# A BACKWARD CYCLING PROGRAMME FOR PEOPLE WITH PARKINSON’S DISEASE: A FEASIBILITY AND PRELIMINARY RESULTS STUDY

## TL;DR

This study shows that backward cycling is a safe and effective exercise for people with Parkinson’s disease, improving gait and balance.

## Contribution

The study introduces backward cycling as a novel, feasible exercise intervention for Parkinson’s disease.

## Key findings

- High retention and adherence rates were observed with minimal burden and one adverse event.
- Participants showed significant improvements in gait velocity, step length, and balance after the program.
- Backward cycling was found to be a safe and beneficial intervention for gait and balance in Parkinson’s disease.

## Abstract

To assess the feasibility of backward cycling for people with Parkinson’s disease. Secondary objectives were to assess changes in gait and balance following a 6-week program.

A single-group prospective pre-test, post-test study with 1-month follow-up.

Twenty-six people with Parkinson’s disease (mean age: 69 (7.74) years, gender: 83% males, time since diagnosis: 6 (4.44) years).

Participants pedaled backward on a stationary bicycle for 30 minutes at moderate intensity twice a week for 6 weeks. Feasibility was assessed by acceptability, suitability, and burden. Data collected at pre- and post-intervention with 1-month follow-up included backward stepping response variables, forward/backward gait variables, Mini-Balance Evaluation Systems Test (MBT), and 6 Minute Walk Test.

There was a high retention rate (95.8%) and adherence rate (100%) with one adverse event and minimal burden. Significant improvements were seen in step count and excursion distance during backward stepping responses, forward and backward gait velocity, forward step length, and the Mini-BESTest.

Backward cycling was a feasible intervention for people with Parkinson’s disease, demonstrating low burden with high retention and adherence rates, and it is a safe exercise with the potential for benefits in gait and balance variables.

LAY ABSTRACT

It is known that people with Parkinson’s disease often have falls due to balance issues, including an increased risk of backward falls. This may be due to known difficulties with stepping and walking in a backward direction. There is limited research looking at backward-directed exercises, therefore this study assessed the safety and effects of a backward stationary cycling program with people with Parkinson’s disease. People who participated in a 6-week backward stationary cycling program showed that it was safe, participants adhered to the program and minimal assistance was needed throughout. Also, at the end of the program, people were able to walk faster in both forward and backward directions, were able to catch themselves better following a loss of balance backward and had better balance overall. This study supports the use of this type of program in clinics.