Parkinson’s disease patients benefit from bicycling - a systematic review and meta-analysis

Abstract

Many Parkinson’s disease (PD) patients are able to ride a bicycle despite being severely compromised by gait disturbances up to freezing of gait. This review [PROSPERO CRD 42019137386] aimed to find out, which PD-related symptoms improve from bicycling, and which type of bicycling exercise would be most beneficial. Following a systematic database literature search, peer-reviewed studies with randomized control trials (RCT) and with non-randomized trials (NRCT) investigating the interventional effects of bicycling on PD patients were included. A quality analysis addressing reporting, design and possible bias of the studies, as well as a publication bias test was done. Out of 202 references, 22 eligible studies with 505 patients were analysed. An inverse variance-based analysis revealed that primary measures, defined as motor outcomes, benefitted from bicycling significantly more than cognitive measures. Additionally, secondary measures of balance, walking speed and capacity, and the PDQ-39 ratings improved with bicycling. The interventions varied in durations, intensities and target cadences. Conclusively, bicycling is particularly beneficial for the motor performance of PD patients, improving crucial features of gait. Furthermore, our findings suggest that bicycling improves the overall quality-of-life of PD patients.

Low physical activity is associated with two hypokinetic motor abnormalities in psychosis

“…Indeed, in idiopathic Parkinson’s disease physical exercise helps improving motor outcomes, i.e. reducing bradykinesia ( Tiihonen et al, 2021 ). Similarly, anecdotal reports in chronic catatonia suggest beneficial effects of physical exercise ( Heckers and Walther, 2021 ).…”

Physical exercise and its effects on people with Parkinson’s disease: Umbrella review

“…No high-quality systematic review evidenced benefit of non-motor outcomes by aerobic exercises ( Table 4 ). Even so, moderate quality studies found improvement in quality of life after performing aerobic exercise protocols [ 25 , 26 ]. Protocol registration prior to commencement of the review and adequate literature search were the critical domains that lowered rating of these studies.…”

Update on Parkinson’s Disease Rehabilitation

“…Since patients with PD have a decreased balance ability in the advanced stage, a bicycle is advantageous in that it can be applied more safely than a treadmill in patients with reduced balance ability. A meta-analysis including 505 PD patients in 2021 demonstrated that bicycling led to improvement in physical functionality, gait speed, balance, and QOL in patients with PD [ 9 ].…”