Cycling in Parkinson's Disease

A Forced Cycling Exercise Program in Individuals With Parkinson's Disease: Can it Improve Gait Parameters?

The purpose of this study is to assess the effectiveness of a forced exercise aerobic exercise program, utilizing a cycling activity, on specific gait parameters and balance in individuals with Parkinson's Disease (PD). Design: pilot, feasibility, randomized control, evaluator blinded. Subjects: Twenty four patients with idiopathic PD Hoehn and Yahr (H&Y) stage II or III. Intervention: Participants randomly assigned to one of two exercise groups, forced exercise or self selected exercise, on cycling machine three times a week for 8 weeks. Both groups to exercise at same aerobic intensity level to keep heart rate at 60-80% heart rate max. Outcomes: Gait parameters of step length, width, and variability as measured by the GAITRite; 6 Minute Walk Test; mini-BESTest (balance testing); exercise tolerance via Patient Reported Outcomes Measurement Information System (PROMIS) scale.

Inclusion Criteria:

• Idiopathic Parkinson's Disease
• Hoehn and Yahr Stages II - III.
• Ages 30-80 years
• Medical Clearance
• Ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

• MOCA: (Montreal Cognition Scale) : rating of less than 24, indicative of cognitive dysfunction
• Changes in Parkinson's medications within the two weeks prior to starting the study
• Anticipated change in Parkinson Disease medications during the course of the study
• Uncontrolled orthostasis
• Symptomatic coronary artery disease
• Fracture of lower limb within 6 months prior to study onset or significant lower limb orthopedic diagnosis that would limit cycling
• Other significant neurologic diagnoses including multiple sclerosis or vestibular disease
• Acute illness
• Physical therapy within the month prior to study entry
• Subjects already participating in a forced exercise or high intensity exercise program
• Any medical condition that the physician investigator determined would compromise safety.