Tuesday, November 27, 2012

How pedal power could ease Parkinson's: Cycling could improve connections in brain regions linked to the disease

This is a very small study with a probable strong experimenter expectation effect so judgment should be reserved for a more definitive study

Cycling could help ease the symptoms of Parkinson’s disease, scientists believe.  The exercise improved connections between brain regions linked to the disease and boosted patients’ co-ordination and balance, research has shown.

Exercising on a bike is ‘an effective, low-cost therapy for the disease’, one researcher said.

US neuroscientist Jay Alberts began the research after noticing improvements in his companion, a Parkinson’s patient, after a long-distance tandem ride across Iowa. 

Dr Alberts, of the Cleveland Clinic Lerner Research Institute, Ohio, said: ‘The finding was serendipitous. I was pedalling faster, which forced her to pedal faster.  'She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.’

In the study, he carried out a series of scans on the brains of 26 Parkinson’s patients who used exercise bikes three times a week for two months.

Some pedalled at their own pace, while others undertook ‘forced-rate’ cycling, in which they were made to pedal faster by motors fitted to their bikes.

The scans revealed pedalling, particularly vigorous pedalling, boosted connections between brain regions linked to movement, the annual meeting of the Radiological Society of North America in Chicago heard.

Researcher Chintan Shah, also from the Cleveland Clinic, said: ‘The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease.’

The scientists are now studying how patients fare with exercise bikes in their homes. They also want to see whether other forms of exercise such as swimming and rowing have similar benefits.

The charity Parkinson’s UK welcomed the research, saying the balance and co-ordination can be badly damaged as the disease progresses.

However, it also cautioned that not all patients will be capable of exercising intensely.  Dr Kieran Breen, the charity’s director of research, said: ‘While it is too soon to encourage people with Parkinson’s to get on their bikes three times a week on the basis of this study, we do know that exercise can be beneficial.

‘A regular exercise routine can help those with the condition to not only improve their general fitness but can also help to improve movement and balance as well as other symptoms of the condition such as anxiety and depression.’


A wonderful story

One feels so sorry for the dear little boy -- only one year old -- but that he is now alive and well is cause for great thankfulness

FLETCHER Dunne would be unlikely to be alive today had it not been for an accidental medical breakthrough borne out of quick-thinking.

The one-year-old is among 37 critically ill Victorian children who have had their lives saved by a medical treatment described by specialists as "magical".

In a medical first this month, the battler was one of four children with life-threatening infections who the Royal Children's Hospital used the unorthodox technique on - all at the same time.

Under the treatment, cardiac surgeons and intensive care specialists cut open the chests of children with the infections and connect their organs via tubes to a heart lung machine. It allows their organs to rest while they are given vital medication.  All four operated on are now recovering.

But the revolutionary procedure - not routinely used by any other Australian hospital for this purpose - was, incredibly, discovered by accident.

Patients with life-threatening infections would traditionally be connected to an extracorporeal membrane oxygenation (ECMO) machine via a tube placed in their neck or groin.

Intensive Care Unit medical director Associate Professor Warwick Butt said they first trialled the new method in 2000 when a 16-year-old girl came in with meningococcal toxaemia.

Medics realised they could not connect her to the ECMO machine as they had run out of medical tubes, or cannulas, for the groin and neck.  "She was in big trouble and we only had a cannula to do open heart surgery," Associate Prof Butt said.

After getting her parents' permission to try the radical new procedure, the team cut her chest open and put her on the ECMO using the heart cannula.

What happened next amazed them.  "It was magical treatment because the tubes were bigger so we could get more blood flow and that meant she could get better quickly," Dr Butt said.  Since then they have used it on almost 40 children.  "Until two years ago no-one else on the planet was doing it," Dr Butt said.  Now, several overseas hospitals use it.

Cardiac surgery deputy director Associate Professor Yves D'udekem said: "We do it when we believe that if we don't, the child will die."

It has been estimated that half of children who develop refractory septic shock die.  Bacteria in their blood causes pressure to plummet and they do not respond to fluid and antibiotic treatment.

But RCH research has found the new method has boosted survival rates from 50 per cent to 80 per cent.

Fletcher presented with meningococcal septicaemia, general medicine paediatrician Dr Daryl Efron said.

SIMONE and Hayden Dunne had put their son, a happy and healthy baby, to bed the previous night.  At 2am he woke, crying, with a temperature and struggling to breathe. After a bath, he vomited and his body began to jolt. Eventually he settled.

The next morning he was taken to his GP, but by that stage was floppy and breaking out in a purple rash and Simone was told to take him to Shepparton Hospital.  "We laid him on the hospital bed and he was so lifeless, he didn't have any energy to make a sound," she said.

He was given antibiotics and flown to the Royal Children's Hospital.

Mrs Dunne said she was frightened he would lose limbs or suffer brain damage. At 3am they received a phone call to say that drastic life-saving intervention was required.

"I've never been so scared in my life but we didn't think twice about signing the consent forms," she said.  "We had full faith in the doctors. We knew that our little boy will have a 15cm cut down his chest but that's nothing compared to the alternative."

After going on ECMO his blood pressure instantly dropped.

"It was so hard to see him like that but from that point every single day he improved," Mrs Dunne said.

Fletcher was on the machine for four days. Gradually he woke up and started moving his arms and legs.

Ten days later he left hospital. His parents feel blessed their baby boy was able to receive the pioneering medical treatment.


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