Monday, May 4, 2015

SpeedGeezer Training

“SpeedGeezer” is a bicycle based exercise strategy designed to improve physical and mental speed in people who are slowing down like people with Parkinson’s disease (PD) and many older adults.  It is based on both published and ongoing scientific experiments from our labThe information that follows is part evidence-based (SpeedGeezer1, SpeedGeezer2) and part expert opinion.  SpeedGeezer may not be suitable for everyone and you don't have to be a Geezer to do SpeedGeezerAlways take your risk assessment and management seriously when beginning a new exercise program.


What is SpeedGeezer?
  • An exercise program to jumpstart the nervous system!
  • One SpeedGeezer session is 30-minutes long.
  • We use a stationary recumbent bicycle but other modes of exercise may work too. 
  • Warm up: You begin by pedaling at a preferred cadence (RPM) against the bike’s lowest resistance setting.  YES(!), this means setting 1 even though it might feel annoying and unproductive to some of you.  Work on pedaling smoothly.  Improve your coordination.
  • Add intervals: After a 5 minute warm-up at your preferred pedaling cadence (PPC), you will begin to do 15-second intervals of pedaling at a fast cadence (Fast Pedaling Cadence = FPC).  Do 20 intervals.  You decide what “fast” is.  Between each 15-second interval you pedal at your PPC for 45-seconds (recovery).  
  • Cool Down: The final (20th) FPC interval is followed by 5 minutes of cool-down at PPC. 
  • You can modify these parameters for your level of conditioning or risk.

Why do this? Every system in the body benefits from exercise.  In both older adults and people with PD, early results show improvements in walking speed and agility. And even though the bicycle exercise involves the legs, we see improvements in the speed of the arms and even in the 9-hole peg test of hand dexterity.  This suggests that the exercise is improving the brain.  And that is great!


Why speed?  
  1. Reducing fall risk: When you slip or trip, you need your nervous system to respond very quickly.  It needs to turn your muscles ON and OFF in the right sequence to restore your balance. 
  2. Anti-Bradykinesia: This symptom of PD involves slowing of movement.  Like any athlete who wants to get faster - you have to train faster.

Why low resistance?
  1. High neural activation: The high speeds allowed by low resistance are the perfect way to cause high neural activation in the brain and spinal cord.
  2.  Risk management: You are beginning a new exercise program or you are adding speedwork to an existing program. Low resistance reduces the strain on the heart, muscles and joints.  We want you to be safe and we don’t want soreness to keep you from exercising.
Why a recumbent bike?  More risk management here.  Recumbent bikes are easier to get on and off of, especially if they have a big open step-through area in front of the seat.  Knock on wood - nobody has fallen off of our recumbent bikes.  The back support also helps if people struggle with their posture.  These bikes are also relatively comfortable to sit on.

What should my FPC and PPC be?  Some people enter our study pedaling at PPC/FPC of 20/30 RPMs.  They typically finish the 12 sessions with a substantial improvement.  Others enter with PPC/FPC of 50/70 or even higher 60/110.  There is a lot of variability here but most people do improve their mobility whether they enter the study fast or slow. You will need to monitor your speed on the bike using whatever information it provides.  Monitoring revolutions per minute (RPM) is most convenient but you can also use speed in miles per hour (mph).  Just keep the resistance low! 

Individualize your session.  During our supervised training sessions we monitor blood pressure and heart rate.  If cardiovascular strain gets too high, we reduce the fast pedaling cadence or increase the recovery between intervals.  See this link on monitoring your heart rate. Early in the 12-session program some SpeedGeezer sessions are shorter (15 rather than 30 minutes) and the participant might only do a few intervals.  On the higher end, someone might graduate from the lower resistance to a higher one - as long as they can still pedal fast.  Some former research volunteers have taken their new knowledge home and created a treadmill version of SpeedGeezer.  Awesome!

When will it start working? Based on participant feedback, the noticeable benefits seem to begin after about four sessions.  Functional tests show improved mobility after 12 sessions (3X/week for 4 weeks or 2X/week for 6 weeks). There are some people who do not notice or report improvements.  It is also possible that exercise might be slowing the disease progression.

How often should I do it? The answer to this is also a matter of priorities and life balance.  Some former research subjects do an abbreviated SG workout almost every day when possible.  It helps to gets them going.  As mentioned above, we are observing good results with 2X per week and 3X per weekSpeed might not be the only domain of fitness you are working on so we want this speedwork to fit in with your other exercise rather than replace it

What if I can't pedal fast?  SpeedGeezer is designed for people who are in the early stages of PD or have moderate symptoms.  In more advanced PD you may have real difficulty pedaling a bike voluntarily.  This is why some people consider using a bike that provides mechanical assistance (like the Theracycle). 

Our research on Exercise for people with Parkinson’s disease is made possible by generous support, from Shake It Off, Inc. See this UDaily Article about our Partnership.I will periodically revise my posts based on on community comments so please check back again.  What do you want to know?  How do you get your speedwork?

Training Sheets are available at the SpeedGeezer Resources Page.