Forced exercise helpful to people with Parkinson’s

well.blogs.nytimes.com

Thursday, October 13, 2011
By GRETCHEN REYNOLDS

Scientific discoveries can be serendipitous, and so it was when Jay L. Alberts, then a Parkinson’s disease researcher at Emory University in Atlanta, mounted a tandem bike with Cathy Frazier, a Parkinson’s patient. The two were riding the 2003 RAGBRAI bicycle tour across Iowa, hoping to raise awareness of the neurodegenerative disease and “show people with Parkinson’s that you don’t have to sit back and let the disease take over your life,” Dr. Alberts said.

But something unexpected happened after the first day’s riding. One of Ms. Frazier’s symptoms was micrographia, a condition in which her handwriting, legible at first, would quickly become smaller, more spidery and unreadable as she continued to write. After a day of pedaling, though, she signed a birthday card with no difficulty, her signature “beautifully written,” Dr. Alberts said. She also told him that she felt as if she didn’t have Parkinson’s.

Impressed, Dr. Alberts, who now holds an endowed research chair at the Cleveland Clinic in Ohio, embarked on a series of experiments in which he had people with Parkinson’s disease ride tandem bicycles. The preliminary results are raising fascinating questions not only about whether exercise can help to combat the disease but also — and of broader import — whether intense, essentially forced workouts affect brains differently than gentler activity does, even in those of us who are healthy.

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After eight weeks of hourlong sessions of forced riding, most of the patients in Dr. Alberts’s study showed significant lessening of tremors and better body control, improvements that lingered for up to four weeks after they stopped riding.

These findings are exciting, Dr. Alberts says, because they contrast with some earlier results involving voluntary exercise and Parkinson’s patients. In those experiments, the activity was helpful, but often in a limited, localized way. Weight training, for instance, led to stronger muscles, and slow walking increased walking speed and endurance. But such regimens typically did not improve Parkinson’s patients’ overall motor control. “They didn’t help people tie their shoes,” Dr. Alberts says.

The forced pedaling regimen, on the other hand, did lead to better full-body movement control, prompting Dr. Alberts to conclude that the exercise must be affecting the riders’ brains, as well as their muscles, a theory that was substantiated when he used functional M.R.I. machines to see inside his volunteers’ skulls. The scans showed that, compared with Parkinson’s patients who hadn’t ridden, the tandem cyclists’ brains were more active.

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“There is data showing that people who exercise intensely have less risk” of developing Parkinson’s and other neurological diseases
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