Zotz (2013) Aquatic physical therapy for Parkinson’s disease


This study aimed to assess the effects of hydrotherapy, specifically the Halliwick Concept, on motor skills in Parkinson’s disease (PD) patients. Seven volunteers in Hoehn & Yar stages II and III, aged between 40 and 70, were evaluated before and after ten hydrotherapy sessions in a heated pool. The Halliwick Concept principles were employed to teach aquatic motor skills. The results demonstrated improvements in buoyancy in both prone and supine positions, as well as in longitudinal rotation in a bipedal stance. The activation of motor control was found to enhance participants’ motor skills.


Parkinson’s disease (PD) is a chronic and progressive neurological disorder that affects motor skills, resulting in postural and balance issues. Aquatic physical therapy (APT) is considered a potential intervention for PD patients, given its benefits in improving balance, reducing postural instability, and enhancing overall treatment for various disorders. This study explores the efficacy of the Halliwick Concept hydrotherapy in enhancing motor skills in PD patients.


Participants: Seven volunteers (aged 40-70) in Hoehn & Yar stages II and III of PD. Intervention: Ten hydrotherapy sessions in a heated pool (32-34°C), lasting 30 minutes each, using the Halliwick Concept principles for aquatic motor skill acquisition. Evaluation: Assessment of motor skills before and after the intervention, including buoyancy, rotations, and striding.


The study revealed significant improvements in the participants’ ability to float in prone and supine positions (p = 0.04*), as well as in longitudinal rotation while standing. These findings suggest that the Halliwick Concept hydrotherapy effectively enhanced motor control and improved motor skills in PD patients.


Aquatic physical therapy has shown promise in improving balance and coordination, particularly in elderly individuals. PD patients often experience motor skill deterioration, making hydrotherapy a valuable intervention. The Halliwick Concept’s focus on aquatic motor skill learning and proprioceptive motor strategies provided a three-dimensional approach to balance and movement control.


Hydrotherapy, following the Halliwick Concept principles, can significantly improve motor skills in PD patients. This intervention may serve as a valuable tool for health promotion, secondary prevention, and the treatment of Parkinson’s disease. Larger-scale longitudinal studies are recommended to further validate these findings and assess the long-term benefits of aquatic therapy for this population.

Keyphrase: Aquatic Therapy for PD

Keywords: aquatic therapy, Parkinson’s disease, motor skills, balance improvement, Halliwick Concept

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