Is the Theracycle beneficial to those with Parkinson's?

10 answers | Last updated: Oct 09, 2016
A fellow caregiver asked...

My nom was diagnosed with Parkinson's at age 77. She is now 80 and is holding her own but mobility is becoming a bigger problem. We are curious about the Theracycle but it is prohibitively expensive. Is there any feedback or reviews on the cost vs benefits of the Theracyle? Is it better than a regular stationary bicycle? Thank you.

Expert Answers

Graham A. Glass, MD, is the deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center (PADRECC) and an assistant clinical professor of neurology at the University of California, San Francisco (UCSF). He completed a fellowship in movement disorders at the Mayo Clinic.

As you and your mom know, exercise is very important in Parkinson's disease and more and more studies have shown the benefit of various types of exercise in Parkinson's disease. Studies have shown great benefit to tandem bicycle riding, tango, and other forms of vigorous exercise. That being said, movement disorders specialists very rarely favor one form of exercise over another because the most important thing is consistency and when someone has no interest in a certain type of activity, they won't be consistent. We believe that the vigorous(meaning that it gets your heart rate up) exercise is important, excercise that works on your balance is important, and exercise that is appropriately safe for the stage of the disease is important. Specifically speaking to the Theracycle question, it is quite expensive and has more "bells and whistles" than a normal exercise bike. That being said, an exercise bike (sometimes a recumbent exercise bike can be safer) with some encouragement to pace the exercise at a faster level may be sufficient.

Community Answers

Ladydawn answered...

The goal of forced (assisted) not voluntary exercise has already been found to be very beneficial for PD motor symptom relief. Larger studies are being conducted at the Cleveland Clinic in Ohio and in Las Vegas, Nevada.

The cycles used in the study are not the over the top Theracycles but motorized pedal assist creations. It is possible to have one built for home use but somewhat complicated. I've been in communication with an expert and realize that the cost will be between $500.00-$1,000 if I can find someone who will build it for my husband with PD, since he can no longer do that.

The value of forced exercise is apparently seen with 40 minute sessions 3 times a week. There should also be a 10 minute warm up and 10 minute cool-down period. For many PwPs this will require several weeks working up to this hour long session.

One advantage to spending the big bucks for a Theracycle or Reck Moto-Med (which is less demanding of space but also very expensive) is that at an exercise/therapy center it is often difficult to monopolize a piece of equipment for 30 minutes let alone the full hour required.

Another problem is finding a therapy/exercise center that has this equipment. You will find many with elliptical or recumbent exercise bikes which often do not get up to the optimum rpms. My husband showed slight improvement after 20 minute sessions 5-6 days a week. He simply couldn't pedal faster than 60 rpm and then could only have use of the equipment for about 20-25 minutes at a time.

Although the current studies are only looking at the movement disorder aspect of forced exercise and PD, I'm sure that there are many of us who can see cognitive and psychological advantages as well.

Some people can get the same results on a treadmill but it is important to only use this equipment with spotters present. At the therapy center my husband's postural instability was noted and he was not allowed to use a treadmill. The best treadmill is a Body Weight Supported Treadmill which is far too expensive for almost all of us but is available in hospital therapy centers.

Believe me, if we could afford either the Theracycle or the Reck equiment, it would be in our home already. What we did do was to add one of those small motor assisted pedalers which will assist him to 60-64 rpm. I can pedal without assistance much faster - the little machine will go up to at least 90 rpm which is optimum for forced exercise. I asked him to put his hands - palms down - on his thighs while he pedals so that his 'bad' arm will also benefit.

He can watch TV by looking straight ahead (none of those awful gym angles where people tilt their heads backwards to see the screen).

What he does like is the little device which allows him to see the rpm. This is important to him. While this isn't his only exercise, it is in the office area where he can use it twice a day if he wants and he uses it more than any other equipment we have for exercies.

A stationary bike offers built in resistance and while it is good for leg strength, I prefer the concept of the little $150.00 motorized pedaler which can also be placed on a table top for working with the hands.

Look into Yoga as well and please consider voice exercises as well as simple hand strength and finger dexterity exercises. We've put up several no-equipment (except someone to read and/or lead) exercises at our blogsite - just check the right column under exercise:[]

I don't think there is a question of the advantages of the cycling form of forced exercise which can get the rate up to 90rpm and will produce results which show symptomatic relief as well as medication dose reduction. I also think that as more studies are in, clever people will build a simpler version which simple assists pedaling at optimum speed while keeping the price below $1,000. At that price point it would be worth the investment.

A fellow caregiver answered...

This product was originally designed for people with P.D. and has helped many to improve their mobility and stamina through walking and stationary exercise. Look here: It would appear to be much more versatile than a Theracycle and, at only a fraction of the cost, might be something to consider first.

Ladydawn answered...

The Dashaway is a clever device and would be an excellent addition for walking and exercise support but it will not provide the advantages of Forced Exercise. I see it as an adjunct but not a substitute.

One thing to note about the Dashaway is that it will provide good support for dog walking. A recent study found that walking a dog was more beneficial for a person than walking with another person.

There has been speculation that Forced Exercise also forces the CNS beyond capacity and in that way reduces some symptoms. Another explanation is that it stimulates manufacture of important proteins which sustain the lives of neurons. PD symptoms have been shown to decrease by as much as 35%.

At a PDF Expert Briefing this afternoon, it was suggested that a tandem bike on a stand might also acheive the same results as long as one person was capable of reaching the desired speeds. Interesting concept, although I worry about the stability but I haven't looked into the available stands yet. Sounds like a win-win if it fits into the budget and the physical condition of the caregiver.

Don't forget an exercise regimen must include aerobic or cardiovascular exercise, strength or resistance training and stretching/flexibility exercises.

Forced Exercise may seem to only target the legs but has been seen to improve upper arm coordination and stiffness relief as well.

Make some calls to find a center which has a either a Theracycle or Reck MotoMed. Centers also provide much needed socialization as well. You may be looking for a Physical Therapy center rather than an Exercise Center.

Dolltearsheet answered...

Thank you all so much for your responses. They are so helpful and supportive. I will research the Dashaway and the Rec Motomed, neither of which I had ever heard of before. Perhaps there is a Physical Therapy center in the Pittsburgh area with a theracycle or rec motomed. The Dashaway looks like another interesting option in that it helps balance and posture. Thank you, again!

A fellow caregiver answered...

Have PD with marked Mobility Disability. Have Theracycle. Has provided major benefits. a the 80-90rpm level for up to 40 minute intervals.. Some days 20 or 30 minutes.. Use as complement to LSVT BIG Physical Therapy Exercises. One improvement from it is increased standing leg strength.

One way lo look at cost benefit is to consider the Opportunity Loss if you don't do this.... the value to the Patient of potential improvement in mobility.

On the other side of the coin....if I had to choose between LSVT BIG Physical Therapy and a Theracycle (fortunately I have both), I would choose LSVT BIG because it teaches new ways to move...even though you have mobility disability..

Bottom line, PD Patients are not meaningfully informed about the benefits and importance of various types of exercises....exercise is like a SECRET WEAPON.....WHY?

From my experience (the impact it has made on my life) I enthusiastically recommend Forced Exercise, for me that is the Theracycle.

Gypsywoman answered...

OK, I have read page after page of entries from caregivers,e tc. who complain about the exorbitant cost of the Theracycle. As a retired person I have only SS benefits, and a mostly paid for home to get by on, I was diagnosed with PD in late 2009, but later, in 2013 that diagnosis was changed to MSA-P, which is a disease in the Parkinson family which is always fatal, because there is no know tx or cure, I have most of the same symptoms as an advanced PD person. My main problem has been falling - over 200 times in two years... my sense of balance is totally awry. I have been using a walker since August of 2012 and am now getting ready to get a motor chair. AND STILL I SWEAR BY THE BENEFITS THE THERACYCLE HAS BROUGHT TO MY LIFE. Perhaps it is because I worked in clinical trial research prior to retirement, but when the research says something helps, it helps! WHen I found out about the research at Cleveland Clinic I knew I needed a Theracycle. I got it about two years ago, and although it hasn't stopped the progression of my disease, it has made such a difference in my everyday functioning and pain level. The things I like about the Theracycle are: I could not possibly pedal that fast for the sustained period needed. I have neither the strength nor the endurance. But you need neither of these with the theracycle. I can ride it in the evening when I am mostly at my worst, and it takes little effort to pedal at a rate of 14-15 mph (equal to 85-90 rpm on the Theracycle) for almost an hour while I sit there and watch TV!!.But you are probably all saying, but HOW does it make you feel better? Currently I am experiencing a drastic pull to the right at my waist. AS result I have developed a very stooped posture and my head hangs down and to the right (dystonia). The constant leaning to the right, was and is causing a marked measure of painful spasms in my left back, which is trying to counterbalance things. Now, unfortunately, in one of my falls over a month ago, I injured my tailbone and have had trouble sitting anywhere for more than a few minutes. That includes the bike. SO I stopped using it very much at all for 3-4 weeks, and boy could I tell the difference. But with the new pain levels, I was unable to stand for more than a few minutes before developing horribly painful back spasms. I did the only thing I could, I got back on my bike (sitting on a heating pad!) and rode! It has only been 4-5 days since i got back into my routine, but my pain has lessened and most importantly I can stand up much straighter, with my head held up high. This is like going from an elephant to a giraffe in my book! The Theracycle has saved my life already because without it I feel that i would have progressed much more rapidly and possible be bedridden by now. Yes $4000 is a lot of money, but I refinanced my home and took some equity out. With the money I got the Theracycle and a Safe Step Tub. I have never felt that it was a mistake and I have never regretted getting the Theracycle. AND I SURE HOPE THAT I CAN WRITE TO YOU IN FIVE YEARS AND SAY IT IS STILL HELPING ME BEAT THE ODDS OF MSA_P.

Shaelyn answered...

My husband has Parkinson's and I bought him the inexpensive portable motorized bike shown on the Amazon link below. He uses it every day while he watches TV while sitting in a chair that is comfortable for him. At this point he is self pedaling, but it's good to know that the motorized ability is there for circulation when he can't. He also turns it backwards and puts it on the counter to exercise his arms. It was a very beneficial purchase and easy to store!

Shaelyn answered...

Sorry, sent before I added the link! Here it is. You may have to copy and paste.

A fellow caregiver answered...

MOTOmed® viva 2_Parkinson Reduce tremor and rigor with » Forced Exercise accelerated passive movement – without negative side effects. Passive movement for more mobility. Up to a 35% Tremor Reduction Further studies distinctly confirm the improvement of motor function in patients engaging in leg training at a speed that is higher than individually possible. Suggested optimal speed levels lie between 80 and 90 pedal revolutions per minute. The study participants showed a 35% improvement in reduction of tremor which continued well after the day of training. In my opinion the MOTOmed is the top of the line - www,motomed,com