Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease

Stuckenschneider, Tim; Helmich, Ingo; Raabe-Oetker, A.; Froböse, Ingo; Feodoroff, Boris

doi:10.1016/j.gaitpost.2015.08.001

Cited by 14 publications

(38 citation statements)

References 24 publications

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“…In addition to upper-body motor function improvements, six sessions of high-cadence cycling also improved gait and mobility. These findings are consistent with other work that has shown increased gait velocity after high-cadence cycling [30, 31] as well as improvements in the TUG test [13]. The minimal detectable change (MDC) for the TUG test in individuals with Parkinson's disease is 3.5 s [32].…”

Section: Discussionsupporting

confidence: 90%

High-Cadence Cycling Promotes Sustained Improvement in Bradykinesia, Rigidity, and Mobility in Individuals with Mild-Moderate Parkinson’s Disease

Ridgel

Ault

2019

Parkinson's Disease

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Introduction. Exercise has been shown to be an important adjunct therapy to medication in Parkinson’s disease (PD). However, the optimal type, frequency, and intensity of exercise or physiotherapy are still being debated. An important part of understanding the optimal frequency is to examine how acute bouts of exercise affect motor function and mobility in this population. The purpose of this study is to assess if six bouts of high-cadence cycling improves motor function and mobility in individuals with PD. Methods. Sixteen subjects with mild-moderate idiopathic PD were randomized into either a high-cadence cycling or a control (stretching) group. High-cadence cycling was completed on a custom motorized recumbent bicycle at a high cadence between 75 and 85 rpm. Cycling and stretching sessions were separated by 1 day of rest and took place over a 15-day period. Motor function and mobility were assessed after every cycling/stretching bout using the UPDRS Motor III scale, Kinesia ONE, and Timed up and Go (TUG). Results. Six bouts of high-cadence cycling improved UPDRS scores (2.5 pts, P=0.002), hand movement amplitude (P=0.013), rapid alternating hand movement speed (P=0.003), gait (P=0.012), and TUG time (1.17 s, P=0.002) from baseline testing to end of treatment. The control group showed no improvements. Conclusions. These findings suggest that they are both acute and sustained improvements in motor function and mobility after high-cadence cycling. Future research should examine how exercise type, frequency, and intensity can be optimized for each individual.

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Section: Discussionsupporting

confidence: 90%

High-Cadence Cycling Promotes Sustained Improvement in Bradykinesia, Rigidity, and Mobility in Individuals with Mild-Moderate Parkinson’s Disease

Ridgel

Ault

2019

Parkinson's Disease

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“…These improvements are consistent with the results of previous studies ( Alberts et al, 2011 ; Alberts et al, 2016 ; Ridgel et al, 2009 ; Stuckenschneider et al, 2015 ), where a rhythmic movement of the lower limb led to an improvement in UPDRS score. The lack of improvement in participants’ lower limb and global scores in the current experiment might be explained by the difference in the protocols between those previous studies and the current one: The previous studies had participants cycle on a bicycle, which involves the whole body, over multiple sessions, whereas in the current study, participants moved a single arm at a time, during a single session.…”

Section: Discussionsupporting

confidence: 93%

“…A variety of pharmacological ( Goetz & Pal, 2014 ) and behavioral (e.g., Carpinella et al, 2017 ; Herman et al, 2007 ; Millage et al, 2017 ; Vergara-Diaz et al, 2017 ) approaches have been developed to mitigate its symptoms. Among the latter is an approach termed “Forced Exercise” ( Alberts et al, 2011 ; Ridgel et al, 2009 ; Stuckenschneider et al, 2015 ). In Forced Exercise, the participants perform exercise (specifically, cycling ( Ridgel et al, 2009 ; Stuckenschneider et al, 2015 )) at a rate that is greater than their preferred voluntary rate of exercise.…”

Section: Introductionmentioning

confidence: 99%

“…Among the latter is an approach termed “Forced Exercise” ( Alberts et al, 2011 ; Ridgel et al, 2009 ; Stuckenschneider et al, 2015 ). In Forced Exercise, the participants perform exercise (specifically, cycling ( Ridgel et al, 2009 ; Stuckenschneider et al, 2015 )) at a rate that is greater than their preferred voluntary rate of exercise. It has been demonstrated to lead to a global improvement in PD symptoms ( Alberts et al, 2011 ; Ridgel et al, 2009 ; Stuckenschneider et al, 2015 ), and has been suggested to alter brain activation patterns in patients with PD ( Alberts et al, 2016 ; Hirsch et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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Improvement in upper-limb UPDRS motor scores following fast-paced arm exercise: A pilot study

Levy-Tzedek

Arbelle

Forman

et al. 2018

RNN

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Background:The symptoms of patients with Parkinson’s disease (PD) have been shown to improve when they perform fast-paced rhythmic cycling movements with their lower limbs.Objective:Our goal in this pilot experiment was to test the feasibility and the benefits of a short exercise program involving fast-paced rhythmic movements of the upper limb for patients with PD.Methods:We used an experimental procedure that elicits large, fast-paced movements by the participants without the direct instructions to do so by the experimenter. Ten participants with PD (71.0±6.5 years old) performed a 50-min fast-paced rhythmic exercise of the upper limb after withdrawal from PD medication for at least 12 hours.Results:Participants improved their kinematic performance, in terms of accuracy and combined speed and amplitude (p < 0.02), as well as their upper-limb MDS-UPDRS motor scores (p = 0.023).Conclusions:The results demonstrate the feasibility of using the described apparatus to perform an exercise session of approximately 50 min with both arms, and give a preliminary indication of the potential benefit of such an exercise program.

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“…13 Forced exercise (FE) is a form of high intensity exercise where an individual is forced to maintain a higher than preferred cadence, either passively or actively assisted. 14 Animal studies have shown that high intensity exercise can enhance neuroplasticity and reduce the rate of dopaminergic cell loss, as well as improving motor function. 13,15,16 There are a number of modes of exercise that are employed to encourage high intensity exercise in those with neurological conditions.…”

Section: Introductionmentioning

confidence: 99%

Does assisted cycling improve function in those with Parkinson’s disease?

Evens

Clark

2017

Physical Therapy Reviews

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Background: Functional decline is a cardinal sign of Parkinson's disease (PD), a neurodegenerative disease that affects 1% of individuals over the age of 60.Physical symptoms have a detrimental effect on activities of daily living and quality of life. High intensity exercise has enhanced neuroplasticity and reduced the rate of dopaminergic cell loss in animal studies. One form of high intensity exercise is assisted cycling, which has been shown to be effective for those with other neurological disorders. There is no consensus as to the efficacy in those with PD.Objective: To explore the efficacy of assisted cycling in improving motor function in people with PD. . Studies were assessed for quality using a critical appraisal tool. No articles were excluded due to quality.Results: Seven studies were included in this review, with a total sample of 179 participants with a diagnosis of PD. Four studies were randomised control trials, the others included two case control trials, and a single-subject design trial. The level of cycle assistance, length of intervention and sessions varied between studies. All interventions showed improvements in motor function, with a greater effect on those with more advanced PD. Conclusion:There is moderate evidence to show the efficacy of assisted cycling in improving global motor function in individuals with PD. Future research is required to determine optimum assisted cycling interventions in terms of frequency, duration of 2 sessions and length. The long-term effects of assisted cycling should also be explored in future research.

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Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease

Cited by 14 publications

References 24 publications

High-Cadence Cycling Promotes Sustained Improvement in Bradykinesia, Rigidity, and Mobility in Individuals with Mild-Moderate Parkinson’s Disease

High-Cadence Cycling Promotes Sustained Improvement in Bradykinesia, Rigidity, and Mobility in Individuals with Mild-Moderate Parkinson’s Disease

Improvement in upper-limb UPDRS motor scores following fast-paced arm exercise: A pilot study

Does assisted cycling improve function in those with Parkinson’s disease?

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