Journal of Movement Disorders

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Endurance and Efficiency of Cycling and Manual Wheelchairs in Late-Stage Parkinson’s Disease: A Preliminary Study: Mayura Konzo, Masaru Narita, Masaki Naito, Ayumi Ide, Taiyo Kai, Dai Wakabayashi, Wataru Fujita, Tomohiro Shibata, Yohei Okada; J Mov Disord. 2026;19(2):203-207. Published online January 21, 2026; DOI: https://doi.org/10.14802/jmd.25317

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Abstract PDF Supplementary Material: Objective
In late-stage Parkinson’s disease (PD), wheelchair mobility becomes essential, yet little is known about the endurance and efficiency of wheelchairs. For individuals who struggle with manual wheelchair (MW) propulsion, a cycling wheelchair (CW) may provide an alternative. In this study, endurance and efficiency were compared between MWs and CWs during continuous driving, including turning tasks, in late-stage PD.
Methods
Nine participants with late-stage PD performed the 6-minute push test using both MWs and CWs. Total distance, average speed, and the Physiological Cost Index (PCI) were measured. The PCI was calculated from the pre- and post-driving heart rates.
Results
Compared with the use of MWs, the use of CWs resulted in a significantly greater total distance and a lower PCI, and similar patterns were observed among participants at Hoehn and Yahr stage V (n=6).
Conclusion
Compared with MW use, CW use may enable more enduring and efficient mobility in late-stage PD. Further studies are needed to validate these preliminary findings.

Original Article

Factors Associated With the Decline in Daytime Bed Mobility Independence in Patients With Parkinson’s Disease: A Cross-Sectional Study: Masaru Narita, Kosuke Sakano, Yuichi Nakashiro, Fumio Moriwaka, Shinsuke Hamada, Yohei Okada; J Mov Disord. 2025;18(3):231-243. Published online April 25, 2025; DOI: https://doi.org/10.14802/jmd.25035

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Objective
People with Parkinson’s disease (PwPD) experience a gradual decline in bed mobility independence as the disease progresses. Identifying factors associated with nonindependence in daytime bed mobility is crucial for developing effective interventions to increase independence. We investigated factors associated with nonindependence in daytime bed mobility in PwPD.
Methods
This cross-sectional study included 109 PwPD (Hoehn and Yahr [HY] stage 2–4). Patients’ bed mobility ability (turning in bed, supine-to-sitting, and sitting-to-supine) was assessed during the daytime, and they were categorized into independent and nonindependent groups. Potential factors associated with bed mobility independence, including components of the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (rigidity, bradykinesia, tremor, axial symptoms), neck/trunk/hip strength, the Mini-Mental State Examination, and the Trail Making Test-A and B, were evaluated.
Results
The nonindependent group presented significantly increased axial symptoms, increased rigidity in the upper and lower limbs and neck, increased upper limb bradykinesia, and decreased trunk flexion/extension strength in all bed mobility tasks (p<0.05). Multivariate regression analyses revealed that axial symptoms, upper limb rigidity, and trunk extension strength were highly discriminative for nonindependence in turning in bed (the area under the curve [AUC]=0.84). Similarly, upper limb rigidity and axial symptoms were predictive of nonindependence in supine-to-sitting and sitting-to-supine movements (AUC=0.78, 0.92). A significant difference in axial symptoms between the HY stage 4 subgroups was observed only in the sitting-to-supine movement.
Conclusion
Our findings indicate that axial symptoms and upper limb rigidity are key factors contributing to nonindependence in daytime bed mobility tasks among PwPD. Targeting these factors in rehabilitation may help mitigate the decline in bed mobility independence in PwPD.

Citations

Citations to this article as recorded by

Influence of Age on the Effectiveness of Lee Silverman Voice Treatment® BIG in Patients with Parkinson’s Disease: A Retrospective Exploratory Observational Study
Masanobu Iwai, Kazuya Takeda, Soichiro Koyama, Ikuo Motoya, Yuichi Hirakawa, Hiroaki Sakurai, Yoshikiyo Kanada, Nobutoshi Kawamura, Mami Kawamura, Shigeo Tanabe
Geriatrics.2026; 11(3): 63. CrossRef

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