Forced Exercise to Relieve Parkinson's Disease Symptoms

I'm Pedaling as Fast as I Can

In 2003 Cleveland Clinic biomedical engineer Jay Alberts, PhD was on a 480 mile tandem bike trip across the state of Iowa with his friend Kathy who was a PWP (person with Parkinson's) Normally she would pedal at 50-60 rpm, but during this trip with Dr. Alberts she had to pedal at 80-90 RPM. Although the pedaling muscle was provided by Dr Alberts, Kathy's legs moved with the pedals at the speed which he set. When they had gone half the distance they noticed that Kathy's hand tremors had stopped.

Intrigued by Kathy's improvement in motor skills Dr Alberts experimented with another Parkinsons patient in 2006. This patient's symptoms were controlled by an electronic device that had been inserted in his brain by DBS surgery. He rode on the tandem bike with Dr. Alberts for 50 miles with the device turned off. He too exhibited no symptoms during the trip.

This discovery led Dr. Alberts to research Assisted Tandem Bicycle riding based upon his biking and his previous experiences with animal studies. It's called Forced Exercise. "The idea behind it is if we force them to pedal at a higher rate, this allows them to have biochemical changes that are necessary for improvements in motor function," explains Dr. Jay Alberts. "There's a possibility that there's an increase in dopamine or there's an increase in these neuro growth factors."

In a subsequent study with the a voluntary exercise control on a stationary bike or the forced exercise on a tandem bike with a trainer, an improvement of about 30% was measured in the forced exercise group. The improvements declined to 20% about two weeks after the study ended. This suggests the need for regular ongoing forced exercise as a significant part of exercise therapy.

While patients on medication and with deep brain stimulation show a significant improvement with these aids, if the meds are stopped or the DBS is turned off, the patient becomes symptomatic very rapidly. With therapeutic forced exercise, the improvements taper gradually. Dr Alberts feels that the therapies might work well together. By pushing the cyclist past his/her comfort zone by exercising the lower half of the body, the upper half improves. Whether this is a needed stimulus to the central nervous system is still unknown but the goal is to be as symptom free as possible and without the need for medication.

So if the study shows this to be a viable treatment a patient could ride a tandem bike with a friend or family member or use an electric motor driven stationary bike. Because most Parkinson's people cannot pedal at 80-90 rpm, the additional boost to get the leg stimulation comes from either the tandem companion rider or the motor of the stationary bicycle.

I'm hoping that I can convince the Therapy Center to buy a motor driven bike.

references and resources:
Theracycle
Kent State University Magazine summer 2009
ReckMotoMed Website
WNDU.com May 10, 2009
Pedaling to Beat Parkinsons
How You Can Help One Man's Challenge
http://www.lerner.ccf.org/news/documents/LRIMagazineFINAL.pdf
August 4, 2009 Thought you'd like an update
Forced Exercise Appears to Produce Benefits Similar to Levadopa
2011 Addendum:
See PD Trials for contact information about the Dr Albert's Forced Exercise trial, The Therapeutic Effect of Exercise on Parkinson's disease, Study ID: 09-439
2012 Addendum

Forced Exercise and Parkinson's Disease a significant article by Jay Alberts, Susan Linder, Amanda Penko, Mark Lowe and Michael Phillips

Brain Stimulation Breakthrough for Parkinson's Disease

Possible PD treatment without risky surgery

Today I've been reading a fascinating article in the New York Times about a recent new approach to treating Parkinson's disease. It describes spinal cord stimulation in dopamine-deprived rats where a mild electrical current flows up the rodent's spinal cord and into the brain. As long as that current is maintained the rodents regain their ability to move normally.

This procedure in being tested in monkeys now because humans and monkeys are the only two species which get PD naturally. If it is proven to be safe and efficient, spinal cord stimulation will be a potential alternative to DBS since it requires no risky invasive surgery to plant electrodes deep in the brain. It may be effective for some of the 70% of severely impaired PDers who do not qualify for deep brain stimulation.

This could represent a major paradigm shift in available treatments. It is not without drawbacks-tradeoffs, however since one side effect is reported to be a never-ending mini-vibration described by Dr Ali Rezai, director of the Cleveland Clinic Center for Neurological Restoration as "pins and needles."

Read more:
http://www.nytimes.com/2009/03/20/health/20spinal.html?_r=1&ref=health

My HD Days Part I

I went to work for Home Depot 8.5 years ago. I started working in the Millwork Department selling  windows and doors. Because of my experience it was a good fit for them and for me. I had worked as a contractor for 15 years and prior to that spent 10 years running a super market in the Tremont area of Cleveland, which was just starting to gentrify. I was 59 yeas old. I'd had a coronary artery blockage corrected at the Cleveland Clinic a few years before. My health was good.

I enjoyed working at Home Depot and they liked me. I was promoted to Department Supervisor and headed several. At one period I managed a department and was also working as an inventory associate, performing two full time jobs at the same time. I was promoted to become a key-carrying manager. I ran the whole store on Monday afternoons when the salaried managers were meeting. The work hours were all over the clock. There was no set schedule. Sometimes I had to be back at work within 7 hours after concluding the previous shift.

About two years from the time I began work at Home Depot, I noticed that sometimes when falling asleep or waking I would have a sharp discrete pain, like being pricked by a very sharp pin somewhere in my torso, often my chest. I wasn't sure if it was neurological but it crossed my mind. In the beginning it would happen every two or three weeks. As time went by I would get the pains more often. That was the only symptom I had for about two years.

Then one day during a stressful situation with a customer I noticed my left thumb shaking just a little bit. The next instance was when I was giving a talk to 150 people at a store meeting and my whole body shook a little bit. That is when I considered that I probably had Parkinson's and made an appointment with my doctor, Dr. Roth my GP at Kaiser in Cleveland, Ohio. He thought it was PD but wasn't sure if it might not be Essential Tremor. So he referred me to a neurologist.