# Remote dynamic cycling for the customized off-site rehab in Parkinson’s disease.

> **NIH VA I01** · LOUIS STOKES CLEVELAND VA MEDICAL CENTER · 2022 · —

## Abstract

Parkinson’s disease (PD) progressively deteriorates motor function. Successful rehabilitation, leading to a
favorable course of movement disorders in PD, is contingent upon frequent, regular, and patient-specific exercise
regimen that is customized to the individual needs. Latter requires regular interventions from the provider and
frequent visits to the rehab facility. Lack of access, poor social support, inability to travel, home-bound status, or
pandemics are significant hurdles in delivering effective rehab to the PD patients. Our vision is to offer
customized and cost-effective PD rehab using a remotely operated technology near or at the patients’ homes.
This technology would be remotely monitored and customized online to titrate therapeutic outcomes optimized
for each patient. The proof of this concept was already established in our laboratory, a technology called dynamic
cycling. The highlight of this technology is a stationary bike operating at a rapid speed (cadence) with
programmable variability in speed and power/torque hence promoting motor performance superior to traditional
motorized bikes (i.e. static cycling). The next step towards our ultimate vision of at-home exercise therapy is
remotely operated dynamic bike. We have already built remotely operated dynamic bike; the current proposal
will objectively examine the efficacy of a novel, remotely delivered and remotely adjusted dynamic cycling
paradigm using remotely monitored motor outcomes. Comparison will be made with remote static cycling. The
study will be launched at three community based wellness locations to assure the subject safety, ease of access,
compliance, and as needed support. Aim 1 will examine the hypothesis that dynamic cycling will immediately
improve the motor function in PD. The effects will be prominent on the dopamine-sensitive motor deficits. The
repetition will enhance motor improvement. The participants will use wearable sensors for the remote
assessments of motor symptoms in PD before and immediately after each exercise session. The information
from the wearable sensors and the bike will be utilized to further adjust the bike parameters for the next dynamic
cycling session. We will also measure effects on subjective ratings of motor function, cognition and balance
before, and at 0, 3, and 6 months after the cycling intervention. Aim 2 will analyze the effects of dynamic cycling
on motor fluctuations, declining response to levodopa in an early and unpredictable manner significantly affecting
the quality of life in the PD. We hypothesize that dynamic cycling will reduce the motor fluctuations in PD. The
efficacy of dynamic cycling on improvement in motor fluctuation over a 12-hour awake period will be measured
every day with the wearable sensors that communicate via secure cloud. The immediate clinical impact is that
the technology will be immediately deployed to the Veteran’s group homes, nursing homes, and community
based VA clinics. The project will prov...

## Key facts

- **NIH application ID:** 10424644
- **Project number:** 1I01RX003676-01A2
- **Recipient organization:** LOUIS STOKES CLEVELAND VA MEDICAL CENTER
- **Principal Investigator:** Aasef G Shaikh
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10424644

## Citation

> US National Institutes of Health, RePORTER application 10424644, Remote dynamic cycling for the customized off-site rehab in Parkinson’s disease. (1I01RX003676-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10424644. Licensed CC0.

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