[imark3000]

This will interest all who followed Nan Cyclist earlier thread on cycling.

http://www.parkinsonresearchfoundati...c-a70dd919cce1

The Exercycle Company makes a motorized exercise bicycle called the Theracycle. The NIH department National Institute of Neurological Diseases and Stroke gave the company the Phase 1 award under a grant named “Forced Exercise: A New Therapy for the Treatment of Parkinson’s Disease (PD).” The program awarded the grant will seek to modify the Theracycle to replace a tandem bicycle that was used in a forced exercise study at the Cleveland Clinic in Cleveland, Ohio.

In that study, Cleveland Clinic researcher Dr. Jay Alberts showed that test patients undergoing a forced exercise regimen using a tandem bike showed up to a 35 percent improvement in symptoms of Parkinson’s disease compared with a control group that used a regular stationary exercise bike. The stationary bike users showed no noticeable improvement, according to a release from The Exercycle Company. The modified Theracycles to be used in the new study will be enhanced to allow for better data gathering by the researchers.

[Conductor71]

Imad,

Last I saw they wanted a cool two grand, so maybe the NIH could give us a grant to buy them.

My other concern is that Dr. Albert's studies are mentioned in context of this bike, so it seems like he endorses it when has not done so. Nan and I talked of how misleading this is.

I am hoping Nan will comment and give us the inside scoop!

Laura

[soccertese]

Originally Posted by Conductor71

Imad,

Last I saw they wanted a cool two grand, so maybe the NIH could give us a grant to buy them.

My other concern is that Dr. Albert's studies are mentioned in context of this bike, so it seems like he endorses it when has not done so. Nan and I talked of how misleading this is.

I am hoping Nan will comment and give us the inside scoop!

Laura

DEFINATELY sleazy on the part of theracycle imho

[Jim091866]

I attended a PD symposium in Sarasota and heard Dr. Alberts story of how he discovered this therapy-on a charity bike ride where he had a tandem partner who happened to have Parkinson's. After studying the results when this guy finished riding he went to the lab a set about to recreate the experience and here we are. In my opinion it is Dr. Alberts who ought to be profiting-though I suspect he simply wants the therapy to be developed, validated and progress. He is a true scientist in every respect of the word. What ought to be done is to push the insurance companies to provide these bikes to PWP, 35 percent improvement. How much of an improvment do we get out of a given med for example?35 percent is great, this does not take into account the many intangible effects of getting the PD patient to exercise-better mental health, probable increases in mobility after time spent exercising, less medication demand, overall improved health vs a PD patient who doesn't exercise, is depressed, has limited mobility and utilizes more healthcare because of it. More strain on families, on and on. Why is our system so darn blind to this? I know it won't matter but doesn't it just **** you off!

[soccertese]

the published study was quite small and the results were temporary, once you stopped riding the benefits disappeared. and the results seemed to require very vigorous exercising, i have a recumbent bike and 70-80 rpm for even 5 minutes is quite a pace.

i'm reserving judgement until the results of the current trial are published. i've read studies where less strenuous exercise requiring little or no equipment has been beneficial.

can't disagree that exercise is beneficial, just not jumping in whole hog that this is proven beyond a shadow of a doubt.

[wendy s]

I've been trying to access Dr. Alberts' article on his latest biking research - it's been published this month in Exercise and Sports Sciences Review. So far no luck, but I may be able to from work on Fri. The abstract in PubMed doesn't say very much and anytime I've tried to buy just the article from somewhere, I can't make it work.

[wendy s]

Am I disappointed! It was just Dr.Alberts' original research with ten subjects that was published in another journal. I'm so interested in this, but would really like to have the study repeated with larger numbers before I spend the money on something like a Theracycle. On the other hand, I don't feel that I can wait. The guys in my family are handymen, maybe they'll be able to come up with something.

[Nan Cyclist]

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.

[soccertese]

imho,
the alberts study was a very small study, one patient's results might have swung the resulting conclusion. pd phase 1 studies are often successful while the larger phase 2 studies aren't so i'd certainly wait until the results of the 2nd larger study are released before jumping to any final conclusions. it's speculated that phase1 studies are often successful because they attract more "gung ho" candidates where there is a stronger potential placebo affect.

always the skeptic here. hope it works well nan but seems like some research still needs to be peer reviewed and published before being mentioned here.

[wendy s]

Nan, thanks for the comment about the great depth of analysis. I skipped that looking for the results!

Soccertese, I absolutely agree that these studies need to be replicated and reviewed. Too much research being done is a farce. I like this whole thing by Dr. Alberts because this study gives me some hope. Right now I don't know what else to do to either improve myself or slow the progression. I'm a "true believer" in exercise to cure everything LOL, so this really appeals to me.

Nan, please let Dr. Alberts know, if you can, how much we'd like to know his research results. Maybe he or somebody could put a quick review on here once they know instead of us having to search all the time and wait for publication. That can take forever.