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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] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn