Patients pushed hardest showed the most improvement.

PROBLEM: It's commonly known that Parkinson's Disease is a chronic, progressive, disease of central nervous system that affects motor ability -- its recognizable early stages are characterized by shakiness and difficulty walking. No cure exists, which is why back in 2003, the best Dr. Jay Alberts of the Cleveland Clinic Lerner Research Institute rode a tandem bicycle across Iowa with a Parkinson's patient (to raise awareness). Unexpectedly, the patient showed improvements in her condition after the trip. In what now much be common lore at the Institute, Alberts attempted to explain the inexplicable by noticing that his own pace was faster than that of his partner, who was forced, by the cruel mechanics of tandem cycling, to pedal faster in order to keep up. 

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METHODOLOGY: Alberts and his colleagues used functional connectivity MRI to study the brains of 26 patients with Parkinson's Disease before and after they engaged in an 8-week exercise program and then, as a follow-up, one month later. Three times a week, the patients worked out on stationary bicycles. The experimental group used a modified bike that, using an algorithm in the place of a super in-shape doctor, would measure their rate of exertion and use it as a basis to push them harder than they would otherwise choose.

RESULTS: What the researchers referred to as "forced rate activity," others might feel is more accurately labeled "torture." But when they calculated the brain activation of the patients forced to pedal past their comfort level, they found lasting increases in connectivity between two areas of the brain responsible for motor ability: the primary motor cortex and the posterior region of the thalamus.

CONCLUSION: Forced-rate bicycle exercise appears to be an effective therapy for Parkinson's disease. 

IMPLICATION: The treatment delivered dramatic results, and has the distinction of being inexpensive and accessible. Alberts contends that even those without access to their own algorithm for forced-rate activity may be able to see improvement by using an at-home stationary bike. The next step is to evaluate the possible effects of other forms of exercise, like swimming. 

The full study was presented at the annual meeting of the Radiological Society of North America.