Module Objectives:

• Understand the importance of conducting an initial consultation with each participant.
• What should be discussed
• How to answer common questions

Parkinson’s Cycling Classes are unique compared to traditional indoor cycling classes. In an able-bodied class, you’ll have riders you’ve never seen before pop in at the last minute. You may have to quickly help them with bike set-up, but that’s about all the individual attention needed from you.

Each participant in your Parkinson’s Cycling Class should receive a 10-15 minute individual consultation with you (the coach) before they participate in your class.  The purpose will be to:

• Discuss their questions and concerns
• Observe any physical limitations
• Confirm they completed all of their required paperwork
• Establish best methods of future communication – some may not have access to email or texting.
• Perform an initial bike-fit/setup – link to page
• Explain the class format, Heart Rate monitor usage, ect…
• Reaffirm what’s required for each class; proper attire, footwear, water, pre-class medications and pre-class nutrition.

This consultation can be conducted before class if they’re there early enough, by you, your assistant or the club’s manager/owner. We always recommend prospective riders and their caregivers observe a class in action – after the class ends would also be a great time to consult one on one with them.

It is now time to “screen” or talk with each participant. Getting to know the future cyclist with questions like:

• when were you diagnosed?
• what are your symptoms?
• how is your general health?
• have you exercised recently?

Use the Parkinson’s Cycling Screening form. This opens the door to discuss any other health issues that are important.

The Center for Disease Control states that 80% of older adults have one chronic condition, and 50% have at least two. The participants in the Parkinson’s Cycling Program may have other health issues like diabetes or high blood pressure. The health screening questionnaire should be completed by the lead coach for the Parkinson’s Cycling class. He/she will ask important health questions of the participant about his/her general health status and medications.  It is imperative that any secondary health issues have been identified, addressed and you have a doctors approval before allowing the Parkinson’s participant to take part in the Parkinson’s Cycling Program.

For example:

If a participant is currently under the care of a cardiologist or any other specialist it is also a good idea to have a signed release from the doctor stating the participant is safe to exercise. If any conditions are set by a doctor, especially a cardiologist, the coach will follow those specific guidelines.

Your Parkinson’s Cycling screening questions will help you establish parameters for individual success. Please refer to the Parkinson’s Cycling Health Screening Questionnaire in the back of your manual. Feel free to use this form or incorporate your own screening questions and forms for your participants.

Other observations

Other important factors about your future cyclists are important to your success as well as the riders.
During the initial visit or conversation, be aware of these observations.

• Flexibility issues? Are they standing with rounded shoulders?
• Do they shuffle?
• Do they need a walker or cane to stay safe and upright?
• Do they need to sit during your conversation?
• Did they come to the facility alone, or with a support person or persons?

Always encourage the initial 1:1 to be in person or face to face. A lot of fact gathering is done at this time that can be very important for the coach’s and the rider’s success.

I know it sounds a bit taxing and challenging.  Fact gathering is certainly time consuming.  Attention to the details will help you achieve success.  The more the coach talks with and observes the participants during this 1:1 meeting,  the better the coach becomes at anticipating the rider’s  needs.  This creates a smoother beginning and builds mutual respect between the Parkinson’s Cycling Rider and the Parkinson’s Cycling Coach.

Communication

The rapport between the Parkinson’s Cycling Coach and rider is important. Communication is important too. Effective communication allows people to build personal and professional relationships.

Most people with Parkinson’s Disease do not have any cognitive impairment. But conversation might be challenging. Here are some tips for holding great conversations.

1. Hold the conversation at eye level making eye contact at all times. Sit down if the person with Parkinson’s is sitting and assume a relaxed posture to convey patience and a willingness to listen. Be clear and coherent with any questions and allow adequate time for the response. There may not be any cognitive difficulty but due to the muscle and nerve involvement, ability to speak clearly can be compromised.
2. Avoid finishing sentences for someone who has Parkinson’s disease unless requested. Maintain good body language by nodding a “yes” and saying “I see” when understanding of a point that is made. If understanding is not made clear or is not coherent, feel free at that point to ask for clarification or repetition. This will help avoid any misunderstandings.

3.  Email communication or equivalent with each person can be established at this initial visit. The Parkinson’s Cycling Coach will be able to use this to keep the participant/rider involved and validated on their personal achievements and successes. This class is a behavioral change for many of the participants. The updates on their progress over the first month will encourage these riders to make this exercise habit a priority.
Sending encouraging messages such as:
“Great job today Frank! I really liked the way you drank your water today!
“Fantastic ride today, Carol! How did you feel during the ride? Your heart rate was right on target during the work intervals. ”

This email communication goes both ways. The participant or even their significant other/ support person sometimes finds it easier to ask personal questions through email. Once again, this solidifies the relationship when the communication is both ways.
It keeps them coming back for more!

Next review our Initial Baseline Testing for your class participants.