After reading Jay's "It Is Not About the Bike, It Is About the Pedaling" paper, I posed this question to him: "In your new article you say, 'These global changes in motor function and altered activation patterns provide strong evidence for the hypothesis that for patients with PD to derive motor benefits from exercise, assistance is required to achieve a rate of exercise that triggers the release of neurotrophic factors or possibly dopamine.' I know that you haven't done research with the likes of me, but how do you explain the benefits I, and many others, have from forcing ourselves to cycle at the proper rpm, etc.?"

His response was as I expected: "regarding your question...i really think it is a rate issue. i think the majority of PWP probably need assistance to hit this rate...others, like you may not. we have some really interesting olfaction data that is really supporting the rate hypothesis...patients who pedaled at a high right, assisted or voluntary, improved. those under a certain rate did not, even though they were in the assisted group." He is hoping to use this data to support a neuroprotective trial.

I find another interesting facet emerging from people who are doing the Pedaling for Parkinson's program at the Y. After being in a group setting with assisted cycling on a tandem for eight weeks, all of the participants were able to maintain the 80-90 rpm rate on solo spin bikes, even the one woman who had never been on a bike before. Other people joined the spin class because there wasn't enough room in the tandem class. They were also able to maintain the 80-90 rpm and gain benefits. I wonder if watching others achieve success gave them the impetus to sustain the higher rate. As programs are opening at several Ys around the nation in Dec. and Jan., it will be interesting to gather more data with a larger group.