RationaleIndividuals with Parkinson’s disease (PD) often have deficits in kinesthesia. There is a need for rehabilitation interventions that improve these kinesthetic deficits. Forced (tandem) cycling at a high cadence improves motor function. However, tandem cycling is difficult to implement in a rehabilitation setting.ObjectiveTo construct an instrumented, motored cycle and to examine if high cadence dynamic cycling promotes improvements in motor function.MethodThis motored cycle had two different modes: dynamic and static cycling. In dynamic mode, the motor maintained 75–85 rpm. In static mode, the rider determined the pedaling cadence. UPDRS Motor III and Timed Up and Go (TUG) were used to assess changes in motor function after three cycling sessions.ResultsIndividuals in the static group showed a lower cadence but a higher power, torque and heart rate than the dynamic group. UPDRS score showed a significant 13.9% improvement in the dynamic group and only a 0.9% improvement in the static group. There was also a 16.5% improvement in TUG time in the dynamic group but only an 8% improvement in the static group.ConclusionThese findings show that dynamic cycling can improve PD motor function and that activation of proprioceptors with a high cadence but variable pattern may be important for motor improvements in PD.

Outcome measure scores are strong predictors of discharge destination among patients with stroke and provide an objective means of early discharge planning. Discharge decisions should be made with consideration for patient-specific biopsychosocial factors that may supersede isolated results of the outcome measures, and further research needs to assess the success of the location that a patient is referred at discharge.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A194).

The purpose of this study was to (a) assess the feasibility of recruitment/retention of participants, protocol/resource management, and participant safety, and (b) estimate the size of the effect between the experimental and control groups. This was a feasibility study conducted as a prospective pilot double-blind randomized clinical trial. Subjects aged 10-23 years old with acute concussion and dizziness were enrolled from sports medicine centers. Forty-one participants were randomized into treatment and were seen for physical therapy beginning at 10 days post-concussion. Subjects in the experimental group received individually tailored, pragmatically delivered progressive interventions. Subjects in the control received prescriptive sham to minimally progressive interventions. The two primary outcomes were medical clearance for return-to-play and symptomatic recovery. The median number of days to medical clearance for the experimental group was 15.5 and for the control was 26. The median number of days to symptomatic recovery was 13.5 for the experimental group and was 17 for the control. According to Cox proportional hazards regression for time to medical release for return-to-play, the experimental group demonstrated a hazard ratio of 2.91 (95% CI: 1.01, 8.43) compared to the control. For time-to-symptomatic recovery, those in the experimental group demonstrated a hazard ratio of 1.99 (95% CI: 0.95, 4.15) compared to the control. The results indicate that it is feasible and safe to complete this type of intervention study. The results provide strong support for the allocation of resources to conduct well-powered randomized clinical trials of this intervention.