physical and cognitive health in older adults, warranting further high-quality randomized trials to optimize its prescription.