An exploration of the barriers and enablers of using electrically assisted bikes (e-bikes) in the development of a stroke intervention for people after stroke

Abstract

Background: Recently there has been an increased interest in the development of innovative approaches within stroke rehabilitation interventions to ensure long term maintenance of physical activity levels within the stroke population. Electrically assisted bikes (e-bike) have been shown to be an alternative form of physical activity for sedentary individuals and those with physical limitations. Currently the research into the use of e-bike by stroke survivors is limited and has not been explored within the context of stroke intervention design. This study explored the barriers and enablers to using an e-bike by stroke survivors in the development of a stroke rehabilitation intervention.
Methods: A mixed methods case study approach using semi-structured interviews and e-bike usage data was used. Six stroke survivors with the ability to walk with or without assistance, were recruited from stroke support groups. Subject to approval from their doctor, participants had the opportunity to loan either an e-bike or e-trike for a duration of up to three months. Data collection was carried out over three phases: Pre-loan, during the e-bike loan and post e-bike loan. Semi-structured interviews were conducted pre and post loan to identify barriers and enablers and were analysed within the framework of a behaviour change model (the COM-B model).
Results: Of the six participants, only three went on to loan an e-bike and participate in the post-loan interview. Reasons for withdrawal were because of a lack of storage space, non-approval from their doctor and not feeling comfortable using the e-bike. The analysis using the COM-B model identified that the most common barriers were in relation to the effects of physical impairment, knowledge about the e-bike and fear as a negative emotion. The main enablers were the effect that the e-bike had on fatigue, social support and the belief that using the e-bike was a mode of physical activity that was enjoyable and good for their health.
Conclusion: The stroke survivors identified several barriers and enablers to using the e-bike. If e-bikes are going to be used as part of a stroke rehabilitation intervention the barriers need to be addressed and build on the enablers to increase physical activity levels post-stroke.