Cycling for Freezing Gait in Parkinson's Disease | NEJM
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- เผยแพร่เมื่อ 20 ส.ค. 2024
- A 58-year-old man with a 10-year history of idiopathic Parkinson's disease presented with an incapacitating freezing of gait. However, the patient's ability to ride a bicycle was remarkably preserved. (In Video 2, the patient is not wearing a safety helmet because in the Netherlands, wearing a safety helmet is neither required by law nor customary.) bit.ly/c4BQ2f
Wow man, that must be such an amazing sense of freedom
It is... I love riding my bike
When your city has Dutch level of bicycle infrastructure, even able people feel it.
In High School, my TV Prods class had a substitute teacher - and little did I know he had parkinsons. He started to walk across the room, and then out of nowhere he started busting out doing a little Irish jig (like the man 'skipping' in the video).... or so I thought, and I bust out laughing. He explained himself and to this day I still cringe from the feeling I had. It did, however, make me more compassionate and understanding of different people.
Thank you for sharing that ❤
Riding without a helmet as a Parkinsons patient, what a champ! You make us Dutch proud. We'll never succumb to wearing helmets.
That's just like me, I can barely walk with Parkinsons but I can cycle for miles absolutely fine.
wow, that's quite the nuanced phenomenon
@ 1:17 super human strength old lady pushes car out of the way for her friend to ride by.
Comments like these are gold
Cycling has been the best therapy for my wife.
My doc showed me this as I was saying I tried to ride a bike and felt normal even though I can barely walk outside properly due to dizziness and wobblyness. I have a mild brain injury, I was baffled I thought surely I would be unable to ride a bike or a hazard but I was ok.
the world's best transport, shame that many do not realize it!!!!!
That is indeed amazing, its weird how the brain can sometimes function in some fuctions and just really shut down in other
Emocionante! Torço que a bicicleta nos ajude a encontrar um tratamento e a cura pra essa e outras doenças! :) Bike save us!
Astounding. Especially the jaunty wee dismount.
I'll tell you what though, if he hadn't been able to ride the bike it would've been pretty ugly. Talk about sink or swim.
Why ugly? We know that pedestrians suffer far more head injuries than people on bikes that don't wear helmets. Would you suggest pedestrians walk with helmets or not try to walk at all?
Life is full of risk, not taking any risk would kill the human race in a very short space of time.
Nice dismount
I think that's why my prof advised us against using our foot as a visual cue.
We're just now talking about this man in Cervical Differential seminar.
I believe this has a lot to do with balance....Not just exercise!!!
Nope, something about riding the bike gives us PD patients a freedom we don't normally feel
Excellent -very motivational!!!
Good job!
How on earth can he ride a bike but not walk?
The simple answer is this. When both feet are together and you want to start walking, there are no sensory cues for what the next muscle movement needs to be. The brain just has to know the pattern and be able to convert that to a movement. Parkinson's affects the ability to initiate this movement. When peddling, the pedals themselves create pressure on the feet that gives an idea of how muscles should move next - part of this is thought to happen in the spinal cord, unaffected by Parkinson's disease. This is also why when he was forced to step over the clinician's foot (at 0:24), he could start walking much more easily (albeit when this was tried again at 0:29 he lost his balance).
Likely because the issue is that there is something in the brain that is over activated(neural transmitter or neuron issues). When more coordination and other parts of the brain are required and do not have these issues then it can all work out. Basically a different area of the brain(or less effected) is in play when riding. It may be that if there is a NT that is causing over excitation that when more of the body is in use it reduces the NT's local effect allowing for more control.
One would think modern medicine would pretty much know what was going on by now but there is $$$ to be made and golf courses to be played on so...
@ NEJMvideo is this cycling therapy works real for parkinson person and how much duration a person has to cycle in a day
My father in law is suffering from parkinson from past 8 years his movement is restricted...
he has diabetes from past 20 years but in control and also Blood pressure from past 20 years in control and 2 years before he had a slip disc operation done...
@@nagarathna I dont think the cycling is a form of therapy. Parkinsons patient cant control their movements properly, but when they have another force controlling or aiding their movement for some reason they stop twitching and jittering. Here the force aiding the patients movement is the bike pedals. I'm a bit sketchy on the details and mind you im just a highschool student but i participate in events such as brain bee where i learned something similar to this. To understand the disease you should research it.
Like i said I dont exactly remember the facts, but notice how the nurse aiding the man while he was walking kept on putting her foot in front of him? She wasn't showing him how to walk or take a step, she was trying to get his brain to interpret her foot as an obstacle in an attempt to get the man to stop jittering and take a step. I think that parkinsons doesnt allow for regular movement but only allows reactional movement or something like that.
"You missed the point here. The point is not that biking will cure his Parkinson's. The point is that discrete acts (like taking the first step in walking) and continuous acts (like the cyclic nature of cycling) rely on different networks in the brain. Whereas discrete actions mostly involve the basal ganglia (the part that is disrupted in PD), more cyclical actions rely on the cerebellum, which is typically not really affected in PD." This is another comment from Robrecht van der Wel on another comment down below explaining that the "bike riding therapy" isnt really therapy but more showing that certain actions are processed in different parts of the brain. Parkinson's attacks the basal ganglia which processes "discrete" acts which is why when not in continous motion the patient is jittering. i assume discrete acts include anything from moving a hand to to getting up walking and even staying still. Meanwhile Continous motion is processed in another area of the brain usually unaffected by the parkinson's disease which is why the patient can ride a bike without much complication. Sadly that therapy wont help or provide a cure for parkinson's at least i dont think so.
Planet Ayurveda's Parkinsonism medicine has been a lifesaver for me. It's a holistic approach that focuses on overall well-being, not just symptom management.
Blessings!
Amazing.
Amazing...
fascinating!
amazing! but not as amazing as the lady pushing the car out of the way @1:16
we only see what they let us see. who knows what other miracles they are trying to keep hidden?
The Elderly and Infirm are basically super heroes anyway. ;)
I start to walk when I hear the funk of James Brown or Cameo
That’s amazing 💖
I see a lot of dutch people almost take pride in having the custom of not wearing a helmet.....Why?
+FireWaia in short it's because - despite what people say - helmets don't reduce risk by very much, if at all: so it's a statement about where the risk lies in cycling - which is with car drivers, and how safety can be improved - which is by more cyclists, and better infrastructure.
+FireWaia It's not to show off what a bunch of badasses we are. We don't wear helmets because cycling is just a safe, normal activity for us. Everybody learns it at a very young age, everybody does it (even our queen and king and prime minister), we have great infrastructure and all motorists are used to having cyclists around. Cycling s just a normal thing to do, not something you have to dress up for.
I live in sweden, it's the same here, but we get taught that however safe it is, a helmet saves lives when the accident actually happens.
The critical thing is the speed of the cars around them. In the Netherlands where cars and bicycles share road space the cars slow down to almost a walking pace as they pass them and always give way -so the chance of a bump is reduced. Cars drive at normal speed when there is a dedicated cycle lane.
Every A&E doctor will tell you that most people who are killed or get seriously hurt in car accidents (car, not bike!) die and suffer because of head injuries. Heads hitting windscreens, dashboards, side windows, other car occupant's heads etc etc. So basically a lot of death and injury could be prevented if people had to wear helmets inside cars. And yet they don't, why?
Amazing
Excellent well done, but these days in the year 2022, why did the patient is not wearing a helmet when cycling. Its much saver and to save your head against injuries as well !!!!!!!!!!!
No helmet
+Spencer Schumann Does he look like a 4 year old kid?
+scarystuff1970 During the first 50 seconds, i would say he walks like one yes.
0:45
Bicycling With Parkinson's
Likely because the coordination required for riding is more intense and also somewhat different(less effected by the disease). It seems to me that PD seems to be related to overactive nerve and neural activity related to certain muscles. The over activeness could be due to decay in other areas that would normally suppress errant nerve activity. Essentially it's like a transistor glitching out causing random voltage potentials across the nerves. I'm only speculating of course but I would think that this disease should have been cured by now. It seems to be a very specific problem with very specific and common effects. Our medical complex needs to stop being for profit and stop playing so much golf. All these problems should be well understood by now. The human body is a machine that works in a very specific and exact way. When there are many example cases it should be easy(when millions of people are working on it) to figure out the causal relationships. But of course sports and Hollywood need more mansions.
Unbelievable they didn't make him wear helment.
Another fun thing some of us get to enjoy because God decided it.
+OneMoreSOB the lord works in mysterious and shaky ways
+OneMoreSOB good one
If you blame God for all the inexplicable 'bad' things happening, you could also thank him for the good. However, I think there's no such thing as an angry God diciding that you should have a nasty disease and someone else will meet with an accident.
I need to rain on this parade sadly. His motions are alright on the bike but as soon as he's stopping his brain will order him to move onwards and will make him fall over (as you can slightly see at the last couple of second of this video). It (sadly) has no use for any kind of therapy and could possibly worsen the symptoms.
+c1f3r866 Drug therapy itself worsens them... :/
+c1f3r866 Just the exercise of riding his bike will do him good, and hopefully make him a bit happier.
You missed the point here. The point is not that biking will cure his Parkinson's. The point is that discrete acts (like taking the first step in walking) and continuous acts (like the cyclic nature of cycling) rely on different networks in the brain. Whereas discrete actions mostly involve the basal ganglia (the part that is disrupted in PD), more cyclical actions rely on the cerebellum, which is typically not really affected in PD.
O dear. This man is trapped in a malfunctioning body. Imagine how it must feel to him to be able to move fluently for once! Even if it is just for a few moments or for a longer bike ride. Plus that it might help us understand better how this motor disease works.
Amazing, but even so, helmet please!