I cycle on a stationary byke to maintain strength of my legs. I do push-ups to keep my arms strong.
I received no guidance or encouragement to exercise from the numerous neuros I have seen.
But I was encouraged to exercise by a relative who had PD 7 years before me.
I started exercising from day one and I increased the rate over 5 years and up to now.
I cannot say objectively that exercise had any impact on the progress of the disease but to me, exercise has it's immediate rewards by giving a feeling of liveliness and joy.
Imad

HI Imad,

even tho you may not see the direct relation from exercise to symptoms, it will be what saves you if you should have a fall or other accident or condition that requires much from your body.

It'a the only thing that can strenthen you at the same time PD weakens you.

As I'm using the term, I don't see forced exercise being used instead of "normal" exercise, but as an addition to it. Exercise, especially where varied, seems very sensible to me.

It may turn out that FE is most appropriate in situations where the limiting factor is dopamine (rather than normal body fitness). For instance, finger taps rather than running.

The key questions are:
- does FE lead to more dopamine in the brain?
- does FE of a finger, say, have a localized effect, to those areas dealing with finger movement?
- is there enough neuroplasticity to change the dopamine economy?

John

In a recently published paper Outubuddin et al. report [1]:

"Objective. The concept of forced exercise has drawn attention for the treatment of Parkinson’s disease symptoms with anecdotal reports of success. This study sought to ascertain any significant effect of forced exercise using a motorized stationary bicycle when compared to controls on Parkinson’s disease symptoms in a blinded, randomized, and controlled setting. Setting. Parkinson’s disease outpatient clinic, Veterans Administration Medical Center. Method. We assessed 23 patients (13 experimental and 10 controls) ... after participation in eight weeks of twice weekly forced exercise or eight weeks of conventional clinic care, and then after a three-month period had elapsed. ... Results did not demonstrate any main effect differences between the exercise and control groups on any measure at any point in time. A within subjects effect was demonstrated for the forced exercise group on overall UPDRS-III scores at the three-month end point. No other within group effects were noted. Results suggest that early enthusiasm for forced exercise may need tempering. Limitations of the study are discussed as well as numerous logistical challenges to this type of study."

Reading the whole paper gives IMHO a more positive take: some key measures improved, but not by enough to show statistical significance given the small sample size.

The paper describes forced exercise of the legs. I notice that, although they did not use it, their machine could force exercise the arms.

Reference

[1] "Parkinson’s Disease and Forced Exercise: A Preliminary Study"
Abu Outubuddin,1,2,3 Timothy Reis,1,2 Raed Alramadhani,1 David X. Cifu,1,2 Alan Towne,1,3 and William Carne1,2
Rehabilitation Research and Practice
Volume 2013 (2013), Article ID 375267, 5 pages
http://www.hindawi.com/journals/rerp/2013/375267/

John

I just read the article referenced above and am curious about a number of things:

1. if the authors were attempting to replicate the FE studies done by Dr. Alberts, why did they not have the patients ride three hours a week at the protocol of 10 minutes warm-up, 40 minutes at cadence and 10 minutes cool down?

2. why did they use a Theracycle when it does not replicate the algorithm that is necessary for mitigation of the disease?

they seem to be making a large effort tauting their product for pd.

it is odd they reported a delayed benefit when comparing a patient to themselves before and after the exercise. other studies with treadmills, weight training, tai chi, dancing, have shown a statistical benefit.

so i'm not going to buy a theracycle!