A backward cycling programme for people with Parkinson's disease: a feasibility and preliminary results study.
Suzanne K O'Neal, Stephanie A Miller, Megan C Eikenberry and 1 others
PMID 38860715WHAT IT FOUND
Twenty-two people with mild to moderate Parkinson's disease completed a six-week backward cycling programme.
They showed improvements in backward stepping responses, gait velocity, and balance. However, the study lacked a control group, so these changes cannot be definitively attributed to the intervention.
Key findings
01Participants required significantly fewer steps to steady themselves after a backward loss of balance at one-month follow-up compared to baseline.
02Backward gait velocity significantly increased from baseline to one-month follow-up, with a mean difference of 13.01 cm/s.
03Balance scores on the Mini-BESTest significantly improved, with a median difference of 3 points between baseline and one-month follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had no control group, so it is impossible to know if the improvements were due to the backward cycling, natural variation, or a learning effect from repeated testing. The sample was small (22 analysed), making the results underpowered and prone to error. Medication status was not recorded during testing, which can affect motor performance in Parkinson's disease. The intervention was supervised in a clinic; safety and feasibility in a home setting were not tested. Participants were only included if they could walk unassisted and had mild to moderate disease (Hoehn and Yahr II-III), so results do not apply to those with more advanced disease or dementia.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume backward cycling is proven to improve Parkinson's symptoms. Because there was no control group, the observed improvements could be due to natural fluctuations in the disease, the placebo effect, or learning the tests. This study only shows that the exercise is feasible and safe in a clinic, not that it is effective.