Well before sunrise, Chuck Linderman launches his daily workout at the Alexandria, Va., boat house: 30 minutes pulling hard on a rowing machine, an equal stint lifting free weights, and 30 minutes pedaling a stationary bike.
He drives himself to sweaty, breathless exhaustion, for Linderman is training for the race of his life – a race against Parkinsons disease.
Linderman is one of a million Americans afflicted by this neurodegenerative disease that kills off the brain cells responsible for the bodys ability to move.
His diagnosis came six years ago, when his wife noticed that his right arm was moving weirdly and that he was having trouble fastening the top button on his dress shirts. His doctor recommended seeing a neurologist.
It took the guy less than 15 minutes to make the diagnosis, said Linderman, 64.
Rowing already played a role in his life. For nearly a decade, he had been active in Alexandria Community Rowings masters program. So his response to Parkinsons was immediate. Fight back with what he knew best: strenuous exercise.
What is the alternative? A descent into invalidism? said Linderman, who retired two years ago from his job as director of a power company association.
Beyond drugs
Exercise of any sort has long been known to be helpful for Parkinsons.
Before the development of effective drug therapy in the 60s, patients often improved with any exercise, even the act of folding laundry, according to Michael Okun, national medical director of the National Parkinson Foundation, which emphasizes exercise as an important tool to fight the disease.
While todays pharmacopeia offers patients effective means to allay the disease early on, most of the drugs have serious side effects, which can include nausea, involuntary movements and memory problems. And many of these medications can lose effectiveness over time.
Much of Lindermans regimen – daily cycling and hard rowing, plus weight training twice a week with a personal trainer – is just the sort of workout that is intriguing researchers.
There is evidence that challenging the muscles through repetitive resistance motion far beyond ones comfort zone can diminish some symptoms.
Preliminary studies show that after eight weeks of cycling three times a week at a pace high enough to break a sweat and raise the heart rate, some patients can recoup much of their mobility for nearly four weeks. After that, gains disappear unless the patient resumes exercising.
While it cannot cure Parkinsons, heavy-duty exercise shows promise for countering, even delaying, the inability to move that the disease causes.
The Michael J. Fox Foundation for Parkinsons Research has funded close to $3 million in exercise research. And Okun of the Parkinsons Foundation said the focus is on finding the most effective exercise.
We know you need to sweat, Okun said. But we dont know exactly what kind of exercise is most effective, its optimum frequency or what the long-term benefits are.
Research promising
Jay L. Alberts, a Parkinsons researcher at the Cleveland Clinic, discovered how good intense cycling could be quite by accident eight years ago, as he rode a tandem bike across Iowa with a friend who has the disease.
The purpose of the trip was simply to show that with Parkinsons, you can live an active life, Alberts said.
But something surprising happened. Although the disease had already robbed his friend of her ability to write legibly, she could suddenly write her name clearly after the first day of strenuous cycling.
The following winter, Alberts rode with patients in Tucson, Ariz., and elsewhere, and I heard the same kind of thing. I knew we needed to follow this up.
For five years, Alberts has been researching the effects of strenuous cycling on patients. With $1.5 million in grants from the National Institutes of Health and the Department of Veterans Affairs, he has finished a 60-person study and has just launched another for 100 patients.
Although no final answers are in, Alberts work has sparked interest in the Parkinsons world.
Indoor cycling programs have sprung up at YMCAs in Seattle, Cleveland and Sarasota, Fla., with another in the planning stages in Los Angeles. A non-profit called Pedaling for Parkinsons is affiliated with the YMCA.
Alberts has shown that the pace of the exercise is important.
You want to make sure the person is really doing something. They must actively participate, he said.
By cycling intensely, Alberts speculated, you have information about a (muscle) movement going back to the brain. So if you can increase the quality and the quantity of that information, it may trigger biochemical changes in the brain.
Lindermans personal trainer, Rob Kreider, bases much of his weight training program on a similar theory. Kreider has Linderman lift quickly and repetitively. He calls it power lifting rather than strength training.
When you do a curl or a squat, your brain is sending messages to your muscles, Kreider said. So, he reasons, the more repetitions, the more messages to help the Parkinsons sufferer.
Another researcher, University of Florida neuroscientist David Vaillancourt, has been comparing how patients do on two exercise programs, the Parkinsons Foundations Fitness Counts and Progressive Resistance Exercise, which is directed at lifting increasingly heavy weights.
My colleagues and I believe that pushing the patients to work out hard is the key to exercise training in Parkinsons disease, he said.