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Dr. Alberts rides across Iowa with two of his children.
Dr. Alberts rides across Iowa with two of his children.

Could E-Bikes Help Parkinson's Patients?

It's been more than a decade since Iowa native, Jay Alberts made a serendipitous medical discovery. While riding in the annual RAGBRAI bike ride across the state of Iowa on a tandem bike, his 'stroker', a Parkinson's Disease suffer, experienced a dramatic improvement in her condition. Why is still a mystery.

Parkinson's is a progressively debilitative disease (PD). Gradually, suffers lose motor control of their limbs and experience uncontrollable tremors. An estimated one in 500 have the affliction. That's some 7 million people worldwide, and there is no known cure, though it's been found that dancing and music seems to temporarily alleviate symptoms.

That's what's so remarkable about neuroscientist Dr. Jay Alberts' serendipitous discovery in the summer of 2003 while riding tandem across Iowa for the annual RAGBRAI bike ride. A 1994 graduate of Iowa State University from Sanborn, Iowa who earned his doctorate from Arizona State University in 2000, he wanted to raise awareness of PD, especially in rural communities. He invited a 48-year-old female patient to ride tandem with him for the week-long ride from Council Bluffs on the western side of the state, ending on the banks of the Mississippi River. In preparation for the event, each practiced separately in the weeks prior to the ride, the PD patient using a stationary bicycle.

When the ride started that summer, Alberts rode the front seat as the "captain," while the unnamed patient sat on the back "stroker" seat. Because they had trained separately and Alberts was a more experienced cyclist, he pedaled at a rate of some 85 rotations per minute. The 'stroker' has used to pedaling a more modest 40 rotations per minute. Alberts was forcing her to pedal twice as fast as she was used to. This would prove an important distinction.

After two days on the road, both realized that her symptoms were subsiding. Where she could barely write her name at the start of the ride, as seen in the video below, she found her tremors had virtually disappeared.

Intrigued, Dr. Alberts returned to the Cleveland Clinic, where he conducts neurological research, and began investigating the phenomenon, concluding that what seems to make the difference in reducing the symptoms is the pace of pedaling: the faster, longer, and more vigorous the better. Alberts and his colleagues would publish their findings in Exercise and Sports Sciences Review in 2011. Their paper, entitled, "It Is Not About the Bike, It Is About the Pedaling," opens its abstract by stating:

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.
Here is an ABC News report from around this time that features Albert's work.

The ESSR paper also temptingly hints that forced exercise (FE) might also have "neurorestoration" effects for other neurological diseases, including stroke and Alzheimer disease, "as the 'side effects' of exercise include improved cardiovascular fitness and increased energy."

Since a forced exercise regime appears to be the key to stimulating these beneficial effects, this raises an interesting question: Could an electric-assist bicycle be engineered to simulate Dr. Albert's 70-85 rpm cycling rate?

As e-bikes are currently designed, especially European-models, the rider must pedal for the motor to engage and provide additional assistance. US models can have a throttle or a hybrid system allows the rider to switch between modes if desired. What if the motor and its gearing could be adapted to spin the pedals faster, while not necessarily increasing the speed of the bike above regulated limits (25 km/h in Europe, 20 mph in the USA)? Is this feasible and would it be practical?

Electric-assist bicycles are getting smarter with each passing year. Falco eMotors has more than a dozen sensors embedded in it already, allowing the rider to set its power output to match a desired heart rate. A Ford Motor Company prototype also offers this capability. Could their circuitry also be tuned to ensure intervals of FE? It's an interesting question to ask and maybe our friends at Falco, Ford, ZeHus or Superpedestrian might be willing to investigate it.

Here are some other links on this fascinating topic:

Posted By: Bill Moore [31-Dec-2015]

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