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Special Features

Parkinson's Place Iowa interviews Dr. Jay Alberts, Ph.D, Vice Chair of Innovations within the Neurological Institute, The Cleveland Clinic. He is also the neuroscientist who discovered that exercise improves symptoms for people with Parkinson's.

Parkinson's Place Iowa President Kristine Meldrum sat down with Dr. Jay Alberts, Ph.D., to talk about Parkinson's exercise and how necessary education about the "science behind Parkinson's exercise" is for everyone in the Parkinson's Care Team. She also asked Dr. Albert's about his innovative research, which will ultimately provide a prescription for each individual's exercise. In addition, his virtual reality research will be able to predict PD diagnosis much sooner than today's diagnosis process. (See Interview Outline Below)

During the interview, they will refer to Dr. Albert's 2009 landmark study titled Forced, Not Voluntary, Exercise Improves Motor Function, that was the first to proclaim exercise was good for people with Parkinson's. Previously people were told not to exercise which was the worst thing because inactivity actually accelerates the progression of PD disease. During the clinical trial, Dr. Alberts compared two cycling groups: one group riding a tandem bike at a "forced-paced" (pedaling at a higher intensity than they usually would by themselves) versus a group riding at a "voluntary-paced" (pedaling at their own pace). While both groups improved aerobically, the VE (voluntary effort exercise or low intensity) group did not improve the motor scores on the Unified Parkinson's Disease Rating Scale (UPDRS). However, the FE (forced effort exercise or high intensity) group improved 35% from baseline. This group also saw substantial improvements in overall motor function—balance, tremor, stiffness, and Bradykinesia. Also, the FE Group maintained those benefits four weeks after they stopped cycling.

 

The phrase "forced exercise" is a reference to the person on the front of the tandem bike forcing the pedals to spin at a rate of 80 revolutions per minute (rpm) or higher so that the cyclists riding in the back (those living with Parkinson's) also maintained that level of effort. It's important to note that the cyclist in the back was actively working at their highest capacity to spin their legs: they weren't just having their legs pushed for them—they received the benefit because they did the work. 

 

Over the years, Dr. Alberts's research continued to prove that the parameters for slowing the progression of disease and managing symptoms are the following:

  • Pedaling at a target cadence of 80 rpm or above

  • Riding three times per week

  • 30-45 minutes

  • 80-85% Max Heart Rate (6-8 Perceived Heart Rate)

If you have questions about the interview or Kristine's article, you can send them to kristinemeldrum@parkinsonsplaceiowa.org

Key Topics Covered in The Interview:

  1. Latest Update on Dr. Alberts Home Cycle Research Study

  2. Based on the extensive research by Dr. Alberts, we know the parameters for cycling to manage PD symptoms. For example, target 80 rpm in cycling before power or watts and 80 to 85 % MHR (Maximum heart rate). How does that translate to other forms of exercise platforms like boxing?

  3. Kris was speaking at Rock Steady Boxing's Coach Conference and wanted Dr. Alberts to say a word to the RSB coach's about why he thought it was also crucial for them to educate their Parkinson's students on the "science behind PD exercise."

  4. There is an exciting new treadmill clinical trial called SPARX3 with Lead Investigator Professor Daniel M. Corcos, Professor of Neuroscience at Northwestern University. The Cleveland Clinic and other Universities are part of the trial, and Dr. Alberts talks about how SPARX3 and his CYCLE protocol look at the research to customize exercise prescriptions for each PD patient.

  5. Dr. Alberts and Kristine discuss cycling dynamics and how symptoms respond to cadence and time in the saddle. However, everyone starts at a lower cadence and progresses over time. 

  6. Kristine asks Dr. Albert how long it takes for neuroplasticity to occur. 

  7. The question Kristine wants Dr. Alberts to answer. Which should a PWP choose? A Theracycle. Airdyne bike, or Indoor Cycle, to help improve Parkinson's symptoms?

  8. The question, "What question do you get asked the most when you give talks?" leads to another final one.

  9. Can you give us an update on your Virtual Reality research?

By Kris Meldrum, BA ACE GFI, Exercise Professional who works with Parkinsons People
 

Reviewed by Dr. Jay Alberts, Ph.D., The Cleveland Clinic

"There is a formulaic recommendation for how exercise may inspire reductions in Parkinson’s symptoms: relative symptom improvements of up to 35% (and potential slowing of symptom progressions) can be derived from cycling efforts at 80 rpm for 45 minutes at least three times a week. Similar intensities can be maintained through boxing, running, and walking at higher intensities."

REV WEB Kris and Jay 2022 APDA Conference PNG.png.JPG
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