Why We Pedal

In the past, a diagnosis of Parkinson’s Disease usually meant no more exercise and an end to an active lifestyle. But research studies conducted during the last ten years have shown that the best prescription for a Parkinson’s Disease diagnosis is exercise.

The link between cycling and Parkinson’s Disease was not rooted in the labortory but discovered by Dr Jay Alberts while participating in an annual bike ride across Iowa.  As he stated in a recent post on the Davis Phinney Foundation Website:

While many great scientific discoveries are rooted in rigorous laboratory or clinical environments, some are not. In 2003, I pedaled a tandem bike with my companion (a person with Parkinson’s disease) on a multi-day group bike tour through the corn and bean fields of Iowa. Little did I realize at the beginning of this trek that an important discovery about the effects of exercise on Parkinson’s motor function was about to be made.

A few days into the ride, my Parkinson’s companion noticed a dramatic improvement in her handwriting as she wrote out a birthday card – effortlessly and legibly. Initially, I thought that maybe our diet of pie and homemade ice cream was responsible for these improvements in motor function. Who wouldn’t feel better after indulging in such treats?

Turns out it was neither the pie nor ice cream; it was riding the tandem that was making the difference. What is special about tandem cycling? Couples without Parkinson’s jokingly call it a test of marriage, because of the coordination and communication that is required on a bicycle built for two. For us, the tandem enabled us to engage in a type of exercise called “forced-exercise.” Forced-exercise essentially means assisting a person in exercising at a rate that is greater than their preferred, voluntary, exercise rate. In this case, the Parkinson’s patient could pedal at a rate of approximately 55 revolutions per minute (RPMs) when she was exercising by herself. When she rode tandem with me, our pedaling rate or cadence was 80-90 RPMs. Thus, I was “forcing” her to pedal faster than she could by herself.

As a result, Dr Alberts, co-researcher Chintan Shah, and other colleagues from the Cleveland Clinic, used MRI brain scans to investigate the effect of exercise on 26 patients aged from 30 to 75 with mild to moderate Parkinson’s disease. The researchers randomly assigned the patients to one of two groups. One group (13 patients) cycled at their own voluntary pace, while the other group (13 patients) cycled at a “forced” rate of 70 – 90 rpms.

The 2 groups cycled for 40 minutes three days/week for 8 weeks. After reviewing the MRI scans done before and after the trial, they found that the fast pedaling group of cyclists had better brain connectivity. The improvements were still observed through the MRI scans at the 4 week followup test. One of the researchers suggested that this study shows that “forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease”.

This discovery served as the inspiration for a groundbreaking research study by Dr. Alberts and movement disorder neurologist, Dr. Bas Bloem, Radboud University, Netherlands. Funded in part by the Davis Phinney Foundation, the outcome of this research completely reversed the common practice of prescribing rest for Parkinson’s. Doctors now routinely prescribe physical activity as part of Parkinson’s therapy, leading to a much higher quality of life.

The Parkinson’s Cycling Program is useful for people with Parkinson’s disease due to the balance challenges that many experience.  Indoor group cycling lead by a trained coach provides a monitored and safe exercise protocol.  The participant is able to pedal in a controlled environment while being observed as well as coached properly.   The support of the group class enhances the experience so the exercise behavior becomes routine and part of every day life.

There are other benefits of the Parkinson’s Cycling Program as well.  Most Parkinson’s individuals are quite sedentary due to symptomatic issues and difficulty with the daily activities of life. Group cycling gives that individual the opportunity to build the muscles of the lower leg in a safe way. As the quadriceps, hamstrings, and calves become stronger, everyday activities become somewhat easier to handle.

The people with Parkinson’s who are involved in this program also begin to see an increase in energy levels – common for all populations of people who become more active and physically fit. With proper bike fit, these new riders put less stress on their knees, ankles, and spine while increasing their lower body strength.   This is truly beneficial to the population who experience movement issues due to Parkinson’s disease. As with any exercise program, consistency and compliance are critical if the program is going to be effective. Join us and hopefully, you will, through your own experience, be able to proclaim that exercise really is the best medicine.

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