NK

the "forced" exercise I do is actually "assisted" exercise.  I could never 
force myself to do 75 minutes on the cycler without the motor.  in addition, 
I somehow managed another 10 minutes today on the treadmill which is a real 
achievement.

I will make periodic reports on this experiment.

Ray

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
[log in to unmask]

--------------------------------------------------
From: "chew nee kong" <[log in to unmask]>
Sent: Monday, August 17, 2009 9:43 PM
To: <[log in to unmask]>
Subject: Re: Pedalling vs. PD

> Dear Ray
>
> Wow! What an interesting study.
>
> I have a good friend who has suffered from Parkinson's for ten years. He 
> is Mr Teo Kim Hoe, who is the one and only Parkinson's in Malaysia who 
> regularly practices "forced" exercise as reported in this study. He is a 
> very strong believer in exercise as a way to control the progression of 
> Parkinson's. You can view the video recording of Mr Teo doing cycling 
> (spinning) and kickboxing in his blog (www.heroteo.com) or Malaysian 
> Parkinson's website (www.lloydtan-trust.com).
>
> Actually, many Parkinson's patients do carry out exercises, but these are 
> usually light (e.g. morning walk, Tai Chi, waidangong, etc). But Mr Teo is 
> diferent from other Parkinson's patients because he really forces himself 
> to the maximum. I have seen him doing the kickboxing exercise, which I 
> think is a "heavyweight" exercise. No other Parkinson's patients in 
> Malaysia does the kickboxing exercise.
>
> In fact, the reason I decided to do video recording of Mr Teo doing all 
> these "forced" exercises is to give motivation to the Parkinson's 
> patients - that they can still be physically active despite having the 
> illness.
>
> Dr Chew
>
>
>
>> Date: Sun, 16 Aug 2009 10:56:45 -0700
>> From: [log in to unmask]
>> Subject: Fw: Pedalling vs. PD
>> To: [log in to unmask]
>>
>> Rayilyn Brown
>> Director AZNPF
>> Arizona Chapter National Parkinson Foundation
>> [log in to unmask]
>>
>> --------------------------------------------------
>> 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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