Here are some articles I got from Google. I'd love to receive reactions to these studies, especially since the studies have encouraged me to try to pedal as fast as I can on my exercise bike.
1. Exercise Rate Related to Improvements in Parkinson’s Disease
CHICAGO—People with Parkinson's disease benefit from exercise programs on stationary bicycles, with the greatest effect for those who pedal faster, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). Functional connectivity magnetic resonance imaging (fcMRI) data showed that faster pedaling led to greater connectivity in brain areas associated with motor ability.
2. Forced stationary bicycle pedaling therapy at a high steady cadence (RPM) has recently been shown to significantly reduce the symptoms of Parkinson's disease (PD). Dr. Jay Alberts, a researcher at the Cleveland Clinic, in a paper presented in Paris, June 15, 2009, reported that Parkinsons disease patients, who were forced to pedal at a high steady rate (80-90 RPM) showed a 35% improvement in motor function.
3. It Is Not About the Bike, It Is About the Pedaling
Forced Exercise and Parkinson's Disease
Forced exercise has resulted in neuroprotective effects and improved motor function in animal studies. These promising results have not yet been translated fully to humans with Parkinson's disease (PD), as traditional exercise interventions have not yielded global improvements in function. A novel forced exercise intervention is described that has resulted in improved motor function and central nervous system function in PD patients.
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Joanne_Joyce
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I have PD with dystonia of the feet. My MDS has been pushing me to pedaling a bike. I first used a power pedalling unit that has no seat or handlebars. It will pedal for you or you pedal it. I used that for two years, keeping my muscles toned. Then 4 months ago , I bought a tricycle, since I loose my balance. frequently. I becan and could not go a half of a mile now I ride nearly 5 miles each day. I am slow but I am doing it. It makes me feel more upbeat. I seem to move a little faster too. Over all it is working better for my body and mind. I am quiter happy about where I am today compaired to where I was before I got my tricycle.
Dear Margie, your post is so positive and motivating. Thank you! I am currently working on an article for the PD community about the increasing evidence about benefits of cycling and wanted to ask whether you would mind your post being integrated as a motivational anecdote. looking forward to your reply, Maxi
It's called post-exercise ketosis. The liver starts producing ketones during vigorous exercise to compensate for the loss of glucose during extended vigorous exercise. The liver keeps on producing ketones even after exercise. Ketones are what are making your symptoms vanish because they can cross the blood-brain barrier into the brain and restoes vitality to the damaged brain cells. Unfortunately ketone levels fall with ingestion of carbohydrate with most people. The best way to have permanent elevated ketone levels in the body is to go on a low-carb diet which causes one to enter a state of nutritional ketosis. Some people have success producing ketones by simply ingesting coconut oil, But if they are insulin resistant too much insulin is produced which drives serum ketones down again.
Unfortunately most modern exercise researchers have forgotten about exercise ketosis and don't monitor for ketone levels in the blood, but it was widely studied in the 1930's & 40's.
i think it's more than ketones, the jay alberts study reported the benefit lasted for weeks after the forced exercise stopped as have other exercise studies, some weren't forced exercise. they hypothesize it's the synthesis of BDNF and other proteins that influence neuron survival.
maybe ketones help but the level of forced exercise in these studies isn't tremendous, i've been in one and i was never that exhausted and because i was already in pretty good shape noticed very little benefit. tai chi and the tango have shown a benefit.
It does not take much exercise to produce ketones but the more you do the more pronounced the effect. I do a ~ 1 hour walk (5 km) at moderate to brisk pace and my hand tremor stops.for 1/2 -1 hour after exercise. Of course I was always on coconut oil therapy or low carb diet so my baseline ketone levels were elevated to begin with.
I refer you to the following article "Post-exercise ketosis and the hormone response to exercise: a review" (1982) by JH Koeslag
how do you explain the sustained affect after the trial ended? were're both speculating here, aren't we? couldn't this issue be resolved by just administering ketones to pd'ers and see what their affect is or is this not possible?
in reflection, after i was diagnosed in late 2011, i played and coached soccer until 2005, it WAS like a drug, after a vigorous game my symptoms were much diminished and i jogged on off days. now after 12 years i don't feel much better after vigorous exercise and i can still run/jog/hike/ride a bike all day which i attribute to a reduced number of functional neurons.
Indeed the ketone issue could be addressed directly, after addressing the carbohydrate connection, and my challenge to the scientific community involved with neurological disease is why isn't it being addressed.
The presence of modest amounts (100 g daily) carbohydrate can really play havoc with serum ketone levels. The best test would be to put people on a low carb diet and let nutritional ketosis take over. Phinney advised me that it could take up to 6 weeks for ketone levels to rise above 0.5mM, where they start to be of use to the brain. You would have to simulate headaches, constipation etc being part of the keto-adaptation process. I think this would be a very financially demanding trial to design as double-blinded with placebo.
You may find this video of interest on ketones and physical performance on a bicycle in a ketogenic state. Peter Attia is an avid performance cyclist and the effect of physical exercise on serum ketones was simply amazing. The potential for treatment of neurological diseases with nutritional ketosis and exercise was briefly touched on near the end of the video.
How interesting! A 35% improvement in motor function is really good and the extension of benefit by including coconut oil and eating low carb sounds like it's well worth a go.
Aloha im 44, ive had pd over 12 years, I race bmx bikes. I dont win many races anymore, but it keeps me young at heart, keeps depression (from not being able to work ) away. riding a bike has done wonders for me health wise. I dont pedal slow for long periods, I pedal super fast for short periods. Exercise bikes dont do as well as going out and riding. I have to be careful with my jjmping. Im trying to show people with pd that having goals, a good attitude and exercise can do great things. Watch the low carb thing, because most of us have to consume little protein, I say live healthy, consume what your body needs but no excess. I also weight train, surf. Be careful with ketones if they are to high youll also loose muscle. This is extodinary results for someone who pre dbs was stuck in bed alot.
"The Art & Science of Low Carbohydrate Living" written by peer reviewed scientists Phinney & Voleck use the most current science to support their recommendations. They recttommend 1.5 to 2.5 g protein per day per kg of body weight. I'm cons.uming about 120 g per day on their diet plan and weigh 200 lbs.
I believe your reference to protein is in regards to PWP who are on high doses of Levodopa who need every fraction of medicine they can get. My neurologist told me that can be addressed by timing of meds before eating protein. However, your cautionary note is valid and anyone using high dosages of Levodopa should discuss with their neurologist.
Furthermore, if you have any concerns to your general health you should discuss with your family doctor before proceeding. As Phinney says "you are swimming in shark infested waters and need a GPS, which is a good understanding of the book". I would also add that this book was written for fat people trying to get thin, not PWP pursuing nutritional ketosis. It will not be suitable for everyone.
We are going to be the fittest PD's in the world, if we get going on all the suggestions. I've started the low carbohydrates food option - got the coconut oil - next exercise. I have been thinking about an indoor exercise bike as I'm wobbly on my legs at the present time. Thanks every one for their imput. All best wishes Helen
Hi again - I missed mikaele's remark about 'Be careful with ketones if they are to high youll also loose muscle.' So the more we learn - the more we have to be able to make well advised decisions as to what will work for us. Helen
This is not true and I note that the author has now withdrawn the comment. Reference p 38 "The Art & Science of Low Carbohydrate Living". Nutritional ketosis is run by your body and is self regulating. Ketones do not get too high. I think you'll be very impressed by the book, it's been in the works for 30 years by the authors. All the detail you can imagine about the diet is covered very extensively.
I am speaking from my experience with over 10 years with this disease. My improving health, yes I time my protein intake after my meds, yes I exercise daily, I went from a wheelchair to placing 6 th in bmx us nationals in 1 year. I had balance problems, falling breaking bones to being near normal, with a healthy balanced life, determination, I lost my marriage of 20 years, my family, almost my life (severe depression from loosing career as a fiirefighter/ paramedic, family, wife, and hung myself), to being a competive athlete again (recently in us nationals bmx race came in 6th in my class), have a gf now. I am trying to show, not just talk, about what we as people with pd can do, no excuses, balance of diet, meds, lifestyle. All in moderation. Im not getting anything from a book, its all my experience. Im dont post on here much because im walking it first. You cant argue witb results, its just how bad do you want it. Im not putting anyone down , just trying to motivate and give hope. I believe the miracle cure is within each of us. Just my opinion/ belief.
I have been working with Dr. Jay Alberts from the Cleveland clinic since early in 2009. I learned about his cycling regimen and pedaling for Parkinson's and was asked to join him in riding across Iowa first in 2009, and 2010 and 2012. I was diagnosed in early 2008 and was in pretty sad shape when I ran across the information about Dr. Alberts' cycling study. Although his protocol called for riding 80-90 RPM for one hour a day three days a week, I went a little overboard and rode that RPM 4-6 days a week for anywhere from an hour and a half to four hours. Within a month my PD symptoms essentially disappeared, so much so that my doctor told me that if he did not know I had Parkinson's, he would Not diagnose it. I missed the Iowa trip in 2011 because I was climbing Mount Kilimanjaro. In 2012 I climbed to Annapurna base Camp in Nepal and in 2013, at age 67, I climbed to the Inca Trail to Machu Picchu in Peru. Because I fell on my bike and broke my finger, I have been cycling inside an hour a day for five days a week, maintaining the 90 RPM for over half an hour and cycling at 80 to 90 the rest of the time.
When I began cycling in 2009, I was taking 8 mg of Requip XL per day. Over the course of a year I was able to reduce my medication to 4 mg. I have since switched to Neupro, first at 4 mg and only recently raising the level of dosage to 6 mg. Although I have some tremor and a problem with rigidity in my right shoulder, I have very few Parkinson's symptoms.
I am working with Dr. Alberts, Pedaling for Parkinson's, and the YMCA to help establish Pedaling for Parkinson's programs across the United States. There is an extensive thread on Pedaling for Parkinson's at neurotalk.psychcentral.com/...
Dr. Rossi and Dr. DiRocco of NYU gave a presentation on Monday and the bottom line is exercise is the only proven neuroprotector for PD. Use it or lose it.
Perhaps the next question is why or how. From personal experience I have walked 5 km briskly (40-50 minutes) for many years and PD was taking me down so I could no longer walk. The only thing that saved me was coconut oil (ketone therapy).
Keytones will not be counted out for treating PD, and I'm sure we can both drag out dozens of "experts" to support our different points of view:
Nutr Rev. 2003 Oct;61(10):327-41.
Ketones: metabolism's ugly duckling.
VanItallie TB, Nufert TH.
Source
Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, St. Luke's-Roosevelt Hospital Center in New York City, 10025, USA.
Abstract
Ketones were first discovered in the urine of diabetic patients in the mid-19th century; for almost 50 years thereafter, they were thought to be abnormal and undesirable by-products of incomplete fat oxidation. In the early 20th century, however, they were recognized as normal circulating metabolites produced by liver and readily utilized by extrahepatic tissues. In the 1920s, a drastic "hyperketogenic" diet was found remarkably effective for treatment of drug-resistant epilepsy in children. In 1967, circulating ketones were discovered to replace glucose as the brain's major fuel during the marked hyperketonemia of prolonged fasting. Until then, the adult human brain was thought to be entirely dependent upon glucose. During the 1990s, diet-induced hyperketonemia was found therapeutically effective for treatment of several rare genetic disorders involving impaired neuronal utilization of glucose or its metabolic products. Finally, growing evidence suggests that mitochondrial dysfunction and reduced bioenergetic efficiency occur in brains of patients with Parkinson's disease (PD) and Alzheimer's disease (AD). Because ketones are efficiently used by mitochondria for ATP generation and may also help protect vulnerable neurons from free radical damage, hyperketogenic diets should be evaluated for ability to benefit patients with PD, AD, and certain other neurodegenerative disorders.
and a more recent paper:
The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders
Carl E. Stafstrom1,2 and Jong M. Rho3,4,*
Front Pharmacol. 2012; 3: 59.
Abstract
Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat - or at least ameliorate symptoms of - these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more "natural" treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD) used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component.
must every (or nearly every) post here turn into a discussion of coconut oil. I'm about to turn to another online resource. Okay, gripe over, look at this short video on theracycle. youtube.com/watch?v=9fLPpKu...
Hi Joanne_Joyce. You are wrong! There have been studies done on people with Pd. They were announced at the 1st World Parkinson's Congress held in Washington DC in 2006. Why have most of us not heard about it?
Thanks John. I checked out your link and downloaded a research article with an impressive 119 references. I'm lookng forward to reading it (when I'm not too busy exercising.)
. Have you watched this lecture on YouTube:?: Exercise and Parkinson's Disease - YouTube
I have just watched this excellent video and concur fully with what Dr Byl said. I have been doing many of these things for the past 20 years. I have learned a lot from what she said and will try and put it all into practice.
I was in Dr. Alberts study in Cleveland. You can force yourself to pedal (or walk, run, swim, etc) much faster, and for much longer than you usually would, and it forces your brain to produce more dopamine. Ask your dr for a reasonable target heart rate, and work up to it. We pedaled for 40 minutes, 3 x/ week. "Forced" or not doesn't matter; I drew the "self-paced" card, but I wasn't about to lose out: I asked how fast the automated--"forced"--bikes were going and forced myself to go that fast (which Dr. Alberts said was probably best). It works.
I wonder how long the benefit lasts for the forced pedaling ride? I have been keeping a record of my exercises each day and seeing how it relates to my "on" and "off" times. So far I notice that doing exercise prevents me from going into "off" times while I am exercising. The exercise with music I did today staved off my need to take a pill for only 20 minutes. I wonder how the forced pedaling calculates the benefit of 35% ? of moving your legs? If I didn't bike at all I might be 35% less able to move if nothing replaced the biking.
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