Tandem cycling benefits Parkinson’s patients, their care partners

A pilot study presented at AAN 2024 revealed that a tandem cycling programme may improve the overall health and wellbeing of individuals with Parkinson’s disease (PD) and their care partners.

“Our study found that a unique cycling programme that pairs PD patients with their care partners can improve the physical, emotional, and mental wellbeing of both cyclists to improve their quality of life (QoL),” stated Jennifer Trilk, PhD, from the University of South Carolina School of Medicine, Greenville, South Carolina, US, in a press release. [https://www.prnewswire.com/news-releases/tandem-cycling-linked-to-improved-health-for-those-with-parkinsons-care-partners-302076526.html]

The investigators recruited 10 dyads (10 PD patients and their care partners) to evaluate the feasibility, efficacy, therapeutic partnerships, and physical effects of a virtual reality tandem cycling programme. Participants completed a pre-intervention evaluation that includes a series of cognitive and behavioural questionnaires. Additionally, PD patients were given the Parkinson’s Disease Questionnaire (PDQ-39), and their physical functioning was assessed by using the Functional Gait Assessment (FGA) and 10-m Gait Speed. [AAN 2024, abstract P9.017]

Under the supervision of a certified cycling trainer, the dyads did tandem cycling 2 days a week at an indoor cycling studio. Cycling time and intensity were progressed over 8 weeks (from light- to high-intensity), with participants concluding the intervention for 60 minutes per session. A week after the end of the intervention, nine PD dyads and one PD patient (one dyad and one care partner were lost to follow-up) were again given the pretesting battery.

Geriatric Depression Scale – Short Form score dropped from 1 (pretesting) to 0 (postintervention) among PD patients with severe depression and was sustained (8 for both timepoints) among care partners under the ‘normal’ category. The numerical difference in the PD group did not yield a statistically significant difference, but the effect observed in the care partner group was deemed significant (p=0.02), the investigators noted.

In the Brief Resilience Scale, a score increase was observed between pre- and post-testing among low-resilience PD patients (from 0 to 1) and high-resilience care partners (from 2 to 3). “[An] increase in resilience represents a positive improvement post-intervention,” the researchers explained.

Trilk also noted individual improvements in overall resiliency among care partners, which may help reduce care partner burden. “Care partner burden can affect both individuals and cause emotional, physical, financial, and time restraints on their relationship.” [Neurology 2019;92:e2571-e2579]

In the PDQ-39, the PD group had a significant drop in the mobility dimension score (almost 14 points; p=0.02). “Lower scores indicate better QoL; therefore, a decrease in score suggests improvement [in mobility and overall physical function],” they noted.

The investigators added that despite the lack of statistical significance, there were trends for improvement in the other PDQ-39 dimensions such as stigma, social support, emotional wellbeing, communication, cognition, bodily discomfort, and activities of daily living (ADL) in PD patients. These improvements are also important, as symptoms of tremor, rigidity, akinesia, postural instability, and shuffling gait may affect ADL.

Furthermore, PD patients had significant improvements in physical function post-intervention, as reflected by the MDS-UPDRS-III* (–8 points; p<0.01), FGA (3.33 points; p<0.01), and 10-m Gait Speed test (average 0.27 m/s; p<0.01) measurements. Higher MDS-UPDRS-III scores denote greater disease burden, the investigators noted.

“Interestingly, PD patients and care partners had an increase in RMSSD** (p≤0.05). This represents an improved heart rate variability and more responsive autonomic nervous system compared to before the intervention,” the researchers highlighted.

“It is just as important that care partners also receive care, [which] is why we included them as the cycling partner. The goal of our small study was to determine if tandem cycling was beneficial. The next step will be to confirm the results with subsequent studies that would include more participants,” Trilk said.