You have all brought up great questions and information. I had not heard of the NIH grant until now as I've been on the road for the last seven weeks and rather out of touch.

Responding to Jim: In 2003 Dr. Alberts and some friends rode across Iowa in RAGBRAI. The group included the wife of one of the friends who happened to have PD. She and her husband tried to ride a tandem, but it didn't work so Jay Alberts traded spots with his friend and rode captain for Cathy. By the middle of the week Cathy said it felt like she didn't have PD and by the end of the week, her micrographia was gone. Jay was currently doing work on DBS, but because of this experience set up the trial of tandem and solo riders. The critical differential was the rpm, not the style of bike used. Those on the tandems rode at 80-90 rpm with each bike captained by a strong cyclist. Those on stationary bikes rode at their normal pace of 50-55 rpm. As Jim reported, there was a 35% decrease in symptoms for those on the tandems and no difference for those on the solo bikes. Interestingly, the positive effects of the cycling lasted for four weeks after the eight week, 3 hours per week program ended. Compare that with the frequency we take our medicines. In my own case, I've been able to cut my meds by 50% and climb Mt. Kilimanjaro this past summer with a group of MS and PD patients. I was the oldest patient in the group by many years and the only woman with PD. Although I wasn't able to cycle for nearly three weeks, I had enough gas in the tank to make it to the top. It took two months for me to recover, but I never would have had anywhere close to enough energy for the climb without the cycling under my belt.

In the tandem experience, the stoker (PD patient) provides about 25% of the power and the captain provides 75%. On a solo bike of course the rider provides 100% of the power. The curious part to me is that a person who provides 25% of the power at 80-90 rpm has this tremendous benefit while the person who provides 100% but at a slower rpm has no PD benefit.

The Theracycle as it exists now, provides power to turn the legs, but, IF I understand it correctly, does not force the patient to provide 25% or more power. I have heard from several people who have invested $4,000 that they see no benefit from using it. Hopefully others have a better experience. I have never heard Dr. Alberts endorse the Theracycle although their advertising implies his approval.

In Cleveland I was fortunate enough to ride a test bike that has the proper algorithm to require the patient to provide power. I could watch how much power each leg was producing. Although this bike is not yet in general production, I understand it will accurately replicate the tandem experience, even allowing the patient to increase beyond the 25%. I was able to ride it at 100% power and modify my stroke to ensure that each leg was accounting for 50% of the power. It was very cool to actually see how much force each leg was using. I wish I knew when this bike will be available.

Regarding Wendy's comment about Dr. Alberts' most recent article. I have also read it and agree that on the face it goes over old research. What I found fascinating was the depth in which this research is now analyzed. The article moves past what happened to why and how and what implications this has for PD patients and research.

Re Soccertese's comments. This cycling without assistance is certainly not possible for everyone. It's hard to go for an hour nearly every day at that rpm. I find that it's much easier to do on a bike trainer than on a stationary bike. With the trainer I'm using my own bike that is set exactly for my body dimensions. I can change the resistance on both the trainer and on my bike so the incremental changes are much more fine tuned than on a stationary bike. I find it's best to ride in the morning, but even then, I get really tired some days. I keep on doing it because I don't want to face the alternative and, as hard as it is, it works for me.