In the summer of 2003, Dr Jay Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute, took a bike ride that would change medical history. He rode a tandem bike in the week-long Des Moines Register’s Annual Great Bike Race (RAGBRAI). His partner on the bike was a woman affected with Parkinson’s Disease, a long-term degenerative illness afflicting the central nervous system.

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Symptoms of the disorder include shaking, rigidity, difficulty in walking as well as cerebral and behavioural problems and eventually dementia, and total incapacitation after perhaps 15 years. There is no cure. Treatment is generally carried out with medication that attempts to alleviate the symptoms and slow the progress of physical degeneration.

After riding a few days, Alberts noticed that his biking partner was showing signs of physical improvement, especially in her handwriting, which had become more legible and controlled.

“The tandem enabled us to engage in a type of exercise called forced-exercise,” Albert explained. “Forced-exercise essentially means assisting a person in exercising at a rate that is greater than their preferred, voluntary, exercise rate. In this case, the Parkinson’s patient could pedal at a rate of approximately 55 revolutions per minute (RPMs) when she was exercising by herself. When she rode tandem with me, our pedalling rate or cadence was 80-90 RPMs. Thus, I was ‘forcing’ her to pedal faster than she could by herself.”

In 2006, Alberts rode a tandem bike with another patient, also a doctor, who used a deep brain stimulation implant to control his Parkinson’s symptoms. As an experiment, the patient turned the device off for the ride.

“It was a 50-mile day and we rode that first 15 miles, and then we stopped and had a little break,” Alberts said. “And I’ll never forget what he said to me. He looked over and said, ‘Where did my tremor go?’ And I said, ‘I don’t know, but let’s get back on the bike and keep going.’”

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This led to a more controlled 8-week trial using tandem bikes in which Parkinson’s patients rode tandem three times a week for 40 minutes each. The result was a 35 % improvement in Parkinson’s symptoms.

The American road racer Davis Phinney, who won two stages of the Tour de France and the bronze medal in the team time trial event at the 1984 Summer Olympics, was diagnosed with Parkinson’s in 1999, at the age of 40. He started a foundation that bears his name in 2004 and that funds research, including that of Alberts, on the effects of exercise and cycling on the disease.

This and other research has corroborated the positive effects of intense cycling on improving the symptoms of Parkinson’s sufferers. As a result, cycling is being used increasingly in the treatment of Parkinson’s patients. For example, a group called Pedaling for Parkinson’s runs some 90 different classes at YMCAs across the US, and another group, Parkinson’s Cycling Coach, has trained more than 200 coaches across the US that lead classes in using bikes, either on the road or in a gym.

In addition, the motorized bike manufacturer TheraCycle now specializes in producing motorized bicycles for clients with degenerative neurological disorders such as Multiple Sclerosis and Parkinson’s.

Cycling – as well as physical exercise in general – can also reduce the risk of becoming afflicted with the illness, according to a study involving more than 500,000 individuals published in the JAMA Network Open. The authors of the study concluded that “physical activity, particularly moderate to vigorous physical activity, was associated with a significant reduction in Parkinson disease risk.”

The obvious question is: how does it work? According to researchers at the University of Southern California, exercise causes the brain to be ‘smarter’ in how it uses dopamine, a chemical responsible for transmitting signals between the nerve cells of the brain. The researchers found that the brain learns to use the dopamine in a more efficient way that happens to reduce Parkinson’s symptoms.

Not surprisingly, the researchers also found that it improves “overall wellness.” In other words, cycling is good for everyone.

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