050421 Cycling Improves Parkinson’s

050421 Cycling Improves Parkinson’s by Rickey Dale Crain

Thanks to Rickey for letting me use this article.

What do actor Michael J. Fox, evangelist Billy Graham, former US Attorney General Janet Reno and boxer Muhammad Ali have in common?

Answer: Parkinson’s disease, a chronic degenerative disorder of the central nervous system that kills off or impairs the brain cells responsible for the body’s ability to move.

You’ve probably recognized Parkinson’s patients by their shaking hands and awkward gait. Sadly, as the disease progresses, patients also develop behavioral and cognitive problems, including dementia.

It’s not just older folks who are affected. Though the disease usually strikes after age 50, it can begin sooner—Michael J. Fox was just 30 when he was diagnosed.

There is no cure for Parkinson’s…and though a new type of brain surgery technique is promising, it is invasive and not without risk.

Enough with the bad news. Here’s some good news—a commonplace activity that is actually fun and safe can improve brain function and mobility in Parkinson’s patients. The secret is to go fast.

PEDAL TO THE METAL

The revelation comes from a new study that focused on the effects of using stationary exercise bikes. For eight weeks the participants, all of whom were in the middle stages of Parkinson’s, rode stationary bikes three times weekly for 40 minutes per session. One group pedaled at their preferred pedaling rate while making sure they were still in their target heart rate zone. The other group rode stationary cycles with motors and control systems to monitor pedaling rate—and with the assistance of the motors, they pedaled approximately 30% faster than their preferred rate. In effect, this assistance from a motor “forced” riders to move their legs faster than their disease would normally allow.

At the start of the study, after the eight-week exercise sessions and again four weeks later, all participants underwent brain-imaging tests called functional connectivity MRIs. These scans assessed changes in blood oxygen levels in different parts of their brains, which allowed researchers to look at the connections among the various brain regions involved in Parkinson’s.

What the researchers found: After eight weeks of cycling, patients whose motorized cycles had helped them pedal faster showed greater strengthening of connections in brain areas tied to motor function than patients who had pedaled only as fast as they could without assistance…and these positive effects were still evident four weeks after the exercise sessions ended. The results weren’t tied to increased aerobic fitness, the researchers reported. What mattered most was how fast the participants had moved their legs—because this seemed to train the brain to allow better movement.

Interestingly, the types of brain changes brought about by the faster pedaling were similar to those that result from deep brain stimulation, an effective but invasive (not to mention expensive) therapy for Parkinson’s in which a device is surgically implanted in the brain to deliver electrical stimulation to brain areas that control movement and block the abnormal nerve signals that cause tremors. In comparison, fast pedaling offers a very attractive, risk-free, low-cost alternative.

What about improvement in actual symptoms? This study and an earlier non-MRI study by the same researchers found that patients in the “forced” exercise group did indeed show improvements in motor function—including in the upper body, even though the lower body was doing the work. (Fun fact: The inspiration for the study arose when one of the researchers partnered with a female Parkinson’s patient on a long-distance tandem bike ride. The researcher could pedal faster than the patient, which forced her to pedal faster as well—and afterward they noticed improvement in her motor skills!)

More research is needed to determine how long the effects might last and whether other exercise activities, such as rowing, would have similar benefits. The Cleveland Clinic is partnering with an exercise company to develop a motor-driven cycle to replicate the effects of the research.

In the meantime, Parkinson’s patients who want to try this therapy themselves should first get the go-ahead from their doctors. Then patients are encouraged to exercise on a stationary cycle at as fast a rate as they can, turning down the resistance and ramping up their pedaling speed. Alternative: They can get a tandem bicycle, go out on a beautiful day and ask a fit friend to set a brisk pace while cycling with them.

Source: Michael D. Phillips, MD, section head of imaging sciences and vice chairman of research and academic affairs, Imaging Institute, Cleveland Clinic. His study was presented at the annual meeting of the Radiological Society of North America.

My thanks to Rickey Dale Crain for this article. 

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