Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson's disease: a randomized controlled pilot study.

Authors: Volpe D (1) , Giantin MG (1) , Maestri R (2) , Frazzitta G (3)
(1) Department of Physical Medicine and Rehabilitation, S. Raffaele Arcangelo Fatebenefratelli Hospital (2) Department of Biomedical Engineering, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto Di Ricovero e Cura a Carattere Scientifico (3) Department of Parkinson Disease Rehabilitation, 'Moriggia-Pelascini' Hospital
Source: Clin Rehabil
DOI: 10.1177/0269215514536060 Publication date: Not specified E-Publication date: June 3, 2014 Availability: abstract Copyright: © The Author(s) 2014
Language: English Countries: Not specified Location: Not specified Correspondence address:


Article abstract


Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson's disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy.


A randomized single-blind controlled trial.




Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5-3.


Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months).


The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson's Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson's Disease Questionnaire-39.


Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (-5.9 SD4.8 vs. -1.9 SD1.4, p = 0.003), Parkinson's Disease Quetionnaire-39 (-18.4 SD12.9 vs. -8.0 SD7.0, p = 0.006) and falls diary (-2.4 SD2.2 vs. -0.4 SD0.5, p = 0.001).


Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease

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