#6 Forced Exercise To Improve Motor Function in Patient's With Parkinson's


There are a number of effective medicines that help ease Parkinson’s disease symptoms for a few hours, but there may now be a new one on the horizon that a person takes with a dose of perspiration that just might bring relief for weeks: tandem bike riding.

Patients with Parkinson’s disease, slowly lose control of movement. Tremors, difficulty with balance, changes in
speech, and slowness of movement are other major symptoms of this debilitating brain disorder that affects more than 1 million Americans and has no cure.

Parkinson’s wrecks havoc by affecting nerve cells in the brain that make the neurotransmitter called dopamine. It’s dopamine that sends signals to the part of the brain that controls movement, allowing muscles to move on command. With Parkinson’s, however, these special nerve cells break down, the supply of dopamine dwindles, and movement is affected.

This is where tandem bike riding can play an important role.

After pedaling at more than 90 revolutions per minute (RPM) for more than 50 miles in front while a friend with Parkinson’s served as the stoker while pedaling in the back seat of the tandem bike, the curious scientist noticed that his friend’s hand tremors had suddenly disappeared.

In the researcher’s mind, the mysterious side effect of the tandem bike ride held an intriguing medical possibility: Motor control in the arms and hands had improved even though it was only the legs that were exercising. Quite possibly, there was some change taking place in the central nervous system that triggered the release of chemicals that improved motor function.

Typically, a patient with Parkinson’s riding a bike maintains a cadence of around 50-60 RPMs. However, a non-Parkinson’s captain on a tandem bike can drive that cadence to over 90 RPMs. Pedaling that fast may drive the central nervous system of the person with Parkinson’s, resulting in an increase in the release of dopamine that in turn could account for the improved symptoms.

A small eight-week study was launched to gauge the effects of “forced exercise” (tandem riding in which patients are forced to pedal 80-90 RPM) on Parkinson’s symptoms.

The results were impressive: There was a 35% improvement in motor functioning for those patients who did the forced exercise compared to those exercisers who pedaled a stationary bike at their own pace.

The improvement lasted for four weeks after the bike workouts ended, although it tapered gradually over time, which suggests the need for regular ongoing forced exercise as a significant part of this exercise therapy.

By pushing the exerciser past his/her comfort zone by exercising the lower half of the body, it’s now thought that the upper half improves as well. Whether this is a needed stimulus to the central nervous system is still unknown but the goal is to be as symptom-free as possible and without the need for medication, something that tandem riding just may provide. Further studies are now ongoing.

Where Are They Now

Parkinson's disease (PD) is a debilitating brain disorder that affects more than 1 million Americans and has no cure. While available treatments help ease the PD symptoms for a few hours, a novel exercise-based therapeutic strategy can now bring relief to patients for weeks. By conducting "forced exercise" (tandem riding in which patients are forced to pedal 80-90 RPM), patients' motor function can be dramatically improved with effects felt for up to 4 weeks after the training ended.

New studies of the effects of forced exercise in Parkinson’s patients found that forced exercise improved patient’s motor functions clinical ratings by 51% compared to 33% in patients who received medication. Today, more and more hospitals and clinics are taking the initiative and creating programs geared directly towards Parkinson’s patients to provide forced exercise in hopes of improving lives. No updates as of 2017, but the realm of forced exercise has expanded with evidence linked to impactful results in patients recovering from strokes.

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