A New Benefit of Indoor Cycling for People With Parkinson’s

As indoor cycling instructors, we know about the cardiovascular and strength benefits of indoor cycling. You may not know that indoor cycling can also be an effective intervention in the treatment of Parkinson’s disease and other neurological conditions.

There is a scientific consensus that exercise is beneficial in slowing the progression of Parkinson’s disease and other neurological conditions. Growing evidence suggests that cycling may be particularly beneficial. Some research even suggests that cycling may result in a reduction of symptoms of up to 35%.

This is huge news for Parkinson’s patients and their families. Cycling is not a cure for Parkinson’s but there is compelling evidence of big benefits in the reduction of symptoms from this exercise.

The encouraging studies are based on pedaling at a rate of 80–90 rpm—generally about 30% faster than the 50–60 rpms preferred by Parkinson’s patients. It is theorized that the benefit may be because the faster pace of pedaling requires more neuromuscular signaling between the muscles and brain. This increased signaling appears to result in better reception of dopamine at a cellular level.

As an Iowan, I should note that the inspiration for much of this research occurred on RAGBRAI, the famous Iowa cross-state ride. Dr. Jay Albert, a neuro-researcher for the Cleveland Clinic, rode RAGBRAI on a tandem bicycle with a friend who has Parkinson’s. As the ride progressed they noticed the friend showing remarkable daily improvement in symptoms. Was the improvement linked to the higher rate of pedaling forced by the tandem bicycle?  That thought inspired Dr. Albert to pursue research into the benefits of cycling for Parkinson’s patients.

Brain scans of Dr. Albert’s patients show increased brain activity similar to that with treatment with the medication Levodopa. Importantly, exercise does not carry with it the side effects of medications that are a common complaint among Parkinson’s patients.

I am proud to teach cycling at a facility using this research. The YMCA Healthy Living Center in Clive, Iowa, is a unique quasi-medical facility jointly owned by the Des Moines Metro YMCA and Mercy Hospital. In addition to functioning as a community YMCA, the Healthy Living Center has a special mission to help people fight back from various disease conditions and reclaim their health.

More than a dozen programs exist at the Healthy Living Center for patients of cancer, heart disease, stroke, pain management, obesity, neuromuscular disease, and others. For example, neuro wellness classes at the Healthy Living Center are designed to help people with Parkinson’s disease or other neurological diseases where exercise is believed to help reduce symptoms.

New participants in the neuro wellness program are screened by a physical therapist who helps them develop an overall exercise plan.  That plan might include floor exercise, water exercise, or indoor cycling.  Special consideration is given to safety considerations such as fall and overexertion risks.

The design of a neuro cycling classes is similar to that of a traditional class. The largest difference is the emphasis on RPM. Although note, even here, we do not teach excessive rpm with inadequate resistance. Some components are also added to aide in fighting the specific symptoms of Parkinson’s. For instance, loud talk is encouraged, as are exaggerated facial expressions, big stretching motions, and activities that connect brain function to muscle activation.

Dr. Albert’s research suggests that cycling sessions should occur three times per week and last for 60 minutes. They should consist of a 10-minute warm up, 40 minutes of exercise and ten minutes of cool down.  The exercise portion of programs should be conducted at 80-90RPM and 60-85%MHR.

Intense hill efforts that sacrifice RPM are generally not included. Strength efforts are not ignored but they are considered less important than RPM for neurological benefit. Similarly, intense intervals efforts over 85% effort are not used.

At our YMCA, people without neurological disease are also welcome in class. Some may be spouses or care-givers, while others are regular gym-members. Our facility encourages this integration of groups and that integration creates a unique and gratifying culture.

As an indoor cycling instructor, it is exciting for me to be a part of this important work. These people fighting against neurological disease are as driven, determined and tenacious as any athlete I have ever met. They are an inspiration and it is an honor to work with them.

 

3 Responses to “A New Benefit of Indoor Cycling for People With Parkinson’s”

  1. Bill Roach says:

    Also, Mary, be sure to be on the lookout for signs of overexertion or other exercise-induced conditions.

  2. Mary Widdifield says:

    How can one get more information about designing a class beneficial for a person with Parkinson’s? I have a student who comes to my classes regularly and I would like to design classes that are most beneficial to him – or, for example, where the rest of the class is doing hard hills (and lower rpm) I could signal to him to stay at the higher pace.

    Thanks.
    Mary

    • Bill Roach says:

      Hi Mary. You might refer to the organization “Pedaling for Parkinson’s” for the best-researched information. Here are the basics as I understand them.
      1. Safety is paramount. First of all, be conscious of risk of falling, especially during any standing climb or stretching. Getting on or off the bike may also require assistance.
      2. Water and ventilation are even more important for Parkinson’s patients than for other exercisers.
      3. RPM is the “Gold Standard”. Most Parkinson’s patients want so pedal as slow as 40-60RPM, get them up to 80-90RPM. To get there, gears can stay a bit lower and emphasis on pedaling mechanics is important.
      4. Some Parkinson’s specific adaptations can be added but may not be practical in a class with only one Parkinson’s patients. They include combining mental and physical activity i.e. counting down my 7’s while riding; loud expression to counter the vocal volume lost with Parkinsons; and an emphasis on big stretching movements at appropriate times. These may not work if you only have one Parkinson’s patient in a class but they are things good for you to know.
      5. For more on Parkinson’s exercise in general, see the organization “Delay the Disease”, and it’s leader David Zid. They have various materials on the web.

      Please feel free to stay in communication with me if I can help further than these generalized thoughts.

      Bill Roach

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