From: Effectiveness of water-based exercise in people living with Parkinson’s disease: a systematic review
Reference | Aim | Measurement tools (variable) | Evaluation on/off | Participants (n) | Mean age (years) | Disease severity (H&Y) | Duration of PD (years) | Type of intervention | Dropouts during intervention (n) | Adherence | Findings |
---|---|---|---|---|---|---|---|---|---|---|---|
Reuter et al. [29] | To investigate the influence of an intensive exercise training on motor disability, mood and subjective well-being | BMT (strength, flexibility and coordination), UPDRS (PD Disability Scale), CURS (PD specific motor disability), MMSE (dementia), AMQZ (quality of life), SIP (well-being) | On | E = 16 | 65.4 ± 5.9 | 2.84 ± 0.4 | 6.7 ± 3.7 | E = WBE (water program) + LBE (gymnasium program) | E = 0 | 92.8 % | Significant improvements in UPDRS (p < 0.0001), CURS (p < 0.0001), and BMT (p < 0.0001) |
Pellecchia et al. [25] | To evaluate the effects of a rehabilitation program on disability in patients with PD | UPDRS-II (activities of daily living), UPDRS-III (motor symptoms), Ten-Meter Walk (mobility), SaPDDS (PD Disability Scale), Self-rating depression Scale (depression) | On | E = 20 | 59 ± 11.8 | 1.5–3 | 4.8 ± 3.4 | E = LBE + WBE (rehabilitation program) | E = 0 | NR | Significant improvements in UPDRS-II (p < 0.002), UPDRS-III (p < 0.0001), Ten-Meter Walk p < 0.012), SaPDDS (p < 0.001) and Self-Rating Depression Scale (p < 0.0001) |
Pospíšil et al. [27] | To study elucidation of the reaction of basic haemodynamic parameters to water immersion of the lower part of the body | SBP and DBP (blood pressure), HR and RPP (HR × SBP). | On | E = 9 | 71 ± 7 | 2.2 ± 0.7 | 7 ± 3 | E = WBE (balneotherapy) | E = 0 | NR | Significant reduction of HR (p ≤ 0.05) and DBP values (p ≤ 0.05) |
Crizzle and Newhouse [6] | To study the effect of WBE on PD symptoms | ABCS (balance), VPS (health-related quality of life), Ten physical tests (fitness) | On | E = 6 | 71–89 | 2 | NR | E = WBE (water exercise) | E = 2 | 89.5 ± 10.2 % | Improvements were found in all analyzed variables, except in flexibility tests, ABCS and VPS |
Therrien et al. [34] | To study the effect of WBE on postural control and quality of life | BCS (balance and posture), PDQ-8 (quality of life), UPDRS-III (motor symptoms) | NR | NR | NR | NR | NR | E = WBE (aquatic exercise) | NR | NR | Significant improvements in the psychological factor (p = 0.015), UPDRS-III (p = 0.025) and postural stability (BCS) (p < 0.024) |
Sage et al. [31] | To evaluate the effectiveness of four exercise interventions on motor symptoms of PD | UPDRS-III (motor symptoms) | On | E 1 = 12(M) | E 1 = 63.1 ± 9.2 | NR | E 1 = 7.7 ± 6.4 | E 1 = WBE (aquatic exercise) | E 1 = 0 | 90 % | E 1 = UPDRS-III did not improve significantly (p > 0.05) |
E 2 = 17 | E 2 = 65.8 ± 9.9 | E 2 = 3.8 ± 3.9 | E 2 = LBE (aerobic intervention) | E 2 = 0 | E 2 = UPDRS-III did not improve significantly (p > 0.05) | ||||||
E 3 = 18 | E 3 = 68.7 ± 8.3 | E 3 = 5.7 ± 4.0 | E 3 = LBE (strength training) | E 3 = 0 | E 3 = UPDRS-III improved significantly (p < 0.004) | ||||||
E 4 = 24 | E 4 = 68.0 ± 11.0 | E 4 = 5.1 ± 4.5 | E 4 = LBE (sensory attention-focused exercise) | E 4 = 0 | E 4 = UPDRS-III improved significantly (p<0.001) | ||||||
C = 18 | C = 68.6 ± 8.1 | C = 3.2 ± 2.8 | C = nonexercise | C = 0 | |||||||
Ayán and Cancela [2] | To evaluate the feasibility and efficacy of WBE on PD | SFT (fitness), PDQ-39 (quality of life), UPDRS-III (motor symptoms), UPDRS-I (mental status), UPDRS-II (activities of daily living), and BI (autonomy) | On | E = 13 | 65.3 ± 9.6 | 1–3 | 5.8 ± 3.9 | E = WBE (aquatic exercise) | E = 3 | ≥80 % | Significant improvements in PDQ-39 (parts I and II) (p ≤ 0.05), UPDRS-II (p ≤ 0.05), BI (p ≤ 0.01), SFT flexibility (p ≤ 0.05), and SFT aerobic (p ≤ 0.01). |
Ayán and Cancela [1] | To compare the effects of 2 different WBE on PD symptoms | FTSTS (functional mobility), UPDRS-III (motor symptoms) and PDQ-39 (quality of life) | On | E 1 = 11 | E 1 = 68.9 ± 9.6 | E 1= 2.4 ± 0.7 | E 1= 6.1 ± 3.1 | E 1 = WBE (low-intensity water exercise) | E 1 = 1 | 80–85 % | Significant improvements in UPDRS-III (p = 0.006), PDQ-39 (p = 0.001) and FTSTS (p = 0.001) |
E 2 = 10 | E 2 = 71.9 ± 5.1 | E 2= 2.0 ± 0.7 | E 2= 7.5 ± 5.5 | E 2 = WBE (muscular resistance water exercise) | E 2 = 0 | ||||||
Kargarfard et al. [20] | To survey the effects of WBE on balance | BBS (balance) | On | E = 10(W) | E = 87.6 ± 1.4 | NR | NR | E = WBE (aquatic exercise) | E = 0 | NR | Significant improvements in BBS (p ≤ 0.05) |
C = 10(W) | Ca = 60.8 ± 5.5 | C = Maintain their current lifestyle | C = 0 | ||||||||
Kawasaki [21] | To explain the effects of WBE on balance improvement and to discuss the differences with home-based land exercise | BBS (balance), BBT (balance), STS (balance) and ABCS (balance) | NR | E = 15 | NR | NR | NR | E = WBE (therapeutic exercise) | E = 0 | NR | Significant improvements in STS (p < 0.05) and BBT (p < 0.05) |
Ca = 15 | Ca = LBE (similar exercises at home) | Ca = 0 | |||||||||
Vivas et al. [38] | To compare 2 different protocols of physiotherapy (WBE, LBE) on postural stability and self-movement | FRT (flexibility), BBS (balance), gait (balance) TUG (postural stability) and UPDRS (PD Disability Scale) | Off | E = 6 | E = 65.6 ± 3.6 | E = 2.67 ± 0.5 | E = 4.17 ± 1.6 | E = WBE (water-based therapy) | E = 1 | NR | Significant improvements in BBS (p = 0.010) and UPDRS (p = 0.036) |
Ca = 6 | Ca = 68.3 ± 6.9 | Ca = 2.40 ± 0.5 | Ca = 7.83 ± 3.9 | Ca = LBE (land-based therapy) | Ca = 0 | ||||||
Jung et al. [18] | To investigate the effects of WBE on various balance outcomes | ABCS (balance), BBS (balance), postural sway (balance) and STS (balance) | NR | E = 12 | NR | NR | NR | E = WBE (therapeutic exercise program) | E = 3 | NR | Significant improvements in STS (p < 0.039) |
Ca = 12 | Ca = LBE (similar exercises at home) | Ca = 6 |