This is a feel-good health story about a simple, probably harmless therapy that appears to help people manage a debilitating disease with grace. The segment features a researcher and his colleague, as well as a research subject with Parkinson’s disease. The therapy in question requires a bicycle built for two and a willing training partner to nudge their pedal rate a little faster than normal. Before-and-after film shows how this “forced” exercise can dramatically reduce hand tremors. There is no hyping of disease or reeling off of scary statistics. Other treatment options get a brief (though incomplete) mention. Still, despite its charms, it could be better. It doesn’t mention costs, and is short on details when it comes to the quality of the evidence. It entirely overlooks potential harms of the therapy (see “Harms of Treatment”), and fails to adequately quantify the benefit. Sources are skimpy, too.
No mention of cost.
The news report mentions only relative improvement in motor function among people who did forced cycling (35% better than the control group), but cites no data on absolute improvement (35% better than what?). It also fails to say how long this benefit lasts. A press release says people doing forced cycling had 20% better motor improvement after 2 weeks—a substantial drop whose clinical and statistical significance is unknown. The news segment does not quantify any other outcomes of potential interest, such as the impact of exercise on medication dosing or effectiveness.
There is no mention of harms. Parkinson’s patients often have problems with respiratory muscle function as well as with balance and falling. Researchers have studied their response to voluntary cycle ergometry for 15 years or more, and found that many patients are able to cycle safely on a stationary bike in a lab. Could riding a tandem bike on a road cause falls or overtax their breathing? Other research has shown that exercise can alter a patient’s absorption of the medication levodopa, the primary treatment for the condition. Is this something people should know about?
Although the news piece describes a controlled clinical trial at an institution well-known for scientific research, it fails to provide enough information for us to judge its merit ("small" is the only detail). Another sentence could have explained whether subjects in the two groups were similar, how they were assessed, and if their assessment was blinded. Also, showing that "the same brain regions are activated" in "a brain scan of a patient after forced exercise" and a patient "on medication" does not qualify as rigorous support for the role of "forced exercise" in relieving the symptoms of Parkinson’s disease.
One of the appeals of this news segment is that it tells us about a safe, potentially effective treatment without employing scare tactics.
The only expert testimonial in the story comes from the researcher who is the subject of the news report and his colleague. The only patient testimonial comes from a subject enrolled in the researcher’s study. Together the three tell a heart-warming, but potentially one-sided, tale. The story lacks a truly independent voice.
The news segment loosely compares forced cycling to medication, though it does not name the standard treatment for Parkinson’s disease, the medicine levodopa, and does not remind viewers that the research being reported did not study medicine. Anchor Chris Cuomo says “some benefit” of forced cycling lasted for 4 weeks, compared to just a few hours for medication. A news release suggests the benefit of forced cycling may decrease substantially over time, however. (See “Quantification of benefits” above). The news story does not mention deep brain stimulation, which can also be effective.
The availability of tandem bikes is not in question. N/A in this story.
The news report suggests that forced exercise on a bicycle is a novel treatment, a contention supported by our own quick search of the literature. Interestingly, the report leaves the viewer with the impression that researcher Jay Alberts’ tandem bike ride with a patient was quite recent. According to a press release, he first noticed improvement in a woman with Parkinson’s during a ride in 2001, then followed that with a second patient in 2006. This may help to explain why Alberts had film of a patient’s shaky hand before they embarked on their expedition: maybe he had an inkling it might come in handy.
There is no obvious use of text from a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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