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Cycling And Parkinson’s Disease

How Cycling Helps To Slow Down Parkinsons Disease

Researchers look to cycling as possible treatment option for Parkinson’s disease

In the summer of 2003, Dr Jay Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute, took a bike

In the summer of 2003, Dr Jay Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute, took a bike ride that would change medical history. He rode a tandem bike in the week-long Des Moines Registers Annual Great Bike Race . His partner on the bike was a woman affected with Parkinsons Disease, a long-term degenerative illness afflicting the central nervous system.

Symptoms of the disorder include shaking, rigidity, difficulty in walking as well as cerebral and behavioural problems and eventually dementia, and total incapacitation after perhaps 15 years. There is no cure. Treatment is generally carried out with medication that attempts to alleviate the symptoms and slow the progress of physical degeneration.

After riding a few days, Alberts noticed that his biking partner was showing signs of physical improvement, especially in her handwriting, which had become more legible and controlled.

In 2006, Alberts rode a tandem bike with another patient, also a doctor, who used a deep brain stimulation implant to control his Parkinsons symptoms. As an experiment, the patient turned the device off for the ride.

Not surprisingly, the researchers also found that it improves overall wellness. In other words, cycling is good for everyone.

Idea For The Study Started On A Charity Ride

Study investigator Jay L. Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute, first got the notion that exercise might be beneficial for Parkinsons patients during a 2003 charity cycle ride across Iowa, to raise awareness of Parkinsons disease. During that event he rode a tandem with a female Parkinsons patient, whose symptoms improved after the ride.

In a statement, in which he describes the finding as serendipitous, Alberts recalls:

I was pedaling faster than her, which forced her to pedal faster. She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.

Adaptations For Implementation In The Community

Despite the noted benefit of FHCC, the tandem or motor-augmented bicycle equipment is not readily available or affordable. Based on his research on FHCC at The Cleveland Clinic, Jay Alberts, PhD along with Cathy Frazier, a person with Parkinson’s, launched The Pedaling for Parkinson’s program , as an accessible and affordable alternative to FHCC. In PFP, individuals with PD are verbally coached to achieve moderate-exertion, high-cadence cycling on solo-rider spin bikes. This differs from FHCC because there is no physical augmentation, only auditory and social cues encouraging participants to pedal at a high rate.

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Cycle Riders May Speed Research To Slow Down Parkinsons Disease

Day after day, mile upon mile, Sally Terrell pedals away on a stationary bike in her Chagrin Falls, Ohio, home. However, shes doing more than just burning calories. The 62-year-old grandmother may be helping Cleveland Clinic researchers better understand how to slow the progression of Parkinsons disease , a progressive neurological disorder.

Its fantastic. Once I get on the bike its so invigorating and inspiring, exudes Sally, of her 30- to 40-minute rides, three- to four-days per week. Im helping myself and helping the research.

Sally is one of 250 PD patients participating in CYCLE , a multi-site clinical trial funded by a five-year, $3 million grant from the National Institutes of Health. CYCLEs exercise group utilizes indoor cycling bikes from fitness technology company Peloton. The studys principal investigator, Cleveland Clinic researcher Jay Alberts, PhD, aims to determine if long-term, high-intensity aerobic exercise can slow the advancement of PD. Participants, like Sally, are recruited and overseen by teams at Cleveland Clinic and the University of Utah.

Sally says her cycling workouts are invigorating and inspiring. She has a great feeling of accomplishment after finishing a class.

These patients are real pioneers, says Dr. Alberts. By helping us understand more about PD and its evolution, we may be able to change the course of this disease.

One of Sally’s greatest joys is spending time with her grandkids.

Indoor Cycling As Effective In Treating Parkinson’s Disease As Medication Study Finds

Cycling for Parkinson

Indoor cycling is effective, and right now seniors can take part in a World Championships of their own

ByMichelle Arthurs-Brennan2019-09-12T10:52:14Z

People in the early stages of Parkinson’s disease may see their symptoms dramatically improved by aerobic exercise like indoor cycling, a study has shown.

Researchers found that high intensity aerobic exercise on a static bike, using interactive apps, provided ‘about the same improvement’ as medication in patients.

Researchers working in the study, published in The Lancet Neurology, split a group of sufferers into two groups and monitored their progress over six months.

One group pedalled on home trainers, using software which showed course such as Tour de France stages, with variable resistance letting them compete against other patients on hills.

The other group did stretching exercises three times a week, also with an app to maintain motivation.

The control group scored four less points on the scale used to assess the motor skills of Parkinson patients.

Head of the research team professor Bas Bloem told broadcaster NOS: “The effect of cycling is about the same as the improvement we would get from different types of medication. New medication for patients are regarded as meaningful if the improvement it brings has a score of three. That shows you how important the effect of cycling really is.

The first event took place in 2017 and in 2018 2,500 riders took part, covering covering 52,000 km together.

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Functional Magnetic Resonance Imaging

Subjects were scanned on a General Electric Signa Excite 1.5 T scanner at a University Hospital. T1 images were acquired using 3D magnetization-prepared rapid gradient echo sequence, repetition time = 13.12 ms, echo time = 4.2 ms, flip angle = 15°, field of view = 240 × 240 mm, voxel size = 1 mm isotropic. Resting and task fMRI data were acquired using gradient-echo echoplanar imaging sequence, with TR = 3,000 ms, TE = 60 ms, flip angle = 90°, FOV = 240 × 240 mm, voxel size = 3.75 × 3.75 × 7 mm. Each run of resting fMRI scan lasted 6 min, producing 180 volumes of 3D images. For the hand motor task, subjects were required to tap with the index fingers for periods of 30 s alternating with 30 s of rest.

Next, the individual T1-weighted images were co-registered to the mean realigned functional images using a linear transformation the T1 was segmented into gray matter, white matter, and cerebrospinal fluid tissue maps followed by non-linear normalization into the Montreal Neurological Institute space. Temporal band-pass filtering was performed on the residual time series of each voxel to reduce the effect of low-frequency drift and high-frequency noise . The final step in preprocessing was a spatial smoothing with an isotropic Gaussian kernel of 4 mm FWHM.

Second Level Statistical Analysis

Spatial normalization into Talairach space

To perform group level analyses, FC maps were registered into a common space. The fcMRI datasets were coregistered with the anatomical images acquired in scan 1 using local Pearson correlation . Anatomical images were normalized into the standard Talairach-Tournoux space using the AFNI auto-Talairach tool in combination with a modified template developed in house to correctly align the anterior commissure-posterior commissure line . These transformations were then applied to the FC maps to normalize them into Talairach space, which involved resampling to 1×1×1mm resolution. Normalized FC maps were then spatially smoothed with a 6-mm FWHM Gaussian filter in preparation for group-level analysis.

Effect of exercise rate on FC

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Rowing Against The Current Of Parkinsons Disease


There I was, 63 years old, sitting in my 1997 Hudson single behind the start line for the 2015 Head of the Madawaska regatta in eastern Ontario. Cold rain was teeming down as we waited to be called to the start. I had promised myself months earlier that I would race again some day. It had been ten years since I last raced. But this was no ordinary challenge. It wasnt enough to attain the necessary fitness to race, nor the control of balance and timing in the hull that was only 11 inches wide at its widest point. This was all out war against a disease that was robbing me of my physical being, Parkinsons disease. This was my Everest.

In the summer of 2011, I went to see the doctor because I was having trouble handwriting. I had also stopped swinging my right arm when I walked, which I had initially attributed to a stressful job. The doctor didnt like the way I looked and sent me for an assessment at the Ottawa Hospital Neurology Clinic. After some seemingly unusual tests, I was told that I did indeed have Parkinsons disease.

At first, the disease did not seem to have a very profound effect, but eventually my gait and fine muscle control became impaired. Everything I read emphasized the importance of exercise in coping with Parkinsons disease. I began to exercise seriously, both in the gym under the guidance of my physiotherapist, and by doing the two physical activities I loved the most cycling and rowing.


Current Evidence For Efficacy Of Cycling For Pd

Indoor cycling gives Parkinsons patients hope

Multiple small controlled trials have demonstrated that forced high cadence cycling can ameliorate motor symptoms in individuals with PD as measured by the Unified Parkinson’s Disease Rating Scale-Part III and Timed up and Go . In FHCC, individuals with PD pedal with either a tandem corider or a motor providing external augmentation at a cadence of 8090 revolutions per minute which is faster than most individuals would pedal on their own. Although the rate is augmented, cycling on either device is an active, not passive, activity. In comparing FHCC versus cycling at a self-selected cadence on a stationary indoor bicycle, most of the published literature has found that, despite similar cardiovascular exertion in the two modes, improved motor symptoms are only observed in the forced-cadence modality . One recent study did demonstrate gains in both forced and voluntary groups, but it was noted that the voluntary group self-selected to pedal at a cadence near the target achieved by the forced group .

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The Science Behind Parkinsons And Cycling

Dr. Jay L. Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute in Ohio, first got the idea that cycling might improve symptoms of Parkinsons at a fundraising event in Iowa in 2003.

Alberts rode tandem with a female Parkinsons patient named Cathy, whose symptoms improved after the ride specifically her handwriting. As Cathy wrote postcards to her family from across Iowa, he noticed her handwriting had become more legible.

This discovery inspired him to conduct a research study with two groups of Parkinsons patients cycling on stationary bikes three times a week for two months.

One group pedaled at their own chosen speed, while another group pedaled at a more vigorous rate than what they would ordinarily choose for themselves. The more vigorous group of cyclers appeared to have greater improvement in regions of the brain that deal with movement.

The moral of the story is: The harder your pedal, the better the results!

Dynamic Cycling Versus High

Dynamic cycling promoted similar improvements in motor function to that reported in other high-intensity exercise interventions , but the HR and ratings of perceived exertion values recorded during dynamic cycling sessions are defined as light to moderate intensity . During dynamic cycling, the motor does the majority of the work to turn the pedals and less effort is required by the individual. The significant decrease in power in the dynamic group , compared to the static group , reflects this effort. The value of this rehabilitation paradigm is that it promotes significant improvement in PD symptoms with a reduced the risk of injury, excessive fatigue, and non-compliance. All of the individuals in the dynamic group were able to successfully complete three sessions without any unusual fatigue or injuries.

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With Or Without Pd Cycling Is Just Plain Good For Us

What has two wheels and can increase balance, flexibility and joint mobility improve posture and coordination strengthen bones and muscles and decrease body weight and stress levels? You guessed it a bicycle!

Besides strengthening your heart and lungs, lowering your cholesterol and blood pressure, burning obscene amounts of calories, improving your immune system and boosting your mood, cycling helps counter brain shrinkage and maintains healthy connections between the brain and physical body.

Think youre only giving your legs a workout when you hop on a bike? Think again! Biking works the deltoid muscles in your shoulders, as well as the biceps and triceps in your upper arms.

Both muscle groups are activated when you grip onto the handles of the bicycle even more so when youre on an incline and leaning forward as youre riding.

Cycling is also a great exercise for building your abs and strengthening your core, which improves your balance and coordination.

To maximize the muscle-building benefits of cycling for your abs and core, engage your core while cycling by squeezing in your lower ab muscles. This also helps you maintain proper posture while riding.

Not only is cycling a fun way to get fit, its one of the cheapest, most time-efficient and greenest forms of transportation available. An estimated one billion people around the world ride bicycles every day. Why not be one of them?

Pedaling For Parkinsons Mission

Why Indoor Cycling?

The mission of Pedaling for Parkinsons is:

  • To improve the quality of life of Parkinsons disease patients and their caregivers.
  • To educate patients, caregivers, and the general public about the benefits of maintaining an active lifestyle after a Parkinsons diagnosis.
  • To support research dedicated to the prevention and treatment of Parkinsons disease.

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Its Supposed To Be Fun

For all the reasons listed above and more, cycling is an ideal activity for people with Parkinsons. But its also just a fun way to spend time with friends, destress, and enjoy life.

No matter where you live, there is likely a biking group nearby that you could join. We often hear from riders who join cycling groups that they fall in love with more than just riding they fall in love with the people they meet and the friendships they form in the biking community.

Biking can help you set new goals and stay motivated to reach them. It can also be a powerful tool to raise funds for causes you care about or contribute to new research being conducted about cyclings effects on Parkinsons.

I Have A Movement Disorder Which Precludes Me From Traditional Type Of Exercise Will The Theracycle Really Allow Me To Exercise

Yes. The Theracycles motor assists you in attaining continuous exercise for longer periods that, due to lack of strength and endurance, would otherwise not be possible on traditional exercise equipment for users with movement disorders. We are so convinced the Theracycle will work for you, we offer a money-back guarantee within 30-days of delivery if you are not completely satisfied.

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What The Researchers Did

For their study, Alberts, co-researcher Chintan Shah, and other colleagues from the Cleveland Clinic, used functional connectivity magnetic resonance imaging to investigate the effect of exercise on 26 patients aged from 30 to 75 with mild to moderate Parkinsons disease.

fcMRI measures changes in blood oxygen in the brain, which enables researchers to look at how active different brain regions are and how well they connect with each other, explains Shah.

The researchers randomly assigned the patients to one of two groups. One group cycled at their own voluntary pace, while the other group cycled at a forced rate.

The groups completed exercise sessions on stationary bikes three times a week for 8 weeks. Both groups underwent MRI scans at the start and the end of the period, and also after four weeks of follow up.

The forced rate group had bikes fitted with specially controlled motors to make them cycle faster than their voluntary rate, as Alberts explains:

We developed an algorithm to control a motor on the bike and used a controller to sense the patients rate of exertion and adjust the motor based on their input.

What Is Parkinsons

Cycling with Parkinson’s

Parkinsons disease is caused by a breakdown in the nerve cells in the brain. The affected nerve cells do not produce enough dopamine, which affects your ability to move the way you want. Tremors, stiff muscles, slow movement, and trouble with balance or walking are all symptoms of Parkinsons disease.

In time, Parkinsons affects muscles throughout the body, leading to difficulty with swallowing, digestion, facial movements and more.

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Is It Safe To Use

The Theracycle is designed specifically for users with movement disorders and has many safety features. Its motion can be stopped instantly using either a push of a button or a pull of a cord. The structural steel and cast iron parts help support the users weight safely and the seat is extra large for comfort and stability.

Why Does The Theracycle Cost More Than A Basic Exercise Bike

The Theracycle is not a simple exercise bike. The biggest difference is the motor, which allows you to work out at a higher cadence than you can do on your own. The Theracycles custom motor is both unique and essential, as it allows you to work out longer and more efficiently than you can with a traditional stationary or road bike.

Additionally, the bike is custom engineered for the specific needs of people with movement disorders, not only in its open walk-though design, but also when it comes to durability and, most importantly, stability. The Theracycle is built on a very sturdy, heavy structural steel frame. It has a low center of gravity by design, so you can be sure that it will never tip over on you, even if you need to use the bike to pull yourself up.

Finally, there is the issue of quality. We want you to be able to use the Theracycle every day for years to come, so every component mechanical and electrical is built to provide decades of use without failure. All of our parts are precision-made in small production runs, ensuring superior quality and durability. In addition to the powerful, highly specialized motor, the Theracycle is also equipped with sophisticated safety mechanisms and state-of-the-art electronics specifically designed for your needs. Every Theracycle is manufactured in the US and hand-built in Franklin, Massachusetts.

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