Riding A Bike to Treat PD?
 

I don't know if any of you heard about this. This was a news story on our local TV newscast yesterday.

IMAGINE IF THE BEST TREATMENT FOR PARKINSON'S DISEASE TURNED OUT TO BE AS EASY AS RIDING A BIKE.

THE CLEVELAND CLINIC IS CONDUCTING A STUDY THAT IS TRYING DETERMINE IF EXERCISE CAN TRICK THE BRAIN INTO ELIMINATING PARKINSON'S SYMPTOMS.


FOR NINE YEARS, STEVE DERMAN FOUGHT PARKINSON'S DISEASE. LIKE MOST, HE SUFFERS FROM TREMORS UNTIL HE TAKES A RIDE.

(SOT: Steve Derman, Parkinson's Patient)
"The exercise just seems to help my mind as well as my body."

HE'S PART OF A STUDY TESTING THE EFFECT OF EXERCISE ON PARKINSON'S SYMPTOMS.

HE MUST PEDAL OVER EIGHTY R-P-M'S FOR RESULTS TO OCCUR. MOST PATIENTS CAN'T DO THAT ON THEIR OWN, THAT'S WHY A TANDEM BIKE IS USED. IT'S CALLED FORCED EXERCISE.

(SOT: Jay Alberts, Ph.D., Cleveland Clinic)
"The idea behind it is if we force them to pedal at a higher rate, this rate will allow them to have biochemical changes that are necessary for improvements in motor function."

STEVE'S LEGS MAY BE HELPING HIS BRAIN.

(SOT: Jay Alberts, Ph.D., Cleveland Clinic)
"There's a possibility that there's an increase in dopamine or there's a possibility that there's an increase in these neuro growth factors."

WHATEVER IT IS, IT SEEMS TO SLOW STEVE'S TREMORS FROM THIS ... TO THIS AFTER A FEW MINUTES OF CYCLING.

(SOT: Steve Derman, Parkinson's Patient)
"At least in my mind they did. Whether anyone else noticed it, I really don't care but at least I feel that it did."


"SO IF THE STUDY DETERMINES THIS IS A VIABLE TREATMENT OPTION, A PATIENT COULD HAVE A BIKE LIKE THIS IN THEIR HOME AND PEDAL WITH A FAMILY MEMBER."

AFTER EIGHT WEEKS, STEVE NOT ONLY GOT IN TO BETTER PHYSICAL SHAPE, RESEARCHERS NOTICED A CHANGE.


"His tremor was reduced his rigidity was reduced over the course of the study."

BUT THE BENEFITS ONLY LAST AS LONG AS THE PATIENT STICKS TO THE EXERCISE REGIMEN ... STEVE'S MORE THAN WILLING TO USE IT RATHER THAN LOSE IT.



THE STUDY IS COMPARING THE DIFFERENCE BETWEEN FORCED EXERCISE WITH A TANDEM BIKE TO A STATIONARY BIKE WHERE THE PATIENT PEDALS ON THEIR OWN.


Take it for what it's worth,

GregD

Forced Exercise
 

Hi Gregg,
I saw this one too. I thought what a daft idea to use a tandem with a friend or relative peddleing like fury to make your legs reach a certain revolution.
Surely the easiest way would be to motorise an exercise bike!!!
That way, you are not in peril from cars etc, you do not have to phone your friend daily to come and pedal the tandem, and so on.
With a motor fitted to your exercise bike, and a rheostat to vary the speed, you would be totally independant on others.
I have an exercise bike which I lent to my son. I want to get it back and try it.
Ron

Hi Ron,
My thoughts exactly. Also, I've been riding my exercise bike daily for the past 6 months to help control my weight. I have yet to see any reduction in my tremors. I'm sure it will be like everything else so far. It will work for some but not all.

GregD

Hi

I post on the peripheral neuropathy page. I have small fiber neuropathy and severe restless leg (all over body) for which I take Pramipexole...(not a small dose either.) I have been riding a bike more or less for 21 years. I have gone thru periods where I have stopped and I have deteriorated horribly. I was off my bike for a while when they put in a PICC line to give me steroids and then I really went down the tubes. My family lives and breathes cycling and my one daughter is a pro...(one of the few really clean pros-she knows the dangers of fooling with physiology-she is an environmental scientist as well). I am a nurse and a clinical exercise specialist.

I can not explain the exact phenomenon of why cycling works to keep my symptoms more or less in control, of course, my symptoms are not like typical parkinsons. I do however, have severe autonomic neuropathy as well as sensory neuropathy. I not only pedal around on a mountain bike or road bike, I do it to music in one ear only, and I ride in a dark tunnel to challenge my balance (somatosensory system). I stimulate every system, visual, vestibular and somatosensory.

I think some of the benefits have to do with stimulating dopamine and endogenous opioids. I can't run anymore due to desicated discs that require open chest surgery to fix, and I can't tolerate general anesthesia. I am a female, 54 and did my last sprint triathlon at 50....I canned competition for now, as I got so out of shape on steroids and needed almost 2 years to rebuild muscle lost to the treatment. I am not ruling it out as a possibility in the future. Bike trails are a great place to start, as they are flat and safer in terms of traffic. Get a stress test, as recommended before undertaking any new exercise regimen. I bring a cell phone, dog repelent spray, wear a camel back, as I am prone to plunging blood pressures, and I have global anhidrosis, do not sense temperature well, so I have to bring a variety of clothes and layers in unpredictable weather....I also don't feel myself sunburning, and I also have gastroparesis, so I have to sip water the whole time I am on the bike, as my stomach does not empty as it should leaving me feeling like I have a bowling ball in there.....but hey----it is worth every minute! Oh and bring a identification with your medical condition on it.

I highly recommend clipless pedals of the mountain bike variety, shoes you can walk on and shoes that clip in and keep your feet in position, but also release very easily. I wear mtn. bike clipless for my mtn. bike and road for my road bike, but if you have balance problems or gait problems road shoes will cause you problems. Toe clips that fit on regular shoes can make for a slow escape from a pedal, slower than a clipless pedal.....I recommend having several hand positions as well, and I have some adaptive (actually racing bars/aero bars) on my bikes. Proper bike fit is essential. My biggest urk, when I get off a bike or take my feet off even the feet of a chair....it feels like that is stuck in my foot for a half an hour afterwards....

I highly recommend cycling and if a regular bike won't due there are adaptable bikes and stationary bikes, both uprights and recumbents...there are even tandem recumbents...and lots of social opportunities. In my cycling adventures I have met a one legged cyclist who had crossed the Rockies (Lord I can't do that with 2 legs and one blind cyclist.)

Just wear a helmet, eye wear and gloves...padded shorts help too! Nothing like wind in your hair and bugs in your teeth to make you feel great! A bee down your shirt doesn't feel that great....but it happens.

biking
 

Hey guys,

I got a mountain bike for Christmas. I ride the trails on a reserve
close to my home. It has hills and small streams. I always feel
better after I ride. I don't know if it's improving my pd, but it is
easier than other types of exercise and it is good to get outside
and explore nature.

Mary

I wonder if a stair stepper would help in the same way. I have one that someone gave away in my laundry room in my building. It's like this one:

http://www.walmart.com/catalog/produ...de=cii_9324560

I hold on to the top of my secretary (furniture!) while I use it. I haven't used it much, but will do better. There's alot of resistance, and I think it may affect the same muscles as a bike.

This one is better because you can hold on:

http://cgi.ebay.com/New-Exercise-Wor...QQcmdZViewItem

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE 12: 485-492, 2003

Cyclic exercise induces anti-inflammatory signal molecule
increases in the plasma of Parkinson's patients
PATRICK CADET
1
, WEI ZHU
1
, KIRK MANTIONE
1
, MARILYN RYMER
2
, IRVING DARDI

It has been known for many years that immune
system alterations occur with Parkinson's disease (PD).
Changes in lymphocyte populations in cerebrospinal fluid
and blood, immunoglobulin synthesis, and cytokine and acute
phase protein production have been observed in patients with
PD. Hence, there is evidence for inflammation. In this report
we demonstrate that cyclic exercise over months results in a
significant increase in the rise of plasma anti-inflammatory
signal molecules, such as interleukin-10 and adrenocortico-
tropin. Additionally, endogenous plasma morphine levels
increase with the duration of the cyclic exercise protocol.
Morphine is identified and quantified by high performance
liquid chromatography coupled to electrochemical detection
and nano electro-spray ionization double quadrupole
orthogonal acceleration time of flight mass spectrometry.
Proinflammatory cytokine, i.e., interleukin-1, interleukin-6,
plasma levels did not increase. These results matched with
those reported previously, demonstrating enhanced motor
skills and mood elevation with this cyclic exercise protocol,
suggest that this protocol induces the formation of anti-
inflammatory signal molecules, which appear to be associated
with alleviation of some of the clinical characteristics of PD.
Introduction
Idiopathic Parkinson's disease is a degenerative disorder of
the central nervous system. Several pathogenic mechanisms
have been proposed that lead to degeneration of dopamin-
ergic neurons. These mechanisms encompass variables such
as metabolic or toxic factors, oxidative stress and mito-
chondrial dysfunction (1). The primary anatomical features
central to PD patients include: a diminished number of
myelinized dopaminergic cells in the substantia nigra (SN)
and in related brain stem nuclei, a decrease in the dopamine
content in nigrostriatal and mesolimbic pathways, the
presence of Lewy bodies, and the deposition of neuromelanin
(2,3). The perturbation of several neurotransmitters and
neuropeptides has been reported in PD, indicating a more
complicated and widespread pathology. The role of immune
and vascular mechanisms in neurodegenerative diseases such
as PD is, similarly, an important area of investigation (1,4).
Death or injury to neurons in PD leads to the presence of many
pro-inflammatory cytokine molecules, as well (1). This process
resembles classic inflammation, but with minimal or no
participation of macrophages and lymphocytes from blood (1).
In the present report, we determine the plasma level of
pro-and anti-inflammatory cytokines as well as signal mole-
cules most often associated with stress, i.e., adrenocortico-
tropin (ACTH) at baseline (group 1). We also measure these
levels subsequent to the introduction of a 12 week cyclic
exercise regime at week 4 (group 2), week 8 (group 3) and
week 12 (group 4). We demonstrate that anti-inflammatory
signal molecules significantly appear in the plasma months
after initiating and sustaining this cyclic exercise protocol.
These results are correlated with a previous study, which found
that cyclic exercise in Parkinson's patients produced
improvement in motor function and attitude


http://147.52.72.117/ijmm/2003/volume12/number4/485.pdf

rebounder anyone?
 

Somewhere along the line, I read something Dr. Lieberman wrote suggesting that the little trampolines called "Rebounders" are particularly good for PD. Has anyone had experience with them?

They would differ from a bike in several ways but one in particular would be that they "jiggle your innards". According to a book I'm reading called "The Second Brain" (about the nerves controlling the GI system), such jiggling causes a flood of several neurotransmitters which could account for a lot.

I just received some confirmation that my condition is not just a small fiber neuropathy, but likely has central nervous system involvement....and it seems to be a bit similar to MSA, but not as profound, as rapidly declining or quite as debilitating, as of yet or if ever....so I don't quite fit in either forum, or I fit in both...kind of like a high school clique, you know? I don't tremor, but the restless leg is body wide....I do have spasms, fasciulations, numbness, tingling, occassional loss of balance, and a fair amount of pain. I also have a lot of parasomnias and hideous insomnia. My autonomic neuropathy is subsantial. So far my cognition seems OK,but I notice I am not as sharp as I was, but I was pretty sharp mentally, so I have a way to decline before I worry too much.

On the cycling, all I can say is I started cycling at 34, got into citizen level competitive cycling, eventually into sprint triathlon, but by 50, had to hang up the sprint tri and competitive stuff, as adrenaline, seems to make my BP and pulse dump on me....I am 54 now.

I can tell you that for me, you can tell a day when I bike from a day when I don't. Running is fine, but with my problems it also causes problems....walking doesn't get me a 'walker's high'...swimming is OK, but does not for some reason have the same effect as cycling. Endogenous opioids do play a huge role in what ever ails me and I have to keep them coming....problem is, some days, dysautonomia keeps me from moving much...I have to really, really force myself, but it is always worth it.

A bicycle is a great equalizer. I think one of the key things is it stresses balance mechanisms, too. It also develops major muscles that affect gait and also blood return to the heart.

Somthing new to look at out there in the realm of research is Orexin and the hypocretin system. Very cutting edge and a way off, but on the far horizon.

That's a really good idea. I'd need to hold onto something, though, since my balance is bad. I checked and they make them with something to hold on to. They call it a stabilizer. Makes sense.

On Shaking, Exercise, Cycling and arresting PD
 

1. On Shaking and PD
French Dr. Jean Martin Charcot (11/29/1825-08/16/1893), considered "the father" of modern neurology, was told by some of his "shaking palsy" patients who came to see him from outside Paris, how they felt better after particularly "bumpy" train rides. He took the idea seriously enough as to build a "chaise trepidante" or "shaking chair" which was a wooden chair mounted on a wheel with a crank to simulate a bumpy train ride. He experimented with it for a while but later abandoned the idea.

2. From news wires:

" Doctor Embarks on Parkinson's Research
By Caryn Rousseau, The Washington Post
The Associated Press
May 17, 2004

LITTLE ROCK - Searching for a treatment for her Parkinson's disease, Anne James found it nearly 2,500 miles from her Vancouver home. Anne and her husband Ron James found Arkansas cardiologist Dr. Charles Fitzgerald, who inadvertently found a way to ease Parkinson's symptoms using an Enhanced External Counterpulsation (EECP) machine.

Anne, 67, couldn't comb her own hair. Now she can. She loved to play the piano. Now she taps away and sings along. Smelling a flower was difficult. Not anymore.

"When I went down there I was dragging my left foot," Anne said. "Not anymore. My sense of smell improved."

The progress began two years ago, and she says she is still benefiting from Fitzgerald's therapy without an increase in medication. Fitzgerald is on to something, her husband says.

"He has something with that machine," Ron James said. "There is something that that machine does and it needs to be researched immediately."

That's Fitzgerald's plan. He said he's talking with doctors across the country and hopes to set up a study on how a machine used to treat patients with angina and heart blockage could possibly help others with Parkinson's.

"We can say this improves the quality of life for people with Parkinson's," Fitzgerald said. "That's a definite. Does it cure Parkinson's? We don't know."

The beneficial efffects of EECP on PD was confirmed by more than 60 PD patients who underwent EECP treatments afterwards.
While the EECP machine's intended purpose is the improvement of blood flow, it involves as a side effect, a vigorous and otherwise not necessarily pleasant (but beneficial in the case of PD) whole body shaking.

3. Noted PD specialist, Dr. Abe Lieberman, who visited with Dr Fitzgerald to familiarize himself with EECP, submitted a group of his PD patients to a treatment of "back and forth alternating movement" on a "moving bed" designed by Dr. Marvin Sackner and obtained results comparable to those of EECP.
Dr. Lieberman provides a comprehensive analysis of the relationship between exercise. both active (as in walking, running, dancing, bycicling, swimming, etc., and "passive exercise" (as EECP, Moving Bed, Blood Pressure Modulation" (for bedridden or otherwise immobile patients), the biochemical processes at play in exercise, on several articles at: ParkinsonResearchFoundation.org

4. Recently, Ed Phillips, a heart patient (and inventor), not very fond of undergoing multiple by-pass surgery. only option he was being offered, devised a semi-active way of heart conditioning/recovery which he called "rhitmic limb elevation", which helped him and his wife.
Later, at the request of a couple of PD patients who had benefited from the EECP treatments provided by Dr. Fitzgerald, he modified the concept to a "deceivingly simpler" of "blood modulation". When tried on PD patients, Ed's blood modulation therapy's gravity recliner provided significant alleviation of symptoms.

5. As for energetic cycling, famous parkie Jim Wetherell, of INever give up.org reports how he has kept his PD at bay by taking up competitive tricicling.

6. In an analysis of data from the Cancer Prevention Study II Nutrition Cohort, including more than 143,000 men and women, has shown a reduced risk of Parkinson's disease (PD) associated with moderate to vigorous exercise. No protective effect was seen with light exercise such as walking, the researchers, with first author Evan L. Thacker, from the Harvard School of Public Health, in Boston, Massachusetts, noted.

So, there.....

More on exercise as PD prevention/stopper/reverser
 

1. From a presentation at the World Parkinson Congress 2006

http://www.neurologyreviews.com/apr06/parkinsons.html

Excerpt:

"Exercise, as well, is beneficial in reducing stress and maintaining one’s physical health, he said. Dr. Heydrick noted that accumulating evidence suggests that exercise can be neuroprotective and may even help "rewire" the brain to some extent. Examples of physical exercises that patients with Parkinson’s disease might want to consider include stretching such as yoga or Pilates, strength training such as weight lifting, and repetitive movement therapy—for example, walking on a treadmill, bicycling, and/ or swimming, or participating in exercise programs such as Think BIG (and LOUD), The Art of Moving, and Motivating Moves. Speech therapy is another example of repetitive movement therapy (of the vocal chords). Eastern therapies such as tai chi and qi gong may also be beneficial, he said.

"I’ve talked to many patients who have altered their environment ... through behavioral modification and decreased their stress, and the symptom relief—or at least improvement—was significant, and was in my life, too," concluded Dr. Heydrick."

2.
I have been in direct contact with two parkies who tried and proved the benefits of a very simple concept which the developer termed "blood presure modulation therapy", a form of repetitive movement therapy , which amounts to nothing more than laying on motorized see-saw for as long as one can, in order to get a gentle rocking action on the body with amazing alleviation of symptoms, initially temporary but soon longer lasting, including medication reduction, with the continued use of the "rocker".

and back to the original thought....here's a guy with PD who has peddled nearly 46,000 miles...he has a Rx attached to his bike. I think if you click it , it will expand so you can read it. If not you can find it in his website. He actually rides a trike.

Attachment 1507

http://www.inevergiveup.org/

Gayle

My cycling ambitions are far more modest - just a couple of short journeys a day, which sometimes start when I can barely walk to get the bike out. My balance seems to be fine once on the bike. I have only fallen off once -when I was doing 0 mph (!!), whilst negotiating crossing at pedestrian lights with a central reservation, and as I painfully discovered, sloping paving. I preserved what dignity I had left by remounting and carrying on as though it had been a perfectly natural manouevre!! I keep away from busy roads and have the benefit of a local park to cycle round. I certainly recommend it for the exercise and fresh air.

Powered bicycle
 

I spotted an advertisment for a powered bicycle, described as "Automatic mini walker" in the newspaper, but as "EZY Rider mini exercise bike" in their website. The pictures of it are identical. It is a set of pedals attached to a motor, with 4 speed settings and 5 time settings. I have ordered one, it is £80 ($160).
It is described on
www.coopersofstortford.co.uk
Just realised, it will be 240volts, not USA voltage
Ron

EZY RIDER MINI EXERCISE BIKE This Electric Mini Walker will help improve strength, fitness and circulation in your arms and legs, providing essential benefits from the comfort of your own home. Ideal for convalescents, the elderly or as a gentle exercise programme, it is extremely easy to use. Just sit in your favourite chair, put your hands or feet in the stirrups and pedal as you would a bike. A few moments every day gives you the same level of workout for your upper and lower body as a daily walk or cycle ride, yet you don't even have to step outside. Its built-in computer continually displays the elapsed time, pedal revolutions and estimated calories burnt. Features include: four speed settings, five time settings, LCD display and easy touch controls. Measures H29cm x W41cm x D45cm (10 1/2ins x 16ins x 17 3/4ins). Just a few minutes a day of gentle exercise and you will soon feel the benefit. Mains powered with a 1.9m (6ft 3ins) cable. Tell A Friend Price: £79.99 Qty: 1 2 3 4 5 6 7 8 9 10

In the newspaper advert, it says, "it will automatically pedal like a bike, alternatively, use in manual mode for a more strenuous workout."

Oh gosh...
 

If anyone can get me on a bicycle seat..let alone have me ride it..I will be well pleased. I could never ride a bike before PD so I am sure as hell not going to be able to ride one now.Well...I tell a lie.I could kind of ride one...just had to get off round corners. and then climb back up on the "straight." :confused: Yep...I would go off for a half hour bike ride,and 5 hours later I would be back....walking the bike down the road as we lived on a bend.:(

I can bounce though :) ...on a trampoline. When my friend double bounces with me I feel like I have been shot out of a canon.She is twice my size so when she lands....well..you`ve guessed it...I end up in the gods.:confused:
It`s a heck of a long way down but my flappy arms and legs help to slow me down a bit. :p Oh boy...I am so graceful with my ascending and descending...NOT !

But this exercise stuff is spot on.Joking aside [if I can be serious for a minute] I have discovered that I`m quite a whizz at table tennis .Don`t all roll about laughing. Seriously,when I get a bat in my hand my legs seem to take on a new lease of life and off I go....whizzing about the table like I`m at Wimbledon and firing back those cutesy little puffy ping pong balls like there`s no tomorrow. I remain unbeaten at my youth club. So there...lol
Well...almost.

Try a recumbent tricycle
 

I ride a recumbent tricycle. It is wonderful - comfortable and no balance problems - the only downside is the cost. :( But with a script from your doctor, part or all of the cost of the trike MAY covered by insurance (or as a medical expense on taxes - which was true for me here in Arizona).

The link below shows me on my trike...
http://www.pdplan4life.com/exer-trike.htm

I have found my symptoms are less troublesome after riding my trike for an hour a day.

good luck!

Has anyone had any experience of using EMS to exercise with???
I am unable to move very well at all due to stiffness and freezing.

I wondered if electric stimulation of muscles could in anyway benefit. Obviously the are being stimulate is not the root problem, but could it help?

I purchased the machine 3 yrs ago when I was mis-diagnosed with a MND, an the neuros and physios advised me not to use it to preserve muscle power.
Now with my PD diagnosis ,it seems the key is exercise.........so maybe this could be a starting point for me and should get it out of the drawer and hook myself up !!! aaghhhh!!! oops to high!!

I tried some more light PT last week with my arms that are stronger now than they have been for 2 yrs, since my sinemet regime! But I just got so tired , all over!!

I am only 43 yrs and lifted weights reguarly prior to getting sick nearly 4 yrs ago and have always been muscular.........but not anymore.

Anyone any ideas ?? on a workout for a basically wheelchair bound guy , whos mind wants to get fit! but the old bod ain't none to keen!

I have lost about 70 pounds in the past 1yr as I was only eating small , pudding type consitencey type meals, due to the swallowing probs. pre sinemet!!!! yippee!!
Now thats improved , but unable to take in protein, because of the Sinemet, which as you know builds muscle fibres and their strength.
Any ideas on how much protein ,can be taken in the periods between Sinemet as to not affect the drug??


thanks for listening........so many Questions!
PS I am not trying to get into physical shape , just so I can work out and gain some strength back and help eleviate the stiffness?

You should ask PT about EMS. It may or may not work for you. I used it after having my back surgeries to help keep my legs from atrophying. But even with EMS, you still need to do physical exercises. A good thing to look into before jumping into weights are those long elastic bands. They come in varying strengths and you can get them from PT as well. Great way to start retraining and reactivating your muscles.

As for protein, I take Sinemet as well but don't have the absorption problems or interference issues that some people do. I just take my meds 45-60 minutes before I eat anything, then I'm fine. I eat a very healthy diet with lean meat, chicken, fish, veggies and fruits, plus take protein powder every day, and I've had no issues. As long as I take my meds before eating, and time my meals so that I don't eat anything 2 hours before taking my meds, I've had no problems.

boomer,
Here is a link to an exercise program that is execellent for PD.
My support group had David Zid as a speaker not too long ago. His program is top notch.
http://www.delaythedisease.com/books/default.asp
GregD

protein ems etc
 

Boomer-

First, protein is not necessarily a problem.
"Protein Restricted or Redistributed Diet: In a small number of PD patients (primarily those experiencing the on/off effect), L-dopa effectiveness can be compromised by the ingestion of some amino acids, the building blocks of proteins. The large neutral amino acids (LNAAs) compete with L-dopa at both the level of absorption from the gastrointestinal tract as well as at the blood-brain barrier...." http://www.homenutrition.com/care_ce...parkinsons.asp

The rest is worth reading too.

Second, I have an EMS too although I haven't used it much. But from reading before I bought it, there is quite a bit of science behind it and a lot of PTs use them too.

Third, creatine does wonders for me in building up muscle especially combined with exercise. Works in just a few days.

Visit http://1fast400.com/. Great site for serious body builders with well researched reports. Love their site name: "Monster Maker"

It's very impressive that you're able to keep up with cycling given all the complications you face! Many kudos to you.

My hubbie uses a Theracycle and it really helps !!!!!!!:winky: