Sage Journals: Discover world-class research

Abstract

Aim:

To investigate the effects of the water-based exercise on balance, mobility, mobility and functional independence, functional performance, fear of falling and quality of life in people with Parkinson’s disease.

Methods:

We searched pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base and SciELO to June 2020 for randomised controlled trials that investigated the effects of water-based exercise in people with Parkinson’s disease. Two comparisons were made: water-based exercise versus usual care and water-based exercise versus land-exercise. The main outcomes were Balance, Confidence, Mobility, Unified Parkinson’s Disease Rating Scale and quality of life. Mean differences (MD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I² test.

Results:

Fifteen randomised controlled trials were found (435 people). Compared to usual care, water-based exercise resulted in improvement in balance MD (9.1, 95% CI: 6.5, 11.8, N = 45). Water-based exercise resulted in improvement in balance MD (3.1, 95% CI: 1.2, 5.0, N = 179), mobility MD (−2.2, 95% CI: −3.3, −1.0, N = 197) and quality of life MD (−5.5, 95% CI: −11, −0.07, N = 98) compared to land-based exercise, but without significant difference in functional performance MD (0.01, 95% CI: −2.6 to 2.7, N = 69). Land-based exercise resulted in improvement in fear of falling MD (−3.5, 95% CI: −5.6, −1.3, N = 58) compared to water-based exercise.

Conclusion:

Water-based exercise was more efficient than land-based exercise and/or usual care in improving balance, mobility and quality of life in people with Parkinson’s disease.

Keywords

Aquatic physical therapy Parkinson’s disease quality of life balance mobility

Get full access to this article

View all access options for this article.

References

Marsden

. Parkinson’s disease. J Neurol Neurosurg Psychiatry 1994; 57(6): 672–681.

Brusse

Zimdars

Zalewski

, et al. Testing functional performance in people with Parkinson disease. Phys Ther 2005; 85(2): 134–141.

Reynolds

Otto

Ellis

, et al. The therapeutic potential of exercise to improve mood, cognition, and sleep in Parkinson’s disease. Mov Disord 2016; 31(1): 23–38.

Abbruzzese

Marchese

Avanzino

, et al. Rehabilitation for Parkinson’s disease: current outlook and future challenges. Parkinsonism Relat Disord 2016; 22(suppl. 1): S60–S64.

Uhrbrand

Stenager

Pedersen

, et al. Parkinson’s disease and intensive exercise therapy – a systematic review and meta-analysis of randomized controlled trials. Neurol Sci 2015; 353(1–2): 9–19.

Zotz

TGG

Souza

Israel

, et al. Aquatic physical therapy for Parkinson’s disease. Adv Parkinson’s Dis 2013; 4: 102–107.

Plecash

Leavitt

. Aquatherapy for neurodegenerative disorders. J Huntingtons Dis 2014; 3(1): 5–11.

Harrison

Bulstrode

. Percentage weight-bearing during partial immersion. Physiother Pract 1987; 3: 60–63.

Terrens

Soh

S-E

Morgan

. The efficacy and feasibility of aquatic physiotherapy for people with Parkinson’s disease: a systematic review. Disabil Rehabil 2018; 40(24): 2847–2856.

10.

Pinto

Salazar

Marchese

, et al. Is hydrotherapy effective to improve balance, functional mobility, motor status, and quality of life in subjects with Parkinson’s disease? A systematic review and meta-analysis. PM R 2019; 11(3): 278–291.

11.

Cugusi

Manca

Bergamin

, et al. Aquatic exercise improves motor impairments in people with Parkinson’s disease, with similar or greater benefits than land-based exercise: a systematic review. J Physiother 2019; 65(2): 65–74.

12.

Clerici

Maestri

Bonetti

, et al. Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of freezing of gait in Parkinson disease: a randomized, controlled study. Phys Ther 2019; 99(5): 591–600.

13.

Silva

AZD

Israel

. Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson’s disease: a randomized clinical trial with a 3-month follow-up. Complement Ther Med 2019; 42: 119–124.

14.

Moher

Liberati

Tetzlaff

. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535.

15.

Higgins

JPT

Green

. The Cochrane library. Issue 4. Cochrane handbook for systematic reviews of interventions 4.2.6. Chichester: John Wiley & Sons, 2006.

16.

Olivo

Macedo

Gadotti

, et al. Scales to assess the quality of randomized controlled trials: a systematic review. Phys Ther 2008; 88(2): 156–175.

17.

Maher

Sherrington

Herbert

, et al. Reliability of the PEDro scale for rating of quality randomized controlled trials. Phys Ther 2003; 83(8): 713–721.

18.

Higgins

Thompson

Deeks

, et al. Measuring inconsistency in meta-analysis. BMJ 2003; 327: 557–560.

19.

Kurt

Büyükturan

, et al. Effects of Ai Chi on balance, quality of life, functional mobility, and motor impairment in patients with Parkinson’s disease. Disabil Rehabil 2018; 40(7): 791–797.

20.

Pérez-de la Cruz

. A bicentric controlled study on the effects of aquatic Ai Chi in Parkinson disease. Complement Ther Med 2018; 36: 147–153.

21.

Pérez-de la Cruz

. Mental health in Parkinson’s disease after receiving aquatic therapy: a clinical trial. Acta Neurol Belg 2018; 119(2): 193–200.

22.

Zhu

Yin

Cui

, et al. Aquatic obstacle training improves freezing of gait in Parkinson’s disease patients: a randomized controlled trial. Clin Rehabil 2018; 32(1): 29–36.

23.

Carroll

Volpe

Morris

, et al. Aquatic exercise therapy for people with Parkinson disease: a randomized controlled trial. Arch Phys Med Rehabil 2017; 98: 631–638.

24.

Palamara

Gotti

Maestri

, et al. Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of balance dysfunction in Parkinson’s disease: a randomized, controlled study with 6-month follow-up. Arch Phys Med Rehabil 2017; 98(6): 1077–1085.

25.

Pérez de la Cruz

. Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson’s disease: a randomized clinical trial. Eur J Phys Rehabil Med 2017; 53(6): 825–832.

26.

Volpe

Giantin

Manuela

, et al. Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson’s disease: a randomized controlled pilot study. Clin Rehabil 2017; 31(8): 1107–1115.

27.

Wang

Zhao

Feng

, et al. Effect of water-based exercise on motor function, balance function and walking ability in patients with Parkinson’s disease. Chin J Contemp Neurol Neurosurg 2017; 17(5): 346–351.

28.

Shahmohammadi

Sharifi

Melvin

JMA

, et al. A comparison between aquatic and land-based physical exercise on postural sway and quality of life in people with Parkinson’s disease: a randomized controlled pilot study. Sport Sci Health 2017; 13: 341–348.

29.

Volpe

Giantin

Maestri

, et al. Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study. Clin Rehabil 2014; 28(12): 1210–1217.

30.

Kargarfard

Chitsaz

Azizi

. Effects of an 8-week aquatic exercise training on balance in patients with Parkinson’s disease. J Isfahan Med Sch 2012; 30(178): 141–150.

31.

Vivas

Arias

Cudeiro

. Aquatic therapy versus conventional land-based therapy for Parkinson’s disease: an open-label pilot study. Arch Phys Med Rehabil 2011; 92(8): 1202–1210.

32.

The Cochrane Collaboration, www.cochrane.org (accessed 3 February 2008).

33.

Donoghue

Stokes

. How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people. J Rehabil Med 2009: 41(5): 343–346.

34.

Dal Bello-Haas

Klassen

Suzanne Sheppard

, et al. Psychometric properties of activity, self-efficacy, and quality of life measures in individuals with Parkinson disease. Physiother Can Winter 2011; 63(1): 47–57.

35.

Morgan

Friscia

Whitney

, et al. Reliability and validity of the Falls Efficacy Scale-International (FES-I) in individuals with dizziness and imbalance. Otol Neurotol 2013; 34(6): 1104–1108.

36.

Tapani

Kari

Heikki

, et al. Neuro-muscular function during therapeutic knee exercise under water and on dry land. Arch Phys Med Rehabil 2001; 82: 1146–1152.

37.

Winstein

Gardner

McNeal

, et al. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil 1989; 70(10): 755–762.

38.

Sato

Yamashiro

Yoshida

, et al. Effects of water immersion on short- and long-latency afferent inhibition, short interval intracortical inhibition and intracortical facilitation. Clin Neurophysiol 2013; 124(9): 1846–1852.

39.

Torres-Ronda

Del Alcazar

. The properties of water and their applications for training. J Hum Kinet 2014; 44(1): 237–248.

40.

Franchignoni

Martignoni

Ferriero

, et al. Balance and fear of falling in Parkinson’s disease. Parkinsonism Relat Disord 2005; 11(7): 427–433.

41.

Pellecchia

Grasso

Biancardi

, et al. Physical therapy in Parkinson’s disease: an open long-term rehabilitation trial. J Neurol 2004; 251(5): 595–598.

42.

Adkin

Frank

Jog

. Fear of falling and postural control in Parkinson’s disease. Mov Disord 2003; 18(5): 496–502.

43.

Daley

Spinks

. Exercise, mobility and aging. Sports Med 2000; 29(1): 1–12.

44.

Brody

Geigle

. Aquatic exercise for rehabilitation and training. Champaign: Human Kinetics, 2009.

45.

Masumoto

Takasugi

Hotta

, et al. Electromyographic analysis of walking in water in healthy humans. J Physiol Anthropol Appl Human Sci 2004; 23(4): 119–127.

46.

Delwaide

Pepin

Maertens

Noordhout

. Parkinsonian rigidity: clinical and physiopathologic aspects. Rev Neurol (Paris) 1990; 146: 548–554.

47.

da Silva

Rda

Santos

, et al. Effects of physical-exercise-based rehabilitation programs on the quality of life of patients with Parkinson’s disease: a systematic review of randomized controlled trials. J Aging Phys Act 2016; 24(3): 484–496.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.25 MB

Effects of water-based exercise on functioning and quality of life in people with Parkinson’s disease: a systematic review and meta-analysis

Abstract

Aim:

Methods:

Results:

Conclusion:

Keywords

Get full access to this article

References

Supplementary Material