It Is Not About the Bike, It Is About the Pedaling

Abstract

Forced exercise has resulted in neuroprotective effects and improved motor function in animal studies. These promising results have not yet been translated fully to humans with Parkinson's disease (PD), as traditional exercise interventions have not yielded global improvements in function. A novel forced exercise intervention is described that has resulted in improved motor function and central nervous system function in PD patients.

Social Comparisons, Social Support, and Self-Perceptions in Group Exercise for People With Parkinson's Disease

“…Exercise is known to reduce anxiety via both physiological and psychological mechanisms (Stathopoulou, Powers, Berry, Smits, & Otto, 2006). The symptom reduction induced by exercise (Alberts et al, 2011;Ridgel et al, 2012) could also relieve some stress. Furthermore, participants found the program to be free of stigma, inclusive and welcoming, and a safe space where they could display symptoms without fear of judgment.…”

Forced Aerobic Exercise Preceding Task Practice Improves Motor Recovery Poststroke

“…Neurological disease has been shown to decrease cardiovascular fitness and diminish motor output, serving as a barrier to achieving and maintaining high-intensity aerobic exercise (Billinger, Coughenour, Mackay-Lyons, & Ivey, 2012). Forced exercise (FE), a mode of exercise in which the voluntary efforts of the person are augmented to facilitate sustained exercise of greater intensity, has been shown to overcome these consequences of neurological disease (Alberts, Linder, Penko, Lowe, & Phillips, 2011;Ridgel, Vitek, & Alberts, 2009). People with Parkinson's disease (PD) participated in a lower-extremity cycling intervention in which the pedaling rate was augmented to 80-90 revolutions per minute (rpm; Alberts et al, 2011;Ridgel et al, 2009).…”

“…Forced exercise (FE), a mode of exercise in which the voluntary efforts of the person are augmented to facilitate sustained exercise of greater intensity, has been shown to overcome these consequences of neurological disease (Alberts, Linder, Penko, Lowe, & Phillips, 2011;Ridgel, Vitek, & Alberts, 2009). People with Parkinson's disease (PD) participated in a lower-extremity cycling intervention in which the pedaling rate was augmented to 80-90 revolutions per minute (rpm; Alberts et al, 2011;Ridgel et al, 2009). The exercise was not passive, because participants actively contributed to the pedaling to exercise within their prescribed target heart rate (HR) zone.…”

Forced Aerobic Exercise Enhances Motor Recovery After Stroke: A Case Report

“…However, residual neurological impairments have been shown to prevent people from exercising at their full aerobic potential (Billinger et al, 2014). We have overcome this barrier in people with Parkinson's disease (PD) through the implementation of forced exercise (FE), an approach in which the voluntary efforts of people exercising on a stationary bicycle are augmented by a motor, allowing them to achieve and sustain an active pedaling rate greater than their voluntary rate (Alberts, Linder, Penko, Lowe, & Phillips, 2011;Ridgel, Vitek, & Alberts, 2009).…”

“…When this mode of exercise was implemented in people with PD, significant improvements were noted in motor functioning, including rigidity, tremor, and bradykinesia as well as interlimb coordination and grasping force production (Alberts et al, 2011;Ridgel et al, 2009). These changes in global motor function, and the cortical and subcortical changes seen in functional connectivity magnetic resonance imaging, suggest that FE alters CNS processing (Alberts et al, 2011;Beall et al, 2013;Ridgel et al, 2009).…”