[2017] Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson’s disease; A randomized clinical trial

BACKGROUND: Gait, balance disorders and pain associated with Parkinson’s disease represent important therapeutic challenges, as they are related with an increased risk of falls, together with disability and physical decline.
AIM: To compare the effects of an aquatic ai chi training program on the perception of pain, the maintenance of balance and the functional independence of patients with Parkinson’s disease.
DESIGN: A single-blind randomized controlled trial.
SETTING: Parkinson’s associations and municipal pools.
POPULATION: Thirty individuals from two Parkinson’s associations in Spain participated in the study. Inclusion criteria: individuals diagnosed with Parkinson’s disease in stages 1 to 3 (Hoehn and Yahr Scale), older than 40 years, in the off phase (not medicated) and with a score greater or equal to 24 on the Mini-Mental State Examination Scale, without any medical contraindications and who accepted the study norms.
METHODS: The experimental group (N.=15 patients) participated in a program of aquatic ai chi. The control group (N.=15) received therapy on dry land. The intervention lasted 10 weeks with sessions held twice weekly. The pain VAS, Tinetti, Berg, Test Get Up and Go, Five Times Test and Unified Parkinson’s Disease Rating Scale were used.
RESULTS: Significant differences were found between the baseline and one-month follow up assessments in pain perception values (F=26.89, P<0.001), and the Tinetti Test (F=21.57, P<0.001) in the experimental group compared to the control group (P<0.05) with the exception of the FTSTS (P=0.006). In the control group, improvements were only seen on the VAS Pain Scale (F=8.3, P=0.004) and these were less significant than the changes found in the experimental group. Regarding the scores obtained on the UPDRS scale in the experimental group, there were significant differences in activities of daily living and motor examination, with the exception of mentation, behavior and mood.
CONCLUSIONS: An aquatic ai chi program appears to be a valid treatment option for patients diagnosed with mild to moderate Parkinson’s disease for the treatment of pain, balance and functional capacity.
CLINICAL REHABILITATION IMPACT : Physical exercise performed in water has positive effects on some of the necessary elements that contribute towards improved biomechanical gait patterns in our patients with Parkinson’s disease.

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