Diagnosis on a Bicycle?

These days, all practice-changing research must involve expensive and complex technology, no?

No.

In January's edition of The Lancet, three Dutch neurologists have published a study that demonstrates how making the difficult distinction between parkinsonism and atypical parkinsonism can be greatly assisted by asking a simple question: Can you still ride a bicycle?

In their paper, The "bicycle sign" for atypical parkinsonism, Drs. Aerts, Abdo, and Bloem conducted a prospective observational study and found a strong correlation between an inability to ride a bicycle and the gold standard of diagnosis for atypical parkinsonism.

Admittedly, the "bicycle sign" is most significant within populations that often bicycle. One study found that the average Dutch citizen bikes nearly 1.5 miles a day; the average American, only 110 yards per day. Even so, the work of Aerts et al is a heartening sign that research focusing on the history and physical examination of patients can yet bear fruit.