Amazing

A 58-year-old man with a 10-year history of idiopathic 
Parkinson's disease presented with an incapacitating freezing 
of gait. However, the patient's ability to ride a bicycle was 
remarkably preserved.

My absolute favorite part of these videos is the jaunty jump 

off the bike at the end of his ride...as if he is 8 years old and 

ready for his next adventure.

I thought that I would digress from "the route" for a bit to 

present some of the research behind this phenomenon of exercise-provoked wellness.

*For my readers who might like to peruse the actual abstract, I have provided it below.

The rest of you....scroll for the upshot.

Effect of forced-exercise on motor symptoms and cortical 

activation in Parkinson’s disease

Anwar Ahmed, Angela L. Ridgel, Michael J. Phillips, Jerrold L. Vitek, 

Mark L. Lowe, Mark Hutson, Mary Feldman and Jay L. Alberts.

Cleveland Clinic Foundation, Cleveland, Ohio, USA

Background: It has been shown in the past that a long-term 

lower extremity forced-exercise (FE) intervention resulted in 

significant improvements in Parkinson’s disease (PD) symptoms 

in both upper and lower extremity motor function in mild to 

moderate PD. Interestingly, symptomatic motor improvement 

produced by FE is similar to that seen by standard levodopa 

(LD) therapy for PD. This suggests that the two interventions 

may produce similar changes in underlying motor pathway 

network function which translates into motor improvement. 

Previous studies have demonstrated increased functional MRI 

(fMRI) activation in the supplementary motor area (SMA) and 

M1 region in response to LD therapy. The present study utilized 

fMRI activation and Unified Parkinson’s disease motor scores 

(UPDRS-III) to study changes in the motor pathway in response 

to both FE and LD therapy in patients with PD.  We hypothesize 

that both treatment interventions will demonstrate similar 

changes in UPDRS-III score and fMRI activation. 

Methods: UPDRS-III and fMRI examinations were completed 

in 10 mild to moderate PD patients under three randomized 

conditions: no medication, on medication, and no medication 

with FE. (you may skip to the bottom now) The FE intervention consisted of one 40-minute session 

in which patients exercised on stationary tandem cycle with an able-bodied trainer maintaining rate of 80-90 revolutions per 

minute. Gradient echo EPI fMRI was performed on at 3T during 
performance of a bimanual finger tapping and force-tracking task 
utilizing a standard block design. 
Results: FE and LD therapy produced similar significant 
reductions in the UPDRS-III scores: 35% and 38%, respectively.  
fMRI data demonstrates increased activation in the SMA 
and M1 regions in response to both FE and LD therapy. Also 
during force-tracking task and bilateral finger tapping, motor 
performance was 35% better following forced-exercise compared 
to no exercise. 
Conclusion: FE and LD therapy produced a similar pattern of 
fMRI activation and therapeutic response. FE may facilitate central 
motor control processes in PD patients. These findings suggest that 
the same underlying mechanisms may provide symptomatic relief 
from PD symptoms with both LD therapy and FE.


The Upshot: the functional MRI of a patient off meds but 
doing regular forced exercise looks almost identical to the 
brain of a patient on medication. 

Bet there is no doubt any longer as to why I am 'doing this' again. 


tomorrow: The spot light is on Lake View Iowa.