So many questions and I'm not sure I have all the answers but I'll give it a shot.

Voluntary rate is the rate that people normally cycle when they're not encouraged or forced to do anything at a higher cadence. For most people voluntary rate is around 55 RPM. Cadence is not to be confused with speed. Cadence is the number of revolutions per minute and speed is how fast you go over time. The critical part emphasize critical part of Dr. Alberts' research is the cadence. Speed does not matter. Keeping within the cadence of 80 to 90 RPM and keeping your heart rate at 60 to 80% of your maximum heart rate are the key factors to this forced exercise research.

Although it's a challenge, individuals can achieve the RPM consistent with the forced exercise on their own. That's exactly what I did in 2009 when I was training to try to write across Iowa with the Pedaling for Parkinson's group led by Jay. I was terrified it wouldn't make it across Iowa, so I trained 4 to 6 days per week, writing anywhere from 1 1/2 hours to four hours each time, keeping the cadence at 80 to 90 RPM as best I could which was most of the time. After a month of training so hard, my symptoms essentially disappeared, so much so that my doctor told me that if he did not know I had Parkinson's, he would not diagnose it. Understand that I was riding far beyond the protocols that are being followed in Dr. Alberts' research studies. I continue to ride at that cadence for at least an hour 5 to 6 days per week. I've been able to lower my medications from 8 mg of Requip XL to 4 mg and wean myself from Azilect as well. I am currently 67 years old.

I really like the question about being chased versus biomechanical/ Biochemical differences from cycling. My understanding from Jay and his team is that they are studying the biomechanical/ biochemical differences. That said, my own experience is that there are many psychological changes that happened with cycling. For me than non-motor symptoms are certainly more important than the motor symptoms of Parkinson's. So all the relief that I get psychologically is fabulous.

FYI, Dr. Alberts has designed a mechanical cycle that replicates the algorithms of a tandem. These cycles are being tested (of course) before they are put on the market. The other mechanical cycle that is highly advertised has not been shown to be efficacious for people with PD.

It is exactly right that the programs at the YMCA's and other fitness facilities are not research programs. They use exactly the same protocols that are being used in the research setting, but the controls are not in place to make it a research study. It is not meant to be a research study but to offer opportunities for people with Parkinson's to cycle together in a safe situation.