Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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From: "rayilynlee" <[log in to unmask]>
Sent: Friday, August 14, 2009 5:49 PM
To: "parkinsn" <[log in to unmask]>
Subject: Pedalling vs. PD

> Pedalling Report after 3 weeks:
>
> It took about 9 days to reach an hour and more for 2 weeks (75 min 
> currently) on my ACTIVcycler.   I "think" I am a trifle better, but it is 
> not enough improvement to be definitive.  I am not early stage PD.  I did 
> lots of exercise then.    I don't know if my motorized cycler does 80-90 
> rpm or 60 rpm or not (it cost $170).  Theracycle's cycler costs around 
> $4,000 and the rep here has promised to do a demo for me when he is in my 
> area.
>
> I'm going for the 8 weeks daily and still hoping.  Forced exercise is the 
> way to go I think, as we need some help.
>
> Ray
>
> Pedalling hard to head off symptoms of Parkinson's
>
> By Evra Taylor Levy and Eddy Lang, The Gazette
>
> Rapid rhythm exercise shows benefits for people in early stages of the 
> disease.
>
> MONTREAL -- In medicine, most solutions to physical illness come from 
> outside treatments like pills and surgery; but what if the body had the 
> ability to heal itself through a specific physical activity and training 
> program? This week's HealthWatch looks at just this possibility for 
> treating what can be the devastating neurological condition known as 
> Parkinson's disease.
>
> Explain to me what Parkinson's disease is.
>
> Parkinson's disease (PD) is a degenerative brain disorder. It's caused by 
> a lack of dopamine, a neurotransmitter in a critical area of the brain. 
> This deficiency results in problems with the ability to move parts of the 
> body effectively and also affects speech; in advanced cases, dementia and 
> depression often set in.
>
> Who is most likely to develop Parkinson's?
>
> Health Canada estimates that one in every 100 Canadians over the age of 60 
> will be diagnosed with PD. As a result of our aging population, there are 
> 5,000 new cases each year. In 2003, it was estimated that the number of 
> new cases would triple by 2020. So, the older one gets, the more likely 
> that one will be diagnosed with PD. It typically occurs in people over age 
> 60, with men accounting for 50 per cent more cases than women.
>
> What are the symptoms of the disease?
>
> Most of us are familiar with PD's most common trait, namely tremor or a 
> constant shakiness, usually seen in the hands. Other symptoms of the 
> disease include shuffling of the feet, slow movement, limb stiffness, 
> muscle fatigue, impaired balance and coordination of fine movements.
> How does the disease progress?
>
> The onset of PD may be subtle and confused with normal aging, which can 
> delay diagnosis. In fact, patients may be relatively problem-free for the 
> first few years. PD worsens with age, but the rate and type of progression 
> varies from person to person.
>
> Typically, in the early stage of the disease, the symptoms progress from 
> one side of the body to both. This is followed by balance impairment, but 
> at this point people are still able to live independently. As the disease 
> progresses, folks become wheelchair bound or bedridden, often leading to 
> institutionalization.
>
> How is Parkinson's disease treated and do the medications work?
>
> In the beginning stages of the disease, treatment may not be needed at 
> all. There is no cure at this time, so as the disease progresses and 
> requires drug therapy, the goal of treatment is to reduce symptoms by 
> replacing the missing dopamine. Levodopa, a chemical found in both plants 
> and animals, which is converted into dopamine, has been shown to be 
> effective and is often the first medication given. However, its 
> effectiveness lessens over time and as a result other drugs, such as 
> selegiline (sold as Eldepryl), which prevent the breakdown of dopamine in 
> the brain by enzymes, are being incorporated into treatment. Current 
> research in PD focuses on medications that may actually slow its 
> progression.
>
> The study
> Ridgel AL, Vitek JL, Alberts JL. Forced, not voluntary, exercise improves 
> motor function in Parkinson's disease patients. Journal of 
> Neurorehabilitation and Neural Repair July/Aug 2009;23(6):
> 600-608.
>
> What do we know about PD and exercise?
>
> Although exercise improves fitness in PD patients, the studies that have 
> looked at its effects on the disease itself have not shown much benefit. 
> However, these studies looked at voluntary exercise or exercise performed 
> at a rhythm that was most comfortable for the subject. The individual 
> experiences of PD patients engaged in physical activity, like cycling at a 
> fast pace, a method known as forced exercise, found that their Parkinson's 
> symptoms lessened dramatically, and for an extended period of time. 
> Laboratory studies in rat models that mimic PD also showed benefits when 
> placed in motorized spinning wheels.
>
> What's different about this research?
>
> In this study, the five subjects who were randomly assigned to the forced 
> exercise group were teamed up with trainers who worked with them on 
> stationary bikes built for two. On these tandem bicycles, the subjects 
> underwent three 40-minute training sessions per week, during which they 
> were gradually pushed to be able to sustain pedaling rates of 80 to 90 
> revolutions per minute as opposed to the 60-per-minute rate that they 
> would typically roll at if left to their own devices. The five comparison 
> subjects in the study did stationary biking for the same amount of time 
> each week, but without a trainer to make them spin faster.
>
> Why would forced exercise offer any benefits?
>
> The thinking here is that challenging the body to move faster than it is 
> used to somehow activates the key part of the brain that controls body 
> movements. This revving up of those key areas may occur through increased 
> levels of dopamine and compounds that stimulate nerve growth or in 
> activating rusty circuits.
>
> What were the findings?
>
> Quite remarkable, actually. After an eight-week training session, the fast 
> spinners demonstrated a 35-per-cent improvement in the muscle coordination 
> and dexterity that is impaired with PD. Furthermore, these improvements 
> lasted for four weeks after the training period on the bicycles had ended. 
> The voluntary cycling group showed an equivalent degree of improved 
> general fitness, but no change in PD symptoms like tremor, stiffness and 
> slow movements.
>
> What does this mean for people suffering from Parkinson's disease?
>
> While a promising scientific development, tandem training cycles are hard 
> to come by and many patients with PD are too advanced in their condition 
> to even consider this treatment option. On the other hand, spinning 
> classes are all the rage in gyms and fitness centres and it may be 
> worthwhile giving this approach a shot as long as a physician clears the 
> patient for participation. Even if solely for the fitness benefits, 
> getting active can only help PD patients while we wait for more research 
> to confirm these intriguing findings.
>
> The material provided in HealthWatch is designed for general educational 
> purposes only and does not pertain to individual cases. It should not 
> replace necessary medical consultations with your own doctor or medical 
> professional.
>
> Rayilyn Brown
> Director AZNPF
> Arizona Chapter National Parkinson Foundation
> [log in to unmask]
>
>
> 

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