Dear Ray

Whether it is forced or assisted, you are certainly making progress. I am happy for you. 

I read your article on "Simulation". I really wonder whether it is really possible to make the healthy people understand PD enough. But as I said before, if you can make just a few healthy people to feel what PD is like, these few people may be enough to change the world.

NK

> Date: Wed, 19 Aug 2009 22:05:59 -0700
> From: [log in to unmask]
> Subject: Re: Pedalling vs. PD
> To: [log in to unmask]
> 
> 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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