Assisted cycle therapy (ACT): Implications for improvements in motor control

Assisted Cycle Therapy (ACT) is an innovative exercise in which the participant pedals on a bicycle at 35% greater than their preferred cycling rate with the assistance of a mechanical motor. Previous research in Parkinson's Disease patients found improvements in bimanual dexterity (e.g., grasping forces, interlimb coordination) and clinical measures of movement (e.g., UPDRS) after ACT but not after voluntary exercise or no exercise. Recent research with adolescents with Down syndrome found improvements in manual dexterity as measured by the Purdue Pegboard after an acute 30 minute bout of ACT but not after similar Voluntary or No exercise sessions. Improvements in the upper extremity functioning when the lower extremities were exercised suggests that changes are occurring at the cortical level to create improvements in global motor control. Possible central mechanisms include neurogenesis caused by upregulation of neurotrophic factors (e.g., BDNF) or increased sensory input to the motor cortex due to the high pedaling rate. Neurologic disorders that inhibit movement rate are suggested to benefit from ACT. The implications for improving motor, cognitive, clinical and health outcomes in several neurologic disorders will be discussed.