Dynamic High-Cadence Cycling Improves Motor Symptoms in Parkinson’s Disease

Abstract

RationaleIndividuals with Parkinson’s disease (PD) often have deficits in kinesthesia. There is a need for rehabilitation interventions that improve these kinesthetic deficits. Forced (tandem) cycling at a high cadence improves motor function. However, tandem cycling is difficult to implement in a rehabilitation setting.ObjectiveTo construct an instrumented, motored cycle and to examine if high cadence dynamic cycling promotes improvements in motor function.MethodThis motored cycle had two different modes: dynamic and static cycling. In dynamic mode, the motor maintained 75–85 rpm. In static mode, the rider determined the pedaling cadence. UPDRS Motor III and Timed Up and Go (TUG) were used to assess changes in motor function after three cycling sessions.ResultsIndividuals in the static group showed a lower cadence but a higher power, torque and heart rate than the dynamic group. UPDRS score showed a significant 13.9% improvement in the dynamic group and only a 0.9% improvement in the static group. There was also a 16.5% improvement in TUG time in the dynamic group but only an 8% improvement in the static group.ConclusionThese findings show that dynamic cycling can improve PD motor function and that activation of proprioceptors with a high cadence but variable pattern may be important for motor improvements in PD.

Systematic review on strength training in Parkinson’s disease: an unsolved question

“…Three out of the twelve studies included, considered as external resistance cycle ergometer,26,29,33 three weight machines,28,31,38 and two studies considered both weight machines and cuff weights 34–36. One study analyzed elastic bands and cuff weights,32 punching bag,27 water,37 or therapeutic putty,30 respectively, as external resistance.…”

“…Most of the studies involved the training of the lower body with cycle ergometer,26,29,33 water,37 weight machines,31 elastic bands, and cuff weights,32 or both weight machines and cuff weights 34–36. Two studies involved training of both upper and lower limbs with weights/resistance machines 28,38.…”

“…The most frequent test was the Timed Up and Go Test 26,27,31,33,37,38. Other widely used tests were the 6-Minute Walk Test26,27,29 and the 10-Meter Walk Test 31,38.…”

BrainCycles: Experimental Setup for the Combined Measurement of Cortical and Subcortical Activity in Parkinson's Disease Patients during Cycling

“…One may also speculate that the special conditions of bicycling, e.g., continuous resistance and angular momentum of the pedals, may provide feedback that is substantially different from walking. Bicycling has also been recently promoted as a viable therapy for PD (Mohammadi-Abdar et al, 2016), with evidence emerging that it may stimulate improvements in motor control (Ridgel et al, 2009, 2015) and cognitive performance (Alberts et al, 2011; Ridgel et al, 2011), as well as reduce severity of tremor, bradykinesia (Ridgel et al, 2012) and of orthostatic hypotension (Ridgel et al, 2016). …”

Strategies to encourage physical activity in patients with Parkinson's disease: improving quality of life

“…24,60,[73][74][75] Amplitude-specific training for individuals with PD has demonstrated an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) scores, several aspects of ambulation including starting/stopping, and quality and degree of functional reach. 18,66,76,77 Rhythmic dance training includes several styles of dance (tango, ballroom, etc).…”