Electrically assisted bicycles in adults: a scoping review of health outcomes and relevance to rehabilitation.

Abstract

Background: Electrically assisted bicycles (e-bikes) have gained attention as a low-barrier strategy for promoting physical activity among individuals with different levels of exercise tolerance. Although most research has been conducted in community and active-transport settings, some outcomes may be relevant to rehabilitation. This scoping review mapped e-bikes among adults and synthesized health outcomes with potential relevance to rehabilitation.

Methods: Following JBI methodology and PRISMA-ScR reporting guidance, we searched major health databases and supplementary sources from inception to 25 September 2025. We included experimental and observational studies involving adults aged ≥ 18 years who used pedal-assist e-bikes. No restriction was imposed on intervention or exposure duration. Two reviewers independently screened the records, extracted the data, and assessed methodological quality using the Effective Public Health Practice Project tool.

Results: Of 8,242 records identified, 14 studies were included. Most involved healthy adults and were conducted in Europe, with few studies including clinical populations. E-bike protocols varied widely, but several elicited moderate-intensity physiological responses and were associated with greater cycling participation and lower perceived exertion. Evidence on metabolic, cognitive, and psychological outcomes was limited. All included studies received an overall weak methodological quality rating. Study duration ranged from single-session assessments to nine-month interventions, while one community program operated for approximately 21 months.

Conclusions: E-bikes may offer a feasible, low-barrier means of promoting physical activity and cycling participation while reducing perceived exertion. However, the evidence remains exploratory because most studies involved small samples and healthy participants, and few were conducted in clinical rehabilitation settings. Further controlled trials are needed before e-bikes can be routinely recommended for rehabilitation.