Aquatic Therapy Versus Land-Based Therapy in Patients with Parkinson's Disease: A Systematic Review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Physical Therapy

Background:

• Parkinson's Disease (PD) is a leading neurodegenerative disorder causing significant motor and non-motor functional disabilities.
• Aquatic-based therapeutic exercise (AT), leveraging hydrostatic and hydrodynamic properties, presents a potential complementary approach for PD management.
• Traditional land-based therapeutic exercise (LT) is a common intervention, but AT's comparative efficacy requires systematic evaluation.

Purpose of the Study:

• To systematically review and evaluate the effectiveness and safety of aquatic-based therapeutic exercise (AT) compared to land-based therapeutic exercise (LT) in Parkinson's Disease (PD) patients.
• To assess the impact of AT on key outcomes including balance, gait, quality of life, strength, mental health, pain, flexibility, and sleep quality.
• To synthesize evidence from randomized controlled trials (RCTs) to inform clinical practice and future research.

Main Methods:

• A systematic review and meta-analysis was conducted following PRISMA guidelines, searching major databases (PubMed, Scopus, Web of Science, etc.).
• Included studies were RCTs published between 2014-2024, comparing AT interventions with LT control groups in PD patients.
• Outcomes encompassed balance, gait, quality of life, strength, mental health, pain, flexibility, and sleep quality.

Main Results:

• Thirteen RCTs involving 511 PD patients (aged 50-80) were analyzed, with AT generally demonstrating beneficial effects and a favorable safety profile.
• AT significantly improved quality of life, mental health, pain, flexibility, and sleep quality compared to LT (p < 0.05).
• While AT showed improvements in balance, gait, and strength from baseline, comparative evidence against LT for these specific outcomes was inconclusive due to study variability.

Conclusions:

• Aquatic-based therapeutic exercise (AT) is a safe and effective intervention for enhancing quality of life, mental health, pain management, flexibility, and sleep quality in individuals with Parkinson's Disease (PD).
• Evidence suggests potential benefits of AT for balance, gait, and strength in PD patients, though direct comparisons with land-based exercise (LT) require further investigation.
• The variability in study protocols necessitates standardized research designs to definitively establish AT's superiority over LT for all PD-related functional impairments.