Articles

Cycling - 67-Year-Old Powers through Pd

67-year-old Anderson motorcyclist powers through Parkinson's Disease

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Mike Foley

Greenville News - After a pair of bike rides across the country and a 16,000-mile motorcycle trip to Alaska and back, Steve Quam isn’t ready to rest.

For the past three years, Quam, a 67-year-old Anderson resident, has proved that having Parkinson’s Disease is no reason to limit yourself. So, he hasn’t.

“I’m doing pretty good,” Quam said by phone last week about his health. “I did have a joint transplant in my left big toe due to arthritis. But I still seem able to ride my bike and motorcycle.”

Five-and-a-half years ago, Quam was diagnosed with Parkinson’s. The disease cannot be cured. Most people start with uncontrollable tremors, and those progress while normal bodily functions including breathing, balance, movement and heart function worsen as well.

Quam has recently been plagued by extreme daytime fatigue. That makes logging a lot of miles on his bicycle or motorcycle difficult.

“But if I go at my own pace, I can do fine,” he said.

Doing fine is one way Quam copes with the disease. In fact, he rides to help bring awareness and dollars to the fight to cure Parkinson’s. This year, he’ll undertake another epic journey, riding his motorcycle to Colorado and then participating in the Copper Triangle, a grueling 78-mile mountainous bike ride that includes passing through Leadville, Colo., the city at the highest elevation city in the U.S.

Here’s a recap of his exploits in the past four years, all of which benefit the Davis Phinney Foundation for Parkinson’s:

• 2010: Bicycled 4,224 miles from Anacortes, Wash., to Edisto Island.

• 2011: Motorcycled 16,140 miles round-trip from Anderson to Fairbanks, Alaska, and back. In the middle of the motorcycle trip, Quam — who had his bike mailed to him in Colorado — rode the Copper Triangle. He calls that 14-hour, 41-minute journey “the hardest one day bicycle ride of my life.”

• 2012: Bicycled from Edisto Island to Newport, Ore., for a total of 3,631 miles.

• 2013: Will ride his motorcycle from Anderson to Colorado — with his bicycle strapped to it — and then reprise his 2011 ride in the Copper Triangle event, before riding his motorcycle back home.

Quam left home today at 9 a.m. on his way west. But, on Saturday at 12:30 p.m., Quam will ride to Travelers Rest and back on the Greenville Health System’s Swamp Rabbit Trail before a dessert social is held in his honor at St. Matthew United Methodist Church, 701 Cleveland St.

A shorter 10-mile ride from Grandview Cemetery in Travelers Rest to the church starts at 3 p.m.

“These rides and endeavors give me goals to work on,” Quam said. “They keep me from dwelling on the negative.”

 

Cycling - How Pedal Power Can Ease Pd

 

How pedal power could ease Parkinson's: Cycling can improve connections in brain regions linked to the disease

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Scans revealed pedalling boosted connections between brain regions linked to movement
Fiona Macrae

www.dailymail.co.uk - Cycling could help ease the symptoms of Parkinson’s disease, scientists believe.

The exercise improved connections between brain regions linked to the disease and boosted patients’ co-ordination and balance, research has shown.

Exercising on a bike is ‘an effective, low-cost therapy for the disease’, one researcher said.

Some 120,000 Britons have Parkinson’s. Symptoms include tremors, speech problems and a gradual slowing down of the body.

As the disease progresses, speech and balance can be affected and some sufferers become wheelchair-bound.

High-profile patients include Michael J Fox, who was just 30 when he was diagnosed with the condition, and Muhammad Ali.

US neuroscientist Jay Alberts began the research after noticing improvements in his companion, a Parkinson’s patient, after a long-distance tandem ride across Iowa.

Dr Alberts, of the Cleveland Clinic Lerner Research Institute, Ohio, said: ‘The finding was serendipitous. I was pedalling faster, which forced her to pedal faster.

'She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.’

In the study, he carried out a series of scans on the brains of 26 Parkinson’s patients who used exercise bikes three times a week for two months.

Some pedalled at their own pace, while others undertook ‘forced-rate’ cycling, in which they were made to pedal faster by motors fitted to their bikes.

The scans revealed pedalling, particularly vigorous pedalling, boosted connections between brain regions linked to movement, the annual meeting of the Radiological Society of North America in Chicago heard.

Researcher Chintan Shah, also from the Cleveland Clinic, said: ‘The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease.’

The scientists are now studying how patients fare with exercise bikes in their homes. They also want to see whether other forms of exercise such as swimming and rowing have similar benefits.

The charity Parkinson’s UK welcomed the research, saying the balance and co-ordination can be badly damaged as the disease progresses.

However, it also cautioned that not all patients will be capable of exercising intensely.

Dr Kieran Breen, the charity’s director of research, said: ‘While it is too soon to encourage people with Parkinson’s to get on their bikes three times a week on the basis of this study, we do know that exercise can be beneficial.

‘A regular exercise routine can help those with the condition to not only improve their general fitness but can also help to improve movement and balance as well as other symptoms of the condition such as anxiety and depression.’


 

Cycling - HOPE For Parkinson's Patient

 

Hope for Parkinson’s patients

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Tim Freed

Winter Park Observer - Until eight months ago, Robert McRainey had never been cycling in his life. The bike that he bought 25 years ago had remained untouched, and was beginning to collect dust in the garage of his Casselberry home.

Today, McRainey finds himself on a bike at least three times a week, taking a spinning class and riding outdoors whenever he can. While some cyclists take classes to improve their endurance or lose weight, McRainey and the 20 other participants in his spinning class are after something else: a better quality of life with Parkinson’s disease.

Cyclist Roy Roden came to the Crosby YMCA Wellness Center in Winter Park last Wednesday to share the story of his 4,500 mile ride across the U.S. with Parkinson’s disease, an inspiration to McRainey and the other members of the center’s Pedaling for Parkinson’s Program – a stationary cycling class founded on research showing a reduction in symptoms by pedaling a bicycle.

After receiving the surgery for Deep Brain Stimulation (DBS), an electronic device that enables the brain to control movement better, Roden set off on his journey with his wife Lynn from Seattle, Wash., in November. Three months later they arrived in Florida, making a stop in Orlando to speak at the Crosby YMCA before arriving at his final destination in Miami.

“It’s awe-inspiring to see him get his life back, do the DBS and let everybody know that the DBS is working. It’s an option that people should look at,” said McRainey, who was diagnosed with Parkinson’s two years ago. “With him pedaling across the U.S. like that, we would never think that we could do something like that, and the fact that he’s doing it just gives us something to shoot for. Maybe not at quite that level, but we have the ability; all we have to do is go for it.”

As Roden continues his journey toward Miami and a better life with Parkinson’s disease, the members of the Pedaling for Parkinson’s Program continue on their own journey as well, gaining small victories every time they sit on the bike.

“I see people come in and they can hardly get on the bike,” said Howie Apple, a Parkinson’s patient and co-instructor of the spinning class. “By doing it enough times, they develop the skills to even get on the bike.”

“If you get on the bike and do five minutes and then get off, the important thing is to come back. The real issue is to start people off where they are and to improve from there with their own baseline.”

The Pedaling for Parkinson’s program began in 2012 when Apple found research conducted by the Cleveland Clinic showing that up to 35 percent of symptoms were reduced when Parkinson’s patients rode a bicycle, optimally at a rate of 80 to 90 revolutions per minute. Apple approached the Crosby YMCA about a program, and in June of that year, the first group of members began the classes.

McRainey has started to see success with his own symptoms. Before the cycling classes, he often felt fatigued due to his medication, and was forced to take three naps every day. After eight months of classes though, he has now gone down to only one nap every other day. McRainey also mentioned that his depression, a common symptom of Parkinson’s disease, too has dwindled.

“I think it’s amazing. I think everyone is entitled to have the best quality of life that’s available to them so they can be more active in the community,” said Brittany Dixson, the medical fitness coordinator for the Crosby YMCA Wellness Center. “The fact the research backs up what they’re doing is even better. The research already shows that there’s going to be benefits to this, so if they keep going for it, they can hopefully reap all of the benefits that this cycling class will give them.”

Apple, his wife Debbie and co-instructor Terri Callanan are currently monitoring the progress of the program’s members, and plan to submit statistics such as heart rate, time spent riding and average cadence to an institution to prove the effectiveness of cycling, and to show the improvement of the riders.

With the Pedaling for Parkinson’s Program at the Crosby Center being the only program of its kind in Central Florida, Apple also hopes that it will expand to other locations, giving more Parkinson’s patients an opportunity to come together against the disease.

“It means so much to face down the giant, the fact that you’re having to deal with this disease, which is degenerative as time goes on,” McRainey said. “A lot of people may want to give up.”

“The camaraderie by being involved with other folks that are facing the same problem, where you become a community in itself, is just amazing. It’s the difference between night and day as far as that goes.”

 

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Therapy - Can You Ride a Bicycle? #

   

Can you ride a bike? Then you're a marvel

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

A runner-up in the Wellcome science writing prize considers the extraordinary human ability to cycle
Catherine Hess

www.guardian.co.uk - Most of us remember our first proper bike. It's a rite of passage, symbolising our transition from "little" to "big" kid. Even more exhilarating is the day we take our first ride without stabilisers. What most of us don't realise is just how complex the art of riding a bicycle actually is. So complex, in fact, that researchers are just beginning to investigate how on earth we manage to propel ourselves, constantly rocking back and forth with the movement of our legs, on two skinny wheels; simultaneously navigating movement in multiple planes while trying to avoid countless obstacles.

Most extraordinary is what the act of riding a bicycle can tell us about the human brain. In 2010 researchers from the Netherlands published a dramatic case study in the New England Journal of Medicine. Medical researchers at Radboud University in Nijmegen examined patients afflicted with Parkinson's disease, a neurological disorder that results in tremors and involuntary muscle movements. In severe cases, Parkinson's affects balance, co-ordination and limb control and can leave patients unable to walk or carry out basic tasks.

One such patient, a 58-year-old man, suffered from what researchers call "gait freezing". He was incapable of walking to the extent that he required visual guides to help him move one foot in front of the other and was unable to turn while walking. After a few steps the patient would lose his balance and would require his wheelchair.

Astonishingly, however, this patient could still ride his bicycle. Flawlessly. Video evidence, submitted with the published case study (and now available on YouTube), shows the patient, with severe tremors in his arms, shuffling slowly and unsurely down a hallway while being guided by another individual. After several steps he begins to stumble forward until he falls to the ground.

In a second video he is seen riding a bicycle with perfect movement and balance, the marked tremors in his arms are gone and he pedals at a consistent pace and with perfect balance and co-ordination. He cycles away from the camera, turns around and cycles back, slowing, stopping and dismounting perfectly. Once dismounted, however, he is again incapable of walking.

This phenomenon is called kinesia paradoxica. While the mechanisms involved are still not understood, the knowledge is invaluable. It may lead to new forms of physical therapy and exercise for people with Parkinson's disease or other neurological disorders that affect movement, co-ordination or balance.

Currently, the "bicycle sign" is being suggested as an effective and inexpensive way to differentiate between Parkinson's and the rarer atypical Parkinson's. One way in which the two diseases differ is in the ability or loss of ability to ride a bicycle. Individuals with Parkinson's who were able to ride a bicycle before the onset of symptoms retain the ability to cycle. Those with atypical Parkinson's do not.

But how is it possible for a man to ride a bicycle when he is essentially wheelchair-bound? More importantly, how does anyone adapt to the sensory whirlwind that is bicycle riding? Research teams at the University of California, Davis in America and the University of Delft, Netherlands, are trying to find out. What they have discovered is surprising.

While we take it for granted that riding a bicycle is as easy as, well, riding a bicycle, it turns out that it is anything but. Led by Professors Mont Hubbard and Ron Hess, American researchers are attempting to model human-bicycle interactions in a similar manner to pilot-aeroplane or motorist-car interactions. However, there are many more physical and neurological processes involved in riding a bicycle than driving a car.

Riding a bicycle involves continuous use of all the human's primary sensory capabilities, visual, vestibular [balance] and proprioceptive [the awareness of one's body and limb positioning]," says Hess. "The latter involves sensors in the arms providing information about steering inputs. What is more interesting though is the ability of the trained cyclist to ride a bicycle 'hands-free'."

Recent research at the University of California, Davis has demonstrated how subtle body leaning by the cyclist enables this behaviour.

"Imagine trying this control technique in an automobile or an airplane," says Hess.

The goal of this research is to understand how the cyclist interacts with both the environment and the bicycle and to develop bicycles that maximise performance, whether the rider is a Tour de France cyclist or a disabled cyclist needing greater stability or control.

What is clear from research into both the human brain and the bicycle is that despite the bicycle's simplicity we have yet to fully understand how it is that we manage to control it, and what is happening in the brain when we do. Our first wobbly bicycle ride, then, is a more remarkable event than we ever imagined



 

Therapy - How Pedal Power Could Ease Parkinson's #

 

How pedal power could ease Parkinson's: Cycling can improve connections in brain regions linked to the disease

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

Scans revealed pedalling boosted connections between brain regions linked to movement
Fiona Macrae

www.dailymail.co.uk - Cycling could help ease the symptoms of Parkinson’s disease, scientists believe.

The exercise improved connections between brain regions linked to the disease and boosted patients’ co-ordination and balance, research has shown.

Exercising on a bike is ‘an effective, low-cost therapy for the disease’, one researcher said.

Some 120,000 Britons have Parkinson’s. Symptoms include tremors, speech problems and a gradual slowing down of the body.

As the disease progresses, speech and balance can be affected and some sufferers become wheelchair-bound.

High-profile patients include Michael J Fox, who was just 30 when he was diagnosed with the condition, and Muhammad Ali.

US neuroscientist Jay Alberts began the research after noticing improvements in his companion, a Parkinson’s patient, after a long-distance tandem ride across Iowa.

Dr Alberts, of the Cleveland Clinic Lerner Research Institute, Ohio, said: ‘The finding was serendipitous. I was pedalling faster, which forced her to pedal faster.

'She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.’

In the study, he carried out a series of scans on the brains of 26 Parkinson’s patients who used exercise bikes three times a week for two months.

Some pedalled at their own pace, while others undertook ‘forced-rate’ cycling, in which they were made to pedal faster by motors fitted to their bikes.

The scans revealed pedalling, particularly vigorous pedalling, boosted connections between brain regions linked to movement, the annual meeting of the Radiological Society of North America in Chicago heard.

Researcher Chintan Shah, also from the Cleveland Clinic, said: ‘The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease.’

The scientists are now studying how patients fare with exercise bikes in their homes. They also want to see whether other forms of exercise such as swimming and rowing have similar benefits.

The charity Parkinson’s UK welcomed the research, saying the balance and co-ordination can be badly damaged as the disease progresses.

However, it also cautioned that not all patients will be capable of exercising intensely.

Dr Kieran Breen, the charity’s director of research, said: ‘While it is too soon to encourage people with Parkinson’s to get on their bikes three times a week on the basis of this study, we do know that exercise can be beneficial.

‘A regular exercise routine can help those with the condition to not only improve their general fitness but can also help to improve movement and balance as well as other symptoms of the condition such as anxiety and depression.’



 

Cycling - Where Did the Tremour Go?

 

Hemet man bikes to help self, others

Copied from The Northwest Parkinson’s Foundation Weekly News Update

DIANE A. RHODES

The Press-Enterprise - After he was diagnosed with Parkinson's disease in November 1995, Jim Wetherell plunged into a deep depression that no therapist or medication could combat.

While the diagnosis was not a death sentence, it was an end of life as Wetherell knew it. He had to give up his job as a tour bus driver. His relationship with his wife fell apart. So he moved from San Francisco to Hemet.

To help with the anxiety caused from the disease, he started riding a recumbent two-wheeled bicycle. He soon switched to a three-wheeled version.


"I thought I could deal with some of the stress by pedaling it away,"

 

said Wetherell, 66. After a while, one of his biking buddies asked him:

 

where his tremor went? That is when he realized that cycling had more benefits than he knew.

"I'm now on minimal medications and my tremor doesn't bother me,"

 

said Wetherell.

 

"I want people to keep a positive attitude, and even though it's difficult at times, don't let the PD control your life."

Wetherell attached a prescription bottle label to his trike which reads:

 

"Take as directed to strengthen heart, lungs and muscles. Use 3X/week, 20 minutes per dose. For best results, wear spandex."

Further Unnecessary Information:

 In 2001 he started a Web site to offer information, support and inspiration to patients and caregivers: www.inevergiveup.org.

"I wanted a name people would remember," he said about choosing the nickname "Parky" as he set out to "take the park out of Parkinson's."

"I was told that my site has become an important tool for patient support groups at the Parkinson's Institute (in Sunnyvale)," said Wetherell. "Once, I got a call from a college professor at the University of Wales who said he visits my site every day to get him through the day -- that's when I realized it was making a difference."

Writers to his site's guestbook cite the encouragement they receive as a result of seeing all Wetherell has accomplished through cycling -- and all his goals for the future.

He maintains a regimen of 20 miles a day, and in 2005 he set his first major goal -- 50,000 miles, which he achieved in May. Since it took him several years to reach that milestone, he had not anticipated how he would react.

"I found myself not wanting to ride -- I had lost my incentive," said Wetherell. "After two weeks I realized that I needed a goal to keep me riding so I set a high goal -- to ride in the 2010 RAGBRAI (The Register's Annual Great Bicycle Race Across Iowa)."

The seven-day ride covers more than 470 miles, and bikers average 68 miles per day. It is touted as the "oldest, largest and longest bicycle touring event in the world."

This is the 38th year of the race and Wetherell's third trip as part of the Team Pedalling for Parkinson's.

"If I don't find some sponsors I may not get there, but the goal gives me purpose and I'm not giving up," he said. Expenses for the July event are about $1,200.

For the new year, Wetherell has a new trike with rear suspension.


"It helps to absorb the road shock that is normally absorbed by one's body," he said. "My muscles are more rigid due to the Parkinson's disease."

Cycling - For Freezing of Gait

 

News in Context: Cycling for Freezing of Gait

This article has been copied from the Michael J Fox Foundation, and can be viewed on www.michaeljfox.org.

I would strongly recommend that you register with the MJFF in order to get all their news on the research for a cure for Parkinson’s disease, at no cost to yourself.

On April 1, 2010, the New England Journal of Medicine published a case study about a Parkinson’s patient with advanced disease who surprised his doctors by his ability to cycle. The study author, Bastiaan Bloem, PhD at the Radboud University Nijmegen Medical Centre is a recipient of an MJFF award to support PARKFIT, a study that aims to identify and overcome the behavioral barriers to physical activity in PD patients as well as to investigate the effects of exercise on disease progression.

The Michael J. Fox Foundation spoke with Dr. Bloem about the case study and his work to improve physical activity in PD patients.

MJFF: Let’s start with some background. You’ve been funded by MJFF to study exercise and PD. Why is this area of research important?

BB: There are many good reasons to study exercise and PD. Exercise may alleviate some of the physical and cognitive symptoms of PD, and also constipation, sleep disturbances or depression. Exercise also slows down osteoporosis and can reduce the risk of cardiovascular disease.

In studies with rodents with experimental parkinsonism there have been some exciting findings to suggest that exercise can induce adaptive changes in the dopaminergic system, and may thereby be able to modify the course of the disease. It is a provocative finding, and we’re now looking at the full spectrum of these clinical and disease-modifying effects.

MJFF: Going back to the case study, what does this mean for patients? Should doctors start advising PD patients to take up cycling?


BB: I think everybody agrees that exercise is probably good for PD patients. The reason I say probably is that there can be adverse effects as well. For example, falling is a disease of people who are active. So if you start to blindly promote exercise in unstable patients you may see more hip fractures. The other reason for caution is that there is reasonably good evidence to show that PD patients are at increased risk for cardiovascular disease, so for some patients, exercise may increase myocardial infarctions. So it’s important that we continue to investigate this area of research and patients should talk to their doctors or physical therapists before taking up exercise. Patients should also discuss the specific activities that may be best suited to each individual’s needs.

But cycling is a very interesting exercise for PD patients because it restores their ability to participate in social life. The man featured in the New England Journal of Medicine was cycling 10-20 miles each day which restored his independence because he couldn’t walk due to freezing of gait. Although he has trouble with traffic lights, his wife is able to accompany him and he can get from place to place. What’s interesting is that I’ve now been contacted by companies making tricycles. This may be a safer alternative that still provides the benefits.

MJFF: Do you think the finding is specific to cycling? Are there other examples of PD patients who have difficulty walking but can perform other actions?


BB: What we know about Parkinson’s disease is that patients can move unexpectedly well under certain circumstances. Examples include emotions, like the well-known story of a fire breaking out in a nursing home and the first person outside is a PD patient, only to become immobile again once outside. We also know that visual cues are very powerful in affecting movement as well as rhythmic auditory cues. And then there are the exciting examples of motor abilities that seem to be preserved in the face of otherwise severe disease. Ice skating and climbing stairs are examples that are known, but cycling is a completely novel observation. And I think the reason cycling has stirred so much interest is because you can easily get around if you can ride a bike.

MJFF: Do you think the finding is specific to an individual? For example, if a PD patient grew up cycling, he or she may be more likely to be able to cycle even with advanced disease?


BB: I think so. I have a beautiful video of a patient of mine who was a former badminton champion in Holland. If you give him a racket and a shuttle, he beats me every time. It’s not good fun for me to play him! It may be that these movements that are learned early on are stored in different areas of the brain.

MJFF: What does this tell us about how the brain controls movement? Does this tell us anything new about Parkinson’s?


BB: One of my areas of focus is looking at the ability of the brain to compensate for disease. Parkinson’s is, at least in the initial stages, a focal brain disease affecting the basal ganglia and there are many intact brain areas that show a powerful ability to compensate for the focal deficits. Cuing is one example of how the brain overcomes defects. Skating or cycling is another powerful example. And I actually have a whole truckload of videos of amazing examples of how patients come up with clever solutions to overcome movement difficulties.

MJFF: Does this mean that the area of the brain that controls walking versus cycling or skating may be a different region?


BB: I think so. To explain further, movements are initiated by the primary motor cortex. But the primary motor cortex needs to receive start signals from the basal ganglia. And when that’s defective, movements become difficult to start or maintain. What is interesting is that the same motor cortex can be reached by areas of the brain that are not normally involved in generating movement, such as the visual or auditory areas. So they can bypass the defective connections between the basal ganglia and the motor cortex, generating movements from the same motor cortex, but by exploiting different neural circuitries.

And that’s why I think the word hope really is in place here, because it shows that even in the face of severe disability, there is still this powerful ability of patients to exploit intact brain areas and generate movement.

MJFF: What are the next steps for this area of research?

BB: We really need to explore the behavioral strategies adopted by patients in more detail which is why I collect all these videos of different compensatory strategies. But we also need to better understand how this works in the brain. In other ongoing work at our center, we are using functional magnetic resonance imaging of the brain to see which areas are specifically involved in generating these compensatory movements. The hope is that once these areas are identified, we may be able to stimulate them and generate new treatments.

Note by John Pepper:

I have found that I can do most things, if I focus on the actual movement, and not by trying to persuade my body to do it subconsciously.
 

 

Cycling - Can be a Breeze

 

Bicycling can be a breeze for Parkinson's patients

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Scott Goldberg

KARE11.com - On the web site for the New England Journal of Medicine, there is one of those videos that makes people talk.

In the video, a 58-year-old Dutch man with Parkinson's disease is seen shaking so badly he can't walk.

But then the man hops on a bicycle and rides it effortlessly. He pedals smoothly, rides through a U-turn, and then hops off.

As soon as he dismounts, he freezes. He looks as if he could ride the bike for miles, if he wanted to. But he can't take a single step.


"It is fascinating,"

said Dr. Martha Nance, the medical director at Park Nicollet's Struthers Parkinson's Center in Golden Valley.

Nance has seen something like the video before. One of her patients, whom she diagnosed with Parkinson's more than a decade ago, is an avid skier.


"She has aggressively gone out, (and) she continues to ski," Nance said. "It's now 12 years later, and she's still skiing."


Doctors can't say for sure what's behind these stories.

Perhaps the best explanation is that Parkinson's, the neurological disorder that kills some of the brain cells that control movement, only affects certain parts of the brain.


Hands or feet might twitch uncontrollably, but pedaling - or skiing around moguls, for that matter - is a motion controlled from a different place.

"Some patients can use music to get themselves moving," Nance said. "Some people can use marching steps to get themselves moving when they can't walk. So there are a variety of techniques that we can use to help turn on a bigger part of the brain."

Nance and other doctors aren't about to prescribe bicycling as a treatment for Parkinson's, but they say patients should exercise however they're able.

If nothing else, that video proves there can be quality in a life that's been slowed by a cruel disease.

Note by John Pepper:

As I have already said in the other article on cycling, when I use my conscious brain to control any action, such as walking or bringing food to my mouth, or handwriting, I focus my mind on the ‘action’ I don’t try and rely on my subconscious brain to control those actions.

The subconscious brain is not a different area of the brain but the messages emanating from it seem to pass through a different part of the brain

Cycling - Provides a Break for Pd Patients

 

Cycling Provides a Break for Some With Parkinson’s

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Gina Kolata

NY Times - Dr. Bastiaan R. Bloem of the Radboud University Nijmegen Medical Center in the Netherlands thought he had seen it all in his years of caring for patients with Parkinson’s disease. But the 58-year-old man who came to see him recently was a total surprise.

The man had had Parkinson’s disease for 10 years, and it had progressed until he was severely affected. Parkinson’s, a neurological disorder in which some of the brain cells that control movement die,

 

had made him unable to walk. He trembled and could walk only a few steps before falling. He froze in place, his feet feeling as if they were bolted to the floor.

But the man told Dr. Bloem something amazing: he said he was a regular exerciser — a cyclist, in fact — something that should not be possible for patients at his stage of the disease, Dr. Bloem thought.

“He said,

 

Just yesterday I rode my bicycle for 10 kilometers’ — six miles,” Dr. Bloem said. “He said he rides his bicycle for miles and miles every day.”

“I said, ‘This cannot be,’ ” Dr. Bloem, a professor of neurology and medical director of the hospital’s Parkinson’s Center, recalled in a telephone interview. “This man has end-stage Parkinson’s disease. He is unable to walk.”

But the man was eager to demonstrate, so Dr. Bloem took him outside where a nurse’s bike was parked.


“We helped him mount the bike, gave him a little push, and he was gone,” Dr. Bloem said. He rode, even making a U-turn, and was in perfect control, all his Parkinson’s symptoms gone.

Yet the moment the man got off the bike, his symptoms returned. He froze immediately, unable to take a step.

Dr. Bloem made a video and photos of the man trying to walk and then riding his bike. The photos appear in the April 1 issue of The New England Journal of Medicine.

After seeing that man, Dr. Bloem asked 20 other severely affected patients about riding a bike. It turned out that all could do it, though it is not clear why.

Dr. Bloem and other Parkinson’s specialists were amazed. People with Parkinson’s disease can often dance, run, walk smoothly and do complex movements for a few minutes if they are given appropriate signals — emotional or visual cues. There are famous examples, such as a group of Parkinson’s patients who were caught in a fire and managed to run down steps and escape, only to freeze in place when they got outside.

But this effect, known as the kinesia paradox, does not last long. Riding for miles and miles is very different from walking for a few minutes. And until now, Dr. Bloem said, it was not known that patients with Parkinson’s could ride bikes.


“The observation is so novel and exciting that I keep amazing audiences when I show this video during my lectures, even when the audience consists of movement disorder experts,” Dr. Bloem said.

Of course, he added, he is not advocating that Parkinson’s patients hop on bikes and go out on busy roads. They need help in mounting a bike and can get into trouble if they have to stop at traffic lights. They need to ride in safe areas. He recommends that patients ride tricycles, or use stationary bikes or trainers — devices that turn road bikes into stationary ones.

Still, he said, bicycling offers patients an opportunity to be symptom-free while they are riding, to look and feel normal, and to get some real cardiovascular exercise even when their disease is so far advanced that they cannot walk.

Parkinson’s experts were intrigued.


“This is an impressive thing,”

 

said Dr. C. Warren Olanow of the Mount Sinai School of Medicine. “He has described a terrifically interesting case, and there are things to learn from it.”

Dr. Bloem said one explanation for the finding might be that bicycling uses a different part of the brain than walking and might not be so severely affected by Parkinson’s disease. Or it might be that the rhythmic pressure of the pedals on patients’ feet cues the nervous system to allow a cycling movement.

Bicycling does not cure patients, of course. And, added Dr. Lisa M. Shulman, a neurology professor at the University of Maryland School of Medicine, whether most patients with severe Parkinson’s disease will be able to ride a bike “is an empirical question that would need to be tested.” And, she said, those who cannot do one sort of exercise may be able to do another.

But Dr. Bloem said he hoped that perhaps regular exercise might slow the progress of Parkinson’s disease. It does in rats, he said, and he is running a clinical trial in 600 patients to see if exercise also slows the disease in humans.

In the meantime, Dr. Bloem said he knew there was a long way to go from observation to scientific fact. But, he said, that does not mean an observation is useless.


“I’m a strong believer that single cases can provide crucial evidence,” Dr. Bloem said. “Even though this is a single patient, it is very, very provocative.”

 

Note by John Pepper:

I am in the invidious position, where I have managed to overcome many of the motor symptoms of my Parkinson’s Disease. I have no longer needed to take any Pd medication, for the past ten years. My non-motor symptoms, however, continue to give me problems.

 

I have written a book explaining my Parkinson’s history. I agree with Dr Bloem that single cases can provide crucial evidence. My case was quite unique. It is possible that I might have been the only person to whom two crucial factors happened:

1.     I was in the habit of doing regular energetic exercise, for twenty-two years before I was diagnosed, which might not be very unusual. I have continued to do a lot of energetic exercise up exercise, right up to the present time.

2.     I was prescribed a monotherapy of an MAO-b inhibitor by my neurologist, which I took, without any other Pd medication for ten years. I was prescribed Sinamet, which my neurologist thought I might need after eight years, but I took myself off it after three months.

 

I also found that I was able to walk, without falling or exhibiting my usual bad gait, if I focussed on the actual movements of my legs and arms. When my concentration wavered, I walked badly and immediately I re-focussed on my movements, I was back to normal.

 

In my humble opinion, when cycling, we have to focus our attention on what we are doing, as against walking, which we control subconsciously.

 

I call it, “Using my conscious brain, as against my subconscious brain”. I am not a medical person, but we all have to get to know more about our bodies, when faced with a condition like Parkinson’s disease.

 

I know that there is no separate area of the brain, which constitutes the subconscious, but it is only the subconscious movements, which are affected by the Parkinson’s Disease.