Groep mensen tijdens een spinningles
Groep mensen tijdens een spinningles

Ageing in balance: rehabilitating older adults back for cycling

Balance is a challenge, especially for ageing adults. But to get back on your bike in 3 months is no magic, as shown by Dr Eric Maris, in his Donders Challenge study that provided rehabilitative cycling training among senior adults who struggled with balance.

Life is like riding a bike–they say. But what if the way ahead becomes turbulent, and your balance starts to waver? As people age, balance becomes a paramount concern. Deteriorating balance, coupled with the fear of falling, leads older adults to reduce physical activity, impacting both physical health and social engagement. Eric Maris, however, has seen another way to age, as his 89-year-old mother remains physically and socially active. She cycles regularly and can hardly be caught at home when Maris tries to call her. “She inspired me in the way she managed herself to grow old gracefully and happily,” said Maris. 

Maris' research mainly focuses on how our senses, especially our sense of body position (proprioception), help us maintain balance. He saw a way to use his research setup to bring out real-life impact from evidence-based research. In 2023, he undertook a Donders Challenge, initiating a study to develop and evaluate a rehabilitation training program to enhance balance control in older adults while cycling. What were the outcomes of this innovative training?

Pedalling through time: balance training for elders

Twice a week in June 2023, Jenny Braun found herself doing spinning amidst the hustle and bustle of the Radboud University Sports Centre. It all began when she stumbled upon an invitation on the local newspaper to join a bike training program aimed at reclaiming her cycling skills. “It started by Eric coaching us to spin, so that we built up our strength to cycle,” reminisced Braun. Joining her on the spinning bikes were sixteen other fellow senior participants, aged between 66 and 88, who had stopped cycling for more than six months before joining the training.

After three weeks of spinning, Braun and her fellow participants transitioned to a unique experience. “There was this special bike that we rode suspended in a ‘basket’,” she described. This unique bike, crafted by Maris for the study, was a simulator that resembled a real bike but came with a safety harness hanging from the ceiling to prevent falls. “You are protected during training,” Braun chuckled. 

Bike simulator Eric Maris

Over eight weeks on the bike simulator, Braun as well as other participants trained for thirty minutes to control cycling balance and orientation while keeping in check their fear of falling. Their task was to stay in balance while navigating through virtual road conditions mimicking real-world landscapes in VR. “Occasionally Eric asked me if the neighborhood was nice,” recounted Braun. “But I was very focused on biking straight; the surrounding trees felt too real to hit.” 

Each session on the bike simulator pushed Braun to her limits. “I started slow, gradually picking up and switching speed. At the end of training, I could stop with flat feet set on the earth.” That precisely meets the ultimate goal of the training: to transition from the simulator to real-world cycling. In the end, on their own bikes, the seniors put to test the techniques trained on the bike simulator in various scenarios—whether navigating through light traffic or busy streets. The results? A resounding success, as reported in their pre- and six weeks post-training questionnaires, showcasing remarkable improvements in their cycling abilities.

Stay on your bike, and age in balance

An 11-week structured cycling training can effectively restore balance control for senior citizens eager to return to cycling—the study suggests. To Maris, while mastering the bicycle again may require further training, instilling confidence serves as a critical starting point for seniors aiming to regain their balance. “By immersing them in a low-risk, balance-friendly training environment, individuals regain self-confidence,” noted him. “This in turn encourages them to embrace greater muscular challenges, thereby slowing down the decline in muscle strength and balance.”

The benefits for Jenny Braun extended beyond improved cycling balance. She used to be challenged by ascending stairs. “I used to lean against the wall while walking,” said Braun. “But I suddenly started to walk independently at some point after the cycling training.” She then realized balance as being the underlying issue–fortunately, such awareness has motivated her to keep spinning at the gym. And more than that–she expressed desire to engage in similar training sessions again, not only for physical benefits but also for the social connections fostered during the program. “It was a very social moment, when you gradually opened up to fellow participants, sharing collective experience.”

The positive results of the training leaves Maris a unique perspective to probe the deeper mechanics of balance. “It is interesting to think mechanistically how gaining muscle strength improves balance control, which relies on a sharp sensation of the relation between body and space. Do strengthened muscles help us perceive the outer world better?” He revealed his ponder.

Could embracing the joy of riding be the key to unlocking a healthier, more balanced future for us all? We are only left to wonder, as we reflect on the transformative potential of cycling for older adults.

More information

Further details on this study can be found in a dedicated preprint research article currently under peer review. Interested audience could also peep into the basic scientific concepts behind cycling on, a website built by Eric Maris to share knowledge relevant to cycling and how to improve cycling (balance) skills.

This article was written by Rong Ding, PhD candidate at the Max Planck Institute for Psycholinguistics.