That old saw about bike-riding as something one never forgets has taken on a new meaning. According to a report in the latest New England Journal of Medicine, cycling skills learned long ago can remain even when the ravages of Parkinson’s have destroyed most other abilities to get around… or even to stand without aid.
Dr. Bastiaan R. Bloem of the Radboud University Nijmegen Medical
Center in the Netherlands thought he had seen it all in his years of
caring for patients with Parkinson’s disease. But the 58-year-old
man who came to see him recently was a total surprise.
The man had had Parkinson’s disease for 10 years, and it
had progressed until he was severely affected. Parkinson’s, a
neurological disorder in which some of the brain cells that control
movement die, had made him unable to walk. He trembled and could walk
only a few steps before falling. He froze in place, his feet feeling as
if they were bolted to the floor.
But the man told Dr. Bloem something amazing: he said he was a regular
exerciser — a cyclist, in fact — something that should not be possible
for patients at his stage of the disease, Dr. Bloem thought.
“He said, ‘Just yesterday I rode my bicycle for 10 kilometers’ — six
miles,” Dr. Bloem said. “He said he rides his bicycle for miles and
miles every day.”
“I said, ‘This cannot be,’ ” Dr. Bloem, a professor of neurology and
medical director of the hospital’s Parkinson’s Center, recalled in a
telephone interview. “This man has end-stage Parkinson’s disease. He is
unable to walk.”
But the man was eager to demonstrate, so Dr. Bloem took him outside
where a nurse’s bike was parked.
“We helped him mount the bike, gave him a little push, and he was gone,”
Dr. Bloem said. He rode, even making a U-turn, and was in perfect
control, all his Parkinson’s symptoms gone.
Yet the moment the man got off the bike, his symptoms returned. He froze
immediately, unable to take a step.
Parkinson’s has to be among the most bewildering of diseases, to the patient and caregiver alike. A very old friend of mine, former dean of a major theological school and author of a long list of acclaimed books, has had Parkinson’s for decades. He is fortunate also to have a wife with spine of steel and persistence of Job. More than a decade ago, when he was in a period of severe decline, she agitated for changes in his medications she felt needed to be made — and they subsequently left for an anniversary cruise to Scandinavia. Some years later, after he had lost control of his mobility and most other functions it was determined that his Parkinson’s was not Parkinson’s after all, but “Parkinson’s-like symptoms,” and once again his treatment was dramatically changed. To dramatic effect. Having missed his sharp wit and ability to make conversation on earlier visits, the last time I was in their town the three of us enjoyed a long and hilarious lunch in a local restaurant.
If the old, familiar bicycle can be utilized to revive mobility and offer a new route to exercise and enjoyment, it will be very good news for Parkinson’s families.