Impact Of Session-by-Session Adaptive Dynamic Cycling On Hand Tremor In People With Parkinson’s Disease

Parkinson’s disease (PD) is characterized by motor symptoms such as tremor, bradykinesia, and rigidity. Our lab previously showed that weekly adaptation of dynamic cycling was effective in reducing motor symptoms in individuals with PD. However, session-by-session adaptive dynamic cycling will likely promote more robust improvements in these symptoms. PURPOSE: To evaluate changes in hand tremor over 12 sessions of adaptive dynamic cycling. METHODS: Ten people with PD completed a 4-week high-cadence cycling intervention, consisting of 12 sessions (3 sessions per week) on a custom motorized stationary cycle. A session-by-session adaptive exercise prescription was utilized, where resistance levels were changed every session based on an algorithm that evaluated entropy of cadence and cycling effort. Kinesia One was used to quantify tremor based on the Unified Parkinson’s Disease Rating Scale Part III scores (0-4). Resting, postural and kinetic tremor scores from the most affected side were used to assess hand tremor severity. Paired sample t-tests compared pre- and post-intervention scores. RESULTS: Resting tremor in the hand showed no significant change (p = 0.66; pre 1.22 ± 1.9, post 1.47 ± 2.2). Postural tremor of hand showed a slight but non-significant decrease (p = 0.07; pre 1.53 ± 1.56, post 0.76 ± 1.63). However, the kinetic tremor score showed a statistically significant reduction following 12 sessions (p = 0.046; pre 1.91 ± 0.83, post 1.51 ± 0.84). CONCLUSION: These results suggest that 12 sessions of session-by-session adaptive dynamic cycling may selectively reduce action hand tremor in individuals with PD, but did not have significant impact on resting or postural hand tremors. Future research will focus on recruiting a larger cohort to more comprehensively evaluate the effects on different types of motor symptoms in Parkinson’s disease. Supported by: Davis Phinney Foundation