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Table 1 Summary of included studies

From: Health benefits of electrically-assisted cycling: a systematic review

First author, year, country Study design Participants; gender (%female);
Age, years (mean, SD);
BMI, kg/m2 (mean, SD)
Clinical status Exposure conditions Length of intervention Ride characteristics
Distance (km), Topography, Distinctive features, Ride instructions
Acute studies
 Bernsten, 2017, Norway [22] Randomized cross over N = 8, 25%
Age (Mdn, IQR): 39(3)
BMI (Mdn, IQR): 24(7)
Active adults E-bike vs. CB (4 conditions, hilly vs. flat terrain) Trials conducted on same day, 2-min break between trials Route 1: 8.1 km, flat route
Route 2: 7.1 km, one hill climbed twice 130 m elevation gain. Self-selected intensity
 Gojanovic, 2011, Switzerland [18] Non-randomized cross over N = 18, 33.33%
Age: 35.7 (±9.7)
BMI: 24.0 (±3.3)
Inactive adults E-bike LA vs. E-bike HA vs. CB vs. walking Trials conducted over 2-days. 30-min break between trials conducted on same day Biking: 5.1 km, 178 m elevation gain, average gradient 3.4% Instructed to ride at comfortable pace maintaining 60 rpm
Walking: 1.7 km, uphill, 110 m elevation gain, average grade 6.5%
 Hansen, 2017, Belgium [21] Randomized cross over N = 17, 13%
Age: 64 (±7)
Coronary artery disease E-bikes LA vs. E-bike HA vs. CB Trials conducted on separate days (3–4 days between) 10 km, 102 m elevation change
No traffic or stop and go points
Instructed to cycle at self-selected pace on prespecified mode
 La Salle, 2017, USA [26] Randomized cross over N = 12, 50%
Age: M = 25(±1), F = 22(±1)
Body Fat %: M = 16.8(±1.9), F = 23.4 (±3.3)
Active adults with cycling experience E-bike pedal assist vs. E-bike NA Trials conducted in same day. Average time between trials 12-min 3.54 km, hill 0.64 km 11% gradient
Seven pedestrian crossings participants required to dismount and walk. Self-selected pace
 Langford, 2017, USA [23] Non-randomized cross over N = 17, 35%
Age: < 20 yrs. = 3, 20-30 yrs. = 10, 31-40 yrs. = 2, > 50 yrs. = 2
BMI: M = 26.1, F = 23.1
Adults, part of e-bike sharing system E-bike vs. CB vs. Walking Trials conducted on separate days (minimum 24h rest) 4.4 km, 1.6 km downhill (− 33.2 m), 1.8 km flat (− 0.3 m), 1.0 km uphill (+ 33.5 m). Self-selected pace
 Louis, 2012, France [27] Randomized cross-over N = 20 (10 T, 10 UT)
Age: T = 38.7 (±14.8); UT 28.9 (±6.3)
BMI: T = 22 (±1.1), UT = 22.2 (±3.7)
Highly active adults (T)
Recreationally active adults (UT)
E-bike NA vs. E-bike LA vs. E-bike HA Trials conducted on same day. 5-min breaks between trials Completed on indoor trainer.
Instructed to pedal at specified mode for total of 45-min at pre-specified speeds: 15-min at 16 km/hr., 21 km/hr. and free speed totaling 45-min.
 Meyer, 2014, Germany [28] Non-randomized cross over N = 3, 0%
Age: 25, 25, 27
Weight (Kg): 74, 71, 79
Active adults, recreational cyclists E-bike pedal assist vs. E-bike no assist Trials conducted on separate days, 1-day apart. 27 km track divided in 5 sections
 Simons, 2009, Netherlands [20] Non-randomized cross over N = 12, 50%
Age: 52.2 (8.7), range 32–60
BMI: 24.5 (2.6)
42% inactive adults
58% recreationally active adults
E-bike NA vs. E-bike LA vs. E-bike HA Trials conducted in same day. One-hour rest between trials. 4.3 km, flat route, two stop and go section participants required to dismount and restart. Self-selected pace on pre-specified intensity
 Sperlich, 2012, Germany [19] Randomized cross over N = 8, 100%
Age: 38(±15)
BMI: 25.3 (±2.1)
Inactive adults E-bike pedal assist vs. E-bike no assist Trials conducted in same day. One-hour rest between trials. 1.9 km × 5 = 9.5 km, 200 m uphill 1, 5.9%, 700 m downhill, 300 m uphill 2, 5.8%, 700 m flat. Self-selected pace and gear
 Theurel, 2011, France [24] Non-randomized cross over N = 22, 18% female
Age: M = 41(±11), F = 34(±9)
Weight (Kg): M = 68(±18), F = 76(±10)
Active postal workers E-bike vs. CB Trials conducted on same weekday, 1-month apart Postal route, one group completed rides in residential neighbourhood, the other completed the ride in downtown location
 Theurel, 2012, France [25] Non-randomized cross over N = 10, 50% female
Age: F = 30 (±12), M = 35 (±14)
Active adults E-bike vs. CB Trials separated by 1 week 30-min of intermittent cycling on inside track alternating cycling of 10 sec duration and recovery of 20 sec. Aimed to complete 60 m in 10 sec (average speed = 21.6 km/hr)
Longitudinal studies
 Cooper, 2018, UK [32] Single group feasibility N = 20 (report on 18)
Age: 58.1 (±7.9)
BMI: 30.2 (4.4)
Type 2 Diabetes One group e-bike Up to 5 months E-bike training provided. Provision of e-bike for up to 5-months. Support for mechanical issues provided. No instruction on how or when to ride bike
 De Geus, 2013, Belgium [29] Non-randomized cross over N = 24, 46%
Age: M = 47(±7) F = 43(±6)
BMI: M = 27.0 (±2.8), F = 24.7 (±4.6)
Inactive adults a E-bike vs. Control Control = 4 weeks
E-bike = 6 weeks
Instructed to ride e-bike at least three times per week to commute to and from work
 Hochsmann, 2017, Switzerland [30] Pilot randomized controlled trial N = 32, 13%
Age, (Mdn, IQR): F = 35(34–45), M = 43(38–45)
BMI, (Mdn, IQR) E-bike = 29 (27,31), regular bike = 28 (26,29)
Inactive adults E-bike vs. CB 4 weeks Instructed to use bike for active commute to work on at least 3-days per week, over 6 km. Self-selected pace
 Malnes, 2016, Norway [31] Single group pilot N = 25, 72%
Age: 42(±12)
BMI: M = 25.4(±12.3), F = 28.7(±15.8)
Inactive adults One group e-bike Up to 8 months 3 sites: 2 provided e-bikes for up to 8-months, 1 e-bike up to 3-months.
Instructed to use bike as desired. In 2-centres if e-bikes not used they were withdrawn from participant. Group was separated into high and low fitness groups based on baseline testing
 Page, 2017, UK [33] Non-randomized two group N = 31, 80%
Age Range: 21-55 years
Unclear E-bike commuting vs. passive commuting Data reported mid-way into intervention – 2 months No instructions on how to ride bike, full roadside assistance provided.
 Peterman, 2016, USA [13] Single group N = 21, 70% (of 20 in analysis)
Age: 41.5 (±11.5).
Inactive adults One group e-bike 4 weeks Instructed to ride e-bike at least 3 days per week for at least 40-min for commuting
  1. T trained (engage in endurance sport at least 4 times per week), UT untrained (moderately active but less than 4× per week), Inactive <150 min/week of moderate to vigorous physical activity, Active  ≥150 min/week of moderate to vigorous physical activity a report as sedentary but do not specifically measure moderate to vigorous physical activity, F female, M male, NA no assistance, LA low assistance, HA high assistance, CB conventional bike