Cleveland: The National Institutes of Health has awarded Cleveland Clinic researcher Jay Alberts, Ph.D, a 5-year, $3 million grant to conduct a multi-site clinical trial to study the long-term effects of aerobic exercise on slowing the progression of Parkinson's disease.
Alberts is vice-chair of innovation in the Neurological Institute and a staff member in Cleveland Clinic Lerner Research Institute Department of Biomedical Engineering. Alberts is the principal investigator on the CYCLE trial ("CYClical Lower Extremity Exercise for Parkinson's trial").
The new study aims to determine if long-term, high-intensity aerobic exercise can slow the advancement of Parkinson's disease, a progressive neurological disease. To date, no surgical or pharmacological intervention has been effective in slowing the disease's course. This project will be the first long-term investigation of the potential for aerobic exercise to arrest disease progression.
"Our previous work clearly indicates that aerobic exercise, such as cycling, in a controlled laboratory environment improves motor function over the course of eight weeks," said Alberts. "This project is important in understanding how exercise can slow disease progression and the translation of a laboratory-based protocol to the home of the patient. To bring an effective intervention from the Cleveland Clinic to the home of a patient outside of our zip code is an exciting next step in the treatment of Parkinson's."
Cleveland Clinic and University of Utah will recruit 250 Parkinson's patients who will be randomized to a high-intensity home exercise or usual and customary care (UCC) group. The CYCLE Trial exercise group will utilize indoor cycling bikes from fitness technology company Peloton. Participants will be instructed to exercise 3x/week for 12 months; the UCC group will be instructed to engage in their normal activities. The exercise and control groups will undergo identical motor and non-motor evaluation protocols at enrollment, 6, and 12 months.
Overall activity levels will be monitored for both groups via a wearable device. Exercise performance data will be used to determine if there is an optimal exercise dose necessary to slow disease progression. Identifying a necessary exercise dose will provide clinicians with more specific recommendations for Parkinson's disease patients and provides patients an opportunity to play a more active role in the treatment of this disease.
This research will build upon previous work done by Alberts and his team. They recently completed a 100-person in-laboratory randomized clinical trial, and results showed an 8-week high-intensity aerobic exercise program significantly improved global motor function and specific aspects of walking and cognitive function in patients with Parkinson's. These positive outcomes provide strong rationale to evaluate effectiveness of a long-term CYCLE protocol in a home-based setting to impact a greater number of people with Parkinson's disease.
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