Bicycling for Rehabilitation of Persons With Parkinson Disease: A Scoping Review.
John L Palmieri, Lesley Jones, Margaret Schenkman and 1 others
PMID 38693613WHAT IT FOUND
Stationary bicycling reduces Parkinson's disease severity and improves walking speed.
These changes were clinically meaningful, especially with speed-focused training. Balance scores improved but did not reach a level considered meaningful for patients.
Key findings
01Bicycling led to clinically meaningful reductions in disease severity, with improvements ranging from 3.53 to 22.3 points on the UPDRS-III.
02Speed-focused bicycling improved walking speed by amounts considered clinically meaningful (small to large changes of 0.06 to 0.37 m/s).
03While balance scores improved statistically, none of the studies reported changes large enough to be considered clinically meaningful.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review did not assess the quality of the included studies, meaning weak evidence was treated equally with strong evidence. Many studies were not randomized controlled trials, so it is difficult to prove bicycling caused the improvements. There is no established clinical threshold for what constitutes a meaningful improvement in motor symptoms or body functions, so those findings cannot be fully interpreted for practice. Most studies did not report follow-up data, so it is unknown how long the benefits last.
Declared interests
No conflicts of interest were declared by the authors.
The easy way to misread this
Do not assume bicycling is the best choice for improving balance. While scores improved, the changes were not large enough to be considered clinically meaningful, and the effect was not superior to standing exercises in some comparisons.