Effect of E-Bike Versus Bike Commuting on Cardiorespiratory Fitness in Overweight Adults: A 4-Week Randomized Pilot Study Demands of Simulated Commuting Using an Electrically Assisted Bicycle Active transportation to school over 2 years in relation to weight status and physical activity. Use of in-home stationary cycling equipment among parents in a family-based randomized trial intervention. Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents “Walk in to Work Out”: a randomised controlled trial of a self help intervention to promote active commuting Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort Active commuting to school: Associations with environment and parental concerns. Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study A Systematic Review of Bone Health in Cyclists School based bicycle safety education and bicycle injuries in children: a case-control study Improving the recruitment activity of clinicians in randomised controlled trials: a systematic review Active-assisted cycling improves tremor and bradykinesia in Parkinson's disease. Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Physical activity and active commuting to elementary school. A community intervention to prevent traffic accidents among bicycle commuters. Factors influencing participation in a randomized controlled resistance exercise intervention study in breast cancer patients during radiotherapy Effects of active commuting and leisure-time exercise on fat loss in women and men with overweight and obesity: a randomized controlled trial Effects of hybrid cycling versus handcycling on wheelchair-specific fitness and physical activity in people with long-term spinal cord injury: a 16-week randomized controlled trial Increasing participation of cancer patients in randomised controlled trials: a systematic review Towards systematic reviews that inform health care management and policy-making
Objective : To assess if active commuting with an electrically assisted bicycle ( e-bike ) during a 4-week period can induce increases in cardiorespiratory fitness measured as peak oxygen uptake ( V[Combining Dot Above]O2peak ) in untrained , overweight individuals , and if these changes are comparable with those induced by a conventional bicycle . Design : Four-week r and omized pilot study . Setting : Controlled laboratory . Participants : Thirty-two volunteers ( 28 men ) participated . Seventeen { median age 37 years [ interquartile range ( IQR ) 34 , 45 ] , median body mass index [ BMI ] 29 kg/m2 [ IQR 27 , 31 ] } were r and omized to the E-Bike group and 15 [ median age 43 years ( IQR 38 , 45 ) , median BMI 28 kg/m2 ( IQR 26 , 29 ) ] to the Bike group . Interventions : Participants in both groups were instructed to use the bicycle allocated to them ( e-bike or conventional bicycle ) for an active commute to work in the Basel ( Switzerl and ) area at a self-chosen speed on at least 3 days per week during the 4-week intervention period . Main Outcome Measures : V[Combining Dot Above]O2peak was assessed before and after the intervention in an all-out exercise test on a bicycle ergometer . Results : V[Combining Dot Above]O2peak increased by an average of 3.6 mL/(kg·min ) [ SD 3.6 mL/(kg·min ) ] in the E-Bike group and by 2.2 mL/(kg·min ) [ SD 3.5 mL/(kg·min ) ] in the Bike group , with an adjusted difference between the 2 groups of 1.4 mL/(kg·min ) [ 95 % confidence interval , −1.4 - 4.1 ; P = 0.327 ] . Conclusions : E-bikes may have the potential to improve cardiorespiratory fitness similar to conventional bicycles despite the available power assist , as they enable higher biking speeds and greater elevation gain The American College of Sports Medicine ( ACSM ) recommends adults participate in weekly aerobic activity for a minimum of 30 minutes moderate intensity exercise 5 days per week or 20 minutes of vigorous activity 3 days per week . The electrically assisted bicycle may help individuals achieve the ACSM ’s aerobic recommendations and introduce inactive individuals to physical activity . To compare the physiological requirements of riding a bicycle with electric pedal assist versus non-assist among healthy active young adults . 6 males and 6 females completed two r and omized cycling trials using electric pedal assist ( PAB ) and non-assist ( NON ) . Cycling trials were completed over a 3.54 km course with varying terrain . Time to completion was faster in the PAB ( 12.5 ± 0.3 min ) than the NON ( 13.8 ± 0.3 min , p=0.01 ) . Rating of Perceived Exertion ( RPE ) was lower in the PAB ( 12.0 ± 0.4 ) than the NON ( 14.8 ± 0.5 , p < 0.001 ) . There was no difference in mean VO2 between PAB ( 2.3 ± 0.1 L·min−1 ) and NON ( 2.5 ± 0.1 L·min−1 , p=0.45 ) . There was no difference in mean power output when comparing PAB ( 115 ± 11 Watts ) to NON ( 128 ± 11 Watts , p=0.38 ) . There was no difference in heart rate between PAB ( 147 ± 5 bpm ) and NON ( 149 ± 5 bpm , p=0.77 ) . Recreationally active younger ( college age ) individuals may self-select a similar physiological intensity of physical activity regardless of mechanical assistance , result ing in quicker completion of a commuting task with PAB . Both the PAB and NON exercise bouts met ACSM criteria for vigorous exercise OBJECTIVE To prospect ively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth . RESEARCH METHODS AND PROCEDURES A cohort of students from seven elementary schools was measured four times -- in the fall and spring of fourth grade ( N = 1083 ) and fifth grade ( N = 924 ) . Participants were classified as active ( walking , biking , or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting ) or non-active commuters to school . Accelerometers were used to measure physical activity . Height , weight , and skinfolds were objective ly assessed . RESULTS Boys who actively commuted to school had lower BMI ( p < 0.01 ) and skinfolds ( p < 0.05 ) than non-active commuters to school in the fourth grade . Active commuting to school over 2 years was not associated with BMI change or overweight status . DISCUSSION Walking and cycling to school may contribute to preventing excessive weight gain , or leaner children may walk or cycle to school OBJECTIVES The purpose of this study was to examine the use of home exercise equipment in the form of exergame cycling compared to a stationary recumbent bicycle ergometer in front of TV in the home over 3 months among parents of an intervention with their inactive children . The primary outcome was bike use ( total weekly duration ) . Predictors of bike use in the form of theory of planned behavior and self-determination theory were also examined . DESIGN R and omized controlled trial . METHOD Sixty eight parents of children aged 10 - 14 were r and omized to either the exergame condition ( n=36 ) or the st and ard bike condition ( n=32 ) . Weekly bike use was recorded in a log-book . RESULTS The exergame bike and a st and ard bike in front of a TV had similar use across three months ( p=.13 , ηp2=.02 ) , which declined over time ( p<.01 , ηp2=.14 ) . Parents who were active at baseline and had the intention to use the bikes were more likely to use the bikes ( p<.05 ) . Furthermore , those who reported higher perceived control , intrinsic motivation , and affective attitude were more likely to use the bikes ( p<.05 ) . CONCLUSIONS The findings suggested that irrespective of modality , use of exercise equipment declined considerably for parents over three-months . Parents may also benefit from family physical activity interventions , but it depends on their physical activity status , how much they would enjoy using the equipment , and their overall perceived control over being physically active . TRIAL REGISTRATION clinical trials.gov # NCT01373762 . Registered 1 June 2011 Objective To investigate the associations between body composition , cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents . Method Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study . Anthropometry , cardiorespiratory and muscular fitness  were tested at the school location . Question naires were used in order to register mode of transport to school , age , gender and levels of leisure time physical activity . Results A total of 1694 ( i.e. 60 % of all invited participants ) children and adolescents at a mean age of 9.6 and 15.6 respectively ( SD = 0.4 for both groups ) were analyzed for associations with physical fitness variables . Males cycling to school had lower sum of skin folds than adolescents walking to school . Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed . Among children , cycling and walking to school , higher isometric muscle endurance in the back extensors compared to passive commuters was observed . Conclusion Based on this national representative cross-sectional examination of r and omly selected children and adolescents there is evidence that active commuting , especially cycling , is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting Study objective : To determine if a self help intervention , delivered via written interactive material s ( the “ Walk in to Work Out ” pack ) , could increase  active commuting behaviour ( walking and cycling ) . Design : R and omised controlled trial . The intervention group received the “ Walk in to Work Out ” pack , which contained written interactive material s based on the transtheoretical model of behaviour change , local information about distances and routes , and safety information . The control group received the pack six months later . Focus groups were also conducted after six months . Setting : Three workplaces in the city of Glasgow , Scotl and , UK . Participants : 295 employees who had been identified as thinking about , or doing some irregular , walking or cycling to work . Main results : The intervention group was almost twice as likely to increase walking to work as the control group at six months ( odds ratio of 1.93 , 95 % confidence intervals 1.06 to 3.52 ) . The intervention was not successful at increasing cycling . There were no distance travelled to work , gender , or age influences on the results . Twenty five per cent ( 95 % confidence intervals 17 % to 32 % ) of the intervention group , who received the pack at baseline , were regularly actively commuting at the 12 month follow up . Conclusion : The “ Walk in to Work Out ” pack was successful in increasing walking but not cycling . The environment for cycling must be improved before cycling will become a popular option Background Travellers are at risk of acquiring infectious diseases during travel , with risks differing by destination , travel and traveller characteristics . A pre-travel health consultation may minimize this risk . However , uptake of pre-travel health advice remains low . We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia . Methods Prospect i ve enhanced surveillance of notified cases of typhoid , paratyphoid , measles , hepatitis A , hepatitis E , malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014 . Details of pre-travel health preparation and disease-specific risk behaviours were collected . Results Among 180 cases associated with international travel , 28 % were < 18 years , 65 % were VFR travellers and 22 % were frequent travellers , having travelled ≥5 times in the past 5 years . 25 % had sought pre-travel advice from a healthcare provider , and 16 % reported a pre-travel vaccine . Seeking pre-travel health advice did not differ by immigrant status ( P = 0.22 ) or by reason for travel ( P = 0.13 ) but was more commonly sought by first time travellers ( P = 0.03 ) . Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P < 0.001 ) and eating uncooked food ( P = 0.03 ) during travel compared to other travellers . Conclusions Pre-travel health advice seeking practice s and vaccine uptake was suboptimal among cases of notified disease . The results of this study highlight the need for a better underst and ing of barriers to pre-travel health seeking , particularly among high risk travellers , to reduce the importation of infectious diseases into Australia Objectives To investigate associations between modest levels of total and domain-specific ( commuting , other utility , recreational ) cycling and  mortality from all causes , cardiovascular disease and cancer . Design Population -based cohort study ( European Prospect i ve Investigation into Cancer and Nutrition study -Norfolk ) . Setting Participants were recruited from general practice s in the east of Engl and and attended health examinations between 1993 and 1997 and again between 1998 and 2000 . At the first health assessment , participants reported their average weekly duration of cycling for all purpose s using a simple measure of physical activity . At the second health assessment , participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity question naire . Participants Adults aged 40–79 years at the first health assessment . Primary outcome measure All participants were followed for mortality ( all-cause , cardiovascular and cancer ) until March 2011 . Results There were 22 450 participants with complete data at the first health assessment , of whom 4398 died during follow-up ; and 13 346 participants with complete data at the second health assessment , of whom 1670 died during follow-up . Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9 % reduced risk of all-cause mortality ( adjusted HR 0.91 , 95 % CI 0.84 to 0.99 ) . Using the more precise measures of cycling available from the second health assessment , all types of cycling were associated with greater total moderate-to-vigorous physical activity ; however , there was little evidence of an association between overall or domain-specific cycling and mortality . Conclusions Cycling , in particular for utility purpose s , was associated with greater moderate-to-vigorous and total physical activity . While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality , further research is required to confirm how much cycling is sufficient to induce health benefits PURPOSE This study examined the association of objective and perceived neighborhood environmental characteristics and parent concerns with  active commuting to school  , investigated whether parental concerns varied by environmental characteristics , and compared the association of the perceived environment , parental concerns , and objective environment on the outcome active commuting to school . METHODS R and omly selected parents of children ( aged 5 - 18 yr ) , in neighborhoods chosen for their variability in objective ly measured walkability and income , completed question naires about their neighborhood environment , concerns about children walking to school , and children 's behavior ( N = 259 ) . Objective measures of the environment were available for each participant and each neighborhood . Logistic regression analyses were used to investigate the relationships among environment , parental concerns , and walking or biking to or from school  at least once a week . RESULTS A parental concerns scale was most strongly associated with child active commuting ( odds ratio : 5.2 , 95 % CI : 2.71 - 9.96 ) . In high-income neighborhoods , more children actively commuted in high-walkable ( 34 % ) than in low-walkable neighborhoods ( 23 % ) ( odds ratio : 2.1 , 95 % CI : 1.12 - 3.97 ) , but no differences were noted in low-income neighborhoods . Parent concerns and neighborhood aesthetics were independently associated with active commuting . Perceived access to local stores and biking or walking facilities accounted for some of the effect of walkability on active commuting . CONCLUSION Both parent concerns and the built environment were associated with children 's  active commuting to school . To increase active commuting to school , interventions that include both environmental change and education campaigns may be needed Objective To investigate the association between active commuting and  incident cardiovascular disease ( CVD ) , cancer , and all cause mortality .  Design Prospect i ve population based study . Setting UK Biobank . Participants 263 450 participants ( 106 674 ( 52 % ) women ; mean age 52.6 ) , recruited from 22 sites across the UK . The exposure variable was the mode of transport used ( walking , cycling , mixed mode v non-active ( car or public transport ) ) to commute to and from work on a typical day . Main outcome measures Incident ( fatal and non-fatal ) CVD and cancer , and deaths from CVD , cancer , or any causes . Results 2430 participants died ( 496 were related to CVD and 1126 to cancer ) over a median of 5.0 years ( interquartile range 4.3 - 5.5 ) follow-up . There were 3748 cancer and 1110 CVD events . In maximally adjusted models , commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality ( cycling hazard ratio 0.59 , 95 % confidence interval 0.42 to 0.83 , P=0.002 ; mixed mode cycling 0.76 , 0.58 to 1.00 , P<0.05 ) , cancer incidence ( cycling 0.55 , 0.44 to 0.69 , P<0.001 ; mixed mode cycling 0.64 , 0.45 to 0.91 , P=0.01 ) , and cancer mortality ( cycling 0.60 , 0.40 to 0.90 , P=0.01 ; mixed mode cycling 0.68 , 0.57 to 0.81 , P<0.001 ) . Commuting by cycling and walking were associated with a lower risk of CVD incidence ( cycling 0.54 , 0.33 to 0.88 , P=0.01 ; walking 0.73 , 0.54 to 0.99 , P=0.04 ) and CVD mortality ( cycling 0.48 , 0.25 to 0.92 , P=0.03 ; walking 0.64 , 0.45 to 0.91 , P=0.01 ) . No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes . Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes . Conclusions Cycle commuting was associated with a lower risk of CVD , cancer , and all cause mortality .  Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors . Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions Context : Low bone mineral density ( BMD ) is a serious public health problem . Osteoporotic fractures are associated with low bone mass , occurring frequently in the hip and spine . Previous studies have demonstrated a positive relationship between BMD and weightbearing exercise but not a similar positive relationship with nonweightbearing exercise . There is concern that cycling , a weight-supported sport , does not benefit bone health . Objective : To systematic ally review the evidence suggesting that cyclists have impaired bone health at the femoral neck and lumbar spine . Data Sources : Articles in PubMed , Cochrane Library , and CINAHL were identified in December 2009 What is the start date for the search ? based on the following terms and combinations : bicycling , bone density , cyclist . Study Selection : Thirteen studies satisfied inclusion criteria : 2 prospect i ve studies ( level of evidence 2b ) and 11 cross-sectional studies ( level of evidence 2c ) . Data Extraction : Data included sample size , demographics , description of cycling and control criteria , and BMD ( g/cm2 ) at the lumbar spine , femoral neck , and hip . Results : Two prospect i ve studies showed a decrease in femoral neck , total hip , or lumbar spine BMD in cyclists over the study period . Four cross-sectional studies compared cyclists with sedentary controls , and 3 found cyclists ’ lumbar spine and femoral neck BMD similar to that of controls , whereas 1 found cyclists ’ BMD to be lower than that of controls . Seven cross-sectional studies compared cyclists with active controls : 2 found no differences in femoral neck and lumbar spine BMD between cyclists and controls ; 4 found that cyclists had lower lumbar spine BMD than did active controls , including runners ; and 1 reported a trend toward lower lumbar spine BMD in cyclists versus controls . Conclusions : There is concerning but inconsistent , limited- quality disease-oriented evidence —primarily from cross-sectional data —indicating that cyclists may be at risk for low bone mass , particularly at the lumbar spine . Additional longitudinal controlled intervention trials are needed Objectives —To evaluate possible benefits of a school based bicycle safety education program ( “ Bike Ed ” ) on the  risk of bicycle injury in children . Methods —A population based case-control study was undertaken in a region of Melbourne , Australia . Cases were children presenting at hospital emergency departments with injuries received while riding bicycles . Controls were recruited by calling r and omly selected telephone numbers . Data were collected by personal interview . Results — Analysis , based on 148 cases and 130 controls aged 9 to 14 years , showed no evidence of a protective effect and suggested a possible harmful effect of exposure to the bicycle safety course ( odds ratio ( OR ) 1.64 , 95 % confidence interval ( CI ) 0.98 to 2.75 ) . This association was not substantially altered by adjustment for sex , age , socioeconomic status , and exposure , measured as time or distance travelled . Subgroup analysis indicated that the association was strongest in boys ( OR 2.0 , 95 % CI 1.1 to 3.8 ) , younger children , children from families with lower parental education levels , and children lacking other family members who bicycle . Conclusions —It is concluded that this educational intervention does not reduce the risk of bicycle injury in children and may possibly produce harmful effects in some children , perhaps due to inadvertent encouragement of risk taking or of bicycling with inadequate supervision Background Poor recruitment to r and omised controlled trials ( RCTs ) is a widespread problem . Provision of interventions aim ed at supporting or incentivising clinicians may improve recruitment to RCTs . Objectives To quantify the effects of strategies aim ed at improving the recruitment activity of clinicians in RCTs , complemented with a synthesis of qualitative evidence related to clinicians ' attitudes towards recruiting to RCTs . Data sources A systematic review of English and non-English articles identified from : The Cochrane Library , Ovid MEDLINE , Ovid EMBASE , Ovid PsycINFO , Ebsco CINAHL , Index to Theses and Open SIGLE from 2001 to March 2011 . Additional reports were identified through citation search es of included articles . Study eligibility criteria Quantitative studies were included if they evaluated interventions aim ed at improving the recruitment activity of clinicians or compared recruitment by different groups of clinicians . Information about host trial , study design , participants , interventions , outcomes and host RCT was extracted by one research er and checked by another . Studies that met the inclusion criteria were assessed for quality using a st and ardised tool , the Effective Public Health Practice Project tool . Qualitative studies were included if they investigated clinicians ' attitudes to recruiting patients to RCTs . All results / findings were extracted , and content analysis was carried out . Overarching themes were abstract ed , followed by a meta summary analysis . Studies that met the inclusion criteria were assessed for quality using the Critical Appraisal Skills Programme qualitative checklist . Data extraction Data extraction was carried out by one research er using predefined data fields , including study quality indicators , and verified by another . Results Eight quantitative studies were included describing four interventions and a comparison of recruiting clinicians . One study was rated as strong , one as moderate and the remaining six as weak when assessed for quality using the Effective Public Health Practice Project tool . Effective interventions included the use of qualitative research to identify and overcome barriers to recruitment , reduction of the clinical workload associated with participation in RCTs and the provision of extra training and protected research time . Eleven qualitative studies were identified , and eight themes were abstract ed from the data : underst and ing of research , communication , perceived patient barriers , patient – clinician relationship , effect on patients , effect on clinical practice , individual benefits for clinicians and methods associated with successful recruitment . Meta summary analysis identified the most frequently reported subthemes to be : difficulty communicating trial methods , poor underst and ing of research and priority given to patient well-being . Overall , the qualitative studies were found to be of good quality when assessed using the Critical Appraisal Skills Programme checklist . Conclusions There were few high- quality trials that tested interventions to improve  clinicians ' recruitment activity in RCTs . The most promising intervention was the use of qualitative methods to identify and overcome barriers to  clinician recruitment activity . More good quality studies of interventions are needed to add to the evidence base . The meta summary of qualitative findings identified underst and ing and communicating RCT methods as a key target for future interventions to improve recruitment . Reinforcement of the potential benefits , both for clinicians and for their patients , could also be a successful factor in improving recruitment . A bias was found towards investigating barriers to recruitment , so future work should also encompass a focus on successfully recruiting trials OBJECTIVES To develop a rapid cadence cycling intervention ( active-assisted cycling [ AAC ] ) using a motorized bike and to examine physiological perimeters during these sessions in individuals with Parkinson 's disease ( PD ) . A secondary goal was to examine whether a single session of AAC at a high cadence would promote improvements in tremor and bradykinesia similar to the on medication state . DESIGN Before-after pilot trial with cross-over . SETTING University research laboratory . PARTICIPANTS Individuals with idiopathic PD ( N=10 , age 45 - 74y ) in Hoehn and Yahr stages 1 to 3 . INTERVENTION Forty minutes of AAC . MAIN OUTCOME MEASURES Heart rate , pedaling power , and rating of perceived exertion were recorded before , during , and after a bout of AAC . Functional assessment s included tremor score during resting , postural , and kinetic tremor . RESULTS This AAC paradigm was well tolerated by individuals with PD without excessive fatigue , and most participants showed improvements in tremor and bradykinesia immediately after a single bout of cycling . CONCLUSIONS This paradigm could be used to examine changes in motor function in individuals with PD after bouts of high-intensity exercise Background Physical inactivity increases the risk of many chronic diseases including coronary heart disease , type 2 diabetes and some cancers . It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this . An opportunity for working adults to accumulate the recommended activity levels is through the daily commute . Methods Employees will be recruited from workplaces in south-west Engl and and south Wales . In the intervention arm ,  workplace Walk-to-Work promoters  will be recruited and trained . Participating employees will receive Walk-to-Work material  s and support will be provided through four contacts from the promoters over 10 weeks . Workplaces in the control arm will continue with their usual practice . The intervention will be evaluated by a cluster r and omized controlled trial including economic and process evaluations . The primary outcome is daily minutes of moderate to vigorous physical activity ( MVPA ) . Secondary outcomes are : overall physical activity ; sedentary time ; modal shift away from private car use during the commute ; and physical activity/MVPA during the commute .  Accelerometers , GPS receivers and travel diaries will be used at baseline and one year follow-up . Question naires will be used at baseline , immediately post intervention , and one year follow-up . The process evaluation will examine the context , delivery and response to the intervention from the perspectives of employers , Walk-to-Work promoters and employees using question naires , descriptive statistics , fieldnotes and interviews . A cost-consequence study will include employer , employee and health service costs and outcomes . Time and consumables used in implementing the intervention will be measured . Journey time , household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees . Presenteeism , absenteeism , employee wellbeing and health service use will be recorded . Discussion Compared with other forms of physical activity , walking is a popular , familiar and convenient , and the main option for increasing physical activity in sedentary population s. To our knowledge , this is the first full-scale r and omised controlled trial to objective ly measure ( using accelerometers and GPS receivers ) the effectiveness of a workplace intervention to promote walking during the commute to and from work . Trial registration IS RCT N15009100 ( 10 December 2014 ) BACKGROUND Physical activity is associated with low mortality in men , but little is known about the association in women , different age groups , and everyday activity . OBJECTIVE To evaluate the relationship between levels of physical activity during work , leisure time , cycling to work , and sports participation and all-cause mortality . DESIGN Prospect i ve study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination . Mean follow-up from examination was 14.5 years . SETTING Copenhagen University Hospital , Copenhagen , Denmark . PARTICIPANTS Participants were 13,375 women and 17,265 men , 20 to 93 years of age , who were r and omly selected .  Physical activity was assessed by self-report , and health status , including  blood pressure , total cholesterol level , triglyceride levels , body mass index , smoking , and educational level  , was evaluated . MAIN OUTCOME MEASURE All-cause mortality . RESULTS A total of 2,881 women and 5,668 men died . Compared with the sedentary , age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 ( 95 % confidence interval , 0.64 - 0.71 ) , 0.61 ( 95 % confidence interval , 0.57 - 0.66 ) , and 0.53 ( 95 % confidence interval , 0.41 - 0.68 ) , respectively , with no difference between sexes and age groups . Within the moderately and highly active persons , sports participants experienced only half the mortality of non participants . Bicycling to work decreased risk of mortality in approximately 40 % after multivariate adjustment , including leisure time physical activity . CONCLUSIONS Leisure time physical activity was inversely associated with  all-cause mortality in both men and women in all age groups . Benefit was found from moderate leisure time physical activity , with further benefit from sports activity and bicycling as transportation PURPOSE This study was conducted to determine if fifth- grade students who walked or bicycled to school on a regular basis were more physically active than those that did not . METHODS The sample consists of 219 fifth- grade students ( 10.3 + /- 0.6 yr , 44 % male , 58 % minority ) from eight r and omly selected urban and suburban elementary schools . Students wore an Acti-Graph physical activity monitor during the same week that they completed a daily survey to report their mode of transportation to and from school . Students were categorized on the number of reported active commuting trips , to and from school , per week ( regular;>or=5 ( N=11 ) , irregular ; 1 - 4 ( N=25 ) , nonactive ; 0 ( N=183 ) ) . RESULTS Compared with both other groups , regular active commuters accumulated 3 % more minutes of moderate-to-vigorous physical activity ( MVPA ; P=0.04 ) during weekdays . This weekday difference was because of regular active commuters accumulating 8.5 % more minutes of MVPA both before and after school ( P < or= 0.01 ) . No difference in physical activity was seen among groups during school or in the evening . Based on the mean number of minutes the students wore their monitors on weekdays ( 800 min.d ) , the 3 % difference translates into approximately 24 additional minutes of MVPA per day for the regular active commuters . CONCLUSION Walking to school was associated with approximately 24 additional minutes of MVPA per day in fifth- grade students . Additional observational and experimental research in larger , more diverse sample s is needed to further clarify the effects of active commuting to school on total daily physical activity and other health outcomes OBJECTIVE To evaluate an educational intervention design ed to prevent traffic accidents among workers that use the bicycle for commuting . METHODS A longitudinal intervention study with a stepped wedge implementation was carried out between January 2006 and May 2007 . Five neighborhoods with distinct geographic characteristics were selected in the city of Pelotas , Brazil , and 42 census tracts were r and omly selected from these neighborhoods . All households were screened for male bicycle commuters , result ing in a sample of 1,133 individuals . The outcomes analyzed were " traffic accidents " and " near accidents " . The cyclists were interviewed monthly by phone to record traffic accidents and " near accidents " . Every 15 days , from the second month of study , a group of about 60 cyclists was invited to attend the intervention meeting that included an educational component ( a talk and a video presentation ) , distribution of a safety kit ( reflective belt & sash , reflective tape and an educational booklet ) and a bicycle breaks check-up ( maintenance performed if necessary ) . Poisson regression adjusted for time effect was used to assess the intervention effect . RESULTS Nearly 45 % of the cyclists did not attend the intervention . During the study period , 9 % of the study individuals reported a traffic accident and 88 % reported a " near accident " . In total there were 106 accidents and 1,091 near accidents . There was no effect observed from the intervention on either of the outcomes . CONCLUSIONS The intervention tested was not capable of reducing traffic accidents among bicycle commuters . Lack of interest in safety by commuters and external factors , such as road design and motorist behavior , may have together influenced this result Background Over the past years knowledge about benefits of physical activity after cancer is evolving from r and omized exercise intervention trials . However , it has been argued that results may be biased by selective participation . Therefore , we investigated factors influencing participation in a r and omized exercise intervention trial for breast cancer patients . Methods Non-metastatic breast cancer patients were systematic ally screened for a r and omized exercise intervention trial on cancer-related fatigue . Participants and non participants were compared concerning sociodemographic characteristics ( age , marital status , living status , travel time to the training facility ) , clinical data ( body-mass-index , tumor stage , tumor size and lymph node status , comorbidities , chemotherapy ) , fatigue , and physical activity . Reasons for participation or declination were recorded . Results 117 patients ( 52 participants , 65 non participants ) were evaluable for analysis . Multiple regression analyses revealed significantly higher odds to decline participation among patients with longer travel time ( p = 0.0012 ) , living alone ( p = 0.039 ) , with more comorbidities ( 0.031 ) , previous chemotherapy ( p = 0.0066 ) , of age ≥ 70 years ( p = 0.025 ) , or being free of fatigue ( p = 0.0007 ) . No associations were found with BMI or physical activity . By far the most frequently reported reason for declination of participation was too long commuting time to the training facility . Conclusions Willingness of breast cancer patients to participate in a r and omized exercise intervention study differed by sociodemographic factors and health status . Neither current physical activity level nor BMI appeared to be selective for participation . Reduction of personal inconveniences and time effort , e.g. by de central ized training facilities or flexible training schedules , seem most promising for enhancing participation in exercise intervention trials . Trial registration Registered at Clinical Trials.gov : NCT01468766 ( October 2011 ) Background : Aerobic exercise is recommended for weight management but energy balance is often less negative than predicted from exercise energy expenditure ( ExEE ) . Objective : To examine effects of active commuting and leisure-time exercise on  fat loss in women and men with overweight and obesity . Methods : We r and omized 130 younger , physically inactive women and men with overweight and obesity ( body mass index : 25–35 kg m−2 ) to 6 months of habitual lifestyle ( control ; CON , n=18 ) , active commuting ( BIKE  , n=35 ) or leisure-time exercise of moderate ( MOD , 50 % VO2peak reserve , n=39 ) or vigorous intensity ( VIG , 70 % VO2peak reserve , n=38 ) . The primary outcome was change in fat mass measured by dual-energy X-ray absorptiometry , which was analyzed intention-to-treat . Accumulated energy balance was calculated based on changes in body composition , and ExEE was calculated based on heart rate monitoring during exercise . Results : Testing at 3 and 6 months was completed by 95 and 90 participants , respectively . Fat mass was reduced after 3 and 6 months in BIKE ( 3 months : −3.6 ( −5.5 ; −1.7 ) kg ( mean ( 95 % CI ) ) ; 6 months : −4.2 ( −6.6 ; −1.9 ) kg ; both : P<0.001 ) , MOD ( 3 months : −2.2 ( −3.9 ; −0.4 ) kg ; 6 months : −2.6 ( −4.8 ; −0.5 ) kg , both : P<0.02 ) and VIG ( 3 months : −3.4 ( −5.2 ; −1.7 ) kg ; 6 months : −4.5 ( −6.6 ; −2.3 ) kg ; both : P<0.001 ) compared with CON . Furthermore , fat loss was greater in VIG compared with MOD ( 6 months : −1.8 ( −3.6 ; −0.1 ) kg , P=0.043 ) . Based on the ExEE and the accumulated energy balance MOD compensated for the ExEE ( 77 ( 48 ; 106 ) % ) but not BIKE ( 38 ( −18 ; 95 ) % ) and VIG ( 21 ( −14 ; 55 ) % ) . Conclusions : A meaningful fat loss was obtained by 6 months of active commuting and leisure-time exercise , but fat loss was greater with vigorous compared with moderate intensity exercise . Active commuting is an alternative to leisure-time exercise in the management of overweight and obesity .  The trial was registered at clinical trials.gov as NCT01962259 ( main trial ) and NCT01973686 ( energy metabolism sub- study ) Study design : This is an open r and omized controlled trial . Objective : The objective of this study was to investigate the effects of a 16-week hybrid cycle versus h and cycle exercise program on fitness and physical activity in inactive people with long-term spinal cord injury ( SCI ) . Setting : The study was conducted in two rehabilitation centers with a specialized SCI unit . Methods : Twenty individuals ( SCI⩾8 years ) were r and omly assigned to a hybrid cycle ( voluntary arm exercise combined with functional electrical stimulation (FES)-induced leg exercise ) or a h and cycle group . During 16 weeks , both groups trained twice a week for 30 min at 65–75 % heart rate reserve . Outcome measures obtained before , during and after the program were fitness ( peak power output , peak oxygen consumption ) , submaximal VO2 and heart rate ( HR ) , resting HR , wheelchair skill performance time score ) and physical activity ( distance travelled in wheelchair and Physical Activity Scale for Individuals with Physical Disabilities ( PASIPD ) score ) . Changes were examined using a two-factor mixed- measures analysis of variance . Results : For all fitness parameters , except for submaximal VO2 , no interaction effects were found . The hybrid cycle group showed a decrease in VO2 over time in contrast to the h and cycle group ( P=0.045 ) . An overall reduction in HRrest ( 5±2 b.p.m . ; P=0.03 ) and overall increase in PASIPD score ( 6.5±2.1 ; P=0.002 ) were found after 16 weeks of training . No overall training effects were found for the other fitness and activity outcome measures . Conclusion : In the current study , hybrid cycling and h and cycling showed similar effects on fitness and physical activity , indicating that there seem to be no additional benefits of the FES-induced leg exercise over h and cycle training alone Background There are many barriers to patient participation in r and omised controlled trials of cancer treatments . To increase participation in trials , strategies need to be identified to overcome these barriers . Our aim was to assess the effectiveness of interventions to overcome barriers to patient participation in  r and omised controlled trials ( RCTs ) of cancer treatments . Methods A systematic review was conducted . Published and unpublished studies in any language were search ed for in fifteen electronic data bases , including MEDLINE , EMBASE , CINAHL and PsycINFO , from inception to the end of 2004 . Studies of any interventions to improve  cancer patient participation  in RCTs , which reported the change in recruitment rates , were eligible for inclusion . RCTs and non-r and omised controlled trials as well as before and after studies reporting baseline rates specific to the population being investigated were included . Data were extracted by one review er into structured summary tables and checked for accuracy by a second review er . Each included study was assessed against a checklist for method ological quality by one review er and checked by a second review er . A narrative synthesis was conducted . Results Eight studies were identified that met the inclusion criteria : three RCTs , two non-r and omised controlled trials and three observational studies . Six of the studies had an intervention that had some relevance to the UK . There was no robust evidence that any of the interventions investigated led to an increase in  cancer patient participation in RCTs , though one good quality RCT found that urologists and nurses were equally effective at recruiting participants to a treatment trial for prostate cancer . Although there was no evidence of an effect in any of the studies , the evidence was not of sufficient quality to be able to conclude that these interventions therefore do not work . Conclusion There is not a strong evidence -base for interventions that increase  cancer patient participation  in r and omised trials . Further research is required to evaluate the effectiveness of strategies to increase participation in cancer treatment trials Objectives To identify ways to improve the usefulness of systematic review s for health care managers and policy-makers that could then be evaluated prospect ively . Methods We systematic ally review ed studies of decision-making by health care managers and policy-makers , conducted interviews with a purposive sample of them in Canada and the United Kingdom ( n=29 ) , and review ed the websites of research funders , producers/purveyors of research , and journals that include them among their target audiences ( n=45 ) . Results Our systematic review identified that factors such as interactions between research ers and health care policy-makers and timing/timeliness appear to increase the prospect s for research use among policy-makers . Our interviews with health care managers and policy-makers suggest that they would benefit from having information that is relevant for decisions highlighted for them ( e.g. context ual factors that affect a review 's local applicability and information about the benefits , harms/risks and costs of interventions ) and having review s presented in a way that allows for rapid scanning for relevance and then grade d entry ( such as one page of take-home messages , a three-page executive summary and a 25-page report ) . Managers and policy-makers have mixed views about the helpfulness of recommendations . Our analysis of websites found that context ual factors were rarely highlighted , recommendations were often provided and grade d entry formats were rarely used . Conclusions Research ers could help to ensure that the future flow of systematic review s will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions . Research funders could help to ensure that the global stock of systematic review s will better inform health care management and policy-making by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘ front ends ’ for potentially relevant systematic review
There was moderate evidence that  e-cycling provided physical activity of at least moderate intensity , which was lower than the intensity elicited during conventional cycling , but higher than that during walking .
There was also moderate evidence that  e-cycling can improve cardiorespiratory fitness in physically inactive individuals .
Evidence of the impact of e-cycling  on metabolic and psychological health outcomes was inconclusive .
Conclusion E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness .
As such , e-bikes offer a potential alternative to conventional cycling .
Background Electrically assisted bicycles ( e-bikes ) have been highlighted as a method of active travel that could overcome some of the commonly reported barriers to cycle commuting .
The objective of this systematic review was to assess the health benefits associated with e-cycling .