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Ohio researchers find that patients improve tremors and other symptoms after rapid pedaling on bicycles
By Cheryl Powell
Beacon Journal medical writer
Published on Monday, Jun 15, 2009
Northeast Ohio researchers are trying to prove Parkinson's disease patients can pedal their way past the tremors and other problems that often accompany their condition.
Researchers at the Cleveland Clinic and Kent State University are studying whether assisted exercise on a bicycle helps people with Parkinson's feel better.
The initial results are promising.
A study to be published in a national medical journal found patients at the Cleveland Clinic who were forced to pedal at a faster pace than their normal rate on a tandem cycle with a trainer improved their motor function by 35 percent.
Even after they stopped exercising, patients maintained some improvement in their arms and hands four weeks later, said Jay L. Alberts, a researcher in the Cleveland Clinic Lerner Research Institute's Department of Biomedical Engineering.
''It suggests there may be some relatively long-term changes going on here with respect to brain function,'' Alberts said. ''Exercise is fantastic in general. Now we may have found out that exercise may actually be exercise for the brain.''
About 1.5 million Americans have Parkinson's disease, a chronic, slowly progressive movement disorder.
The condition occurs when a group of cells in the brain begins to malfunction and die.
Those cells are responsible for producing a neurotransmitter chemical called dopamine, which sends information to the parts of the brain that control movement and coordination.
Common symptoms include hand, arm, leg, jaw or face tremors; rigidity; slowness of movement; and impaired balance or coordination.
There is no cure, but medication helps treat some symptoms. Some patients also benefit from deep-brain stimulation, which involves implanting electrode contacts in the brain to help control symptoms.
Alberts, a cyclist, discovered the possible link between assisted exercise and improved Parkinson's disease symptoms several years ago while riding a tandem bike with a patient.
After the ride, the patient noted in amazement, ''I don't feel like I
have Parkinson's disease.''
Her handwriting, normally small and illegible, was larger and easy to read.
Alberts immediately had a theory: ''She had to pedal at the same rate as I was. In essence, I was overdriving her pedaling or central nervous system.''
He then rode a 50-mile race on a tandem bike with another Parkinson's patient.
About 15 miles into the race, they stopped for a snack.
''Where did my tremor go?'' the patient asked as he held a doughnut with a steady hand.
''It was at that point that I decided we needed to follow this up,'' Alberts said.
The Cleveland Clinic studies have involved 40 minutes of ''forced'' exercise three times a week on a tandem bike with a trainer who's setting the pedaling rate. The patients must actively contribute to the pedaling.
Another study by Angela Ridgel, an assistant professor of exercise science at Kent State University's School of Exercise, is determining whether passive exercise with a motorized bicycle can also improve Parkinson's symptoms.
In Ridgel's study, patients allow a motorized bicycle to move their legs during three weekly sessions.
Patients complete tests before and after to measure their hand function and cognitive function, as well as the the speed and accuracy of movements.
''We've run nine patients through the passive exercise, and we are getting improvements in function,'' said Ridgel, who started working with Alberts while completing her postdoctoral training at the Cleveland Clinic. ''If people can sit on this bike and let it move their legs without any action, they probably would be more likely to do it.''
Kathy Zweifel, 41, of Seville, said she noticed an improvement in her symptoms after participating in both studies.
The active exercise on the tandem bike, in particular, provided immediate improvement that lasted for several days, she said. But the motorized cycle that moved her legs also helped.
''My tremor was less,'' she said. ''I was stronger. I was steadier. The exercise made a big difference.
''With the tandem bike, I felt better. But there was definite improvement with both. I was shocked that I had any improvement with the bike that was doing the work for me''
If ongoing studies centering on cycling are as effective as initial results show, the research could translate into a standard exercise program for patients with Parkinson's and other neurological problems, Alberts said.
''Many of them are looking to do something to fight the disease,'' he said.
Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com.
Northeast Ohio researchers are trying to prove Parkinson's disease patients can pedal their way past the tremors and other problems that often accompany their condition.
Get the full article here.
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