A Systematic Review of the Effectiveness Aquatic Exercises has for Individuals with Parkinson's Disease

Purpose: The aim of this systematic review was to examine the evidence regarding benefits of aquatic exercise for patients with Parkinson's disease. Methods: Electronic databases used were PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two individuals independently searched for relevant literature & sorted based on the inclusion criteria. Studies were included if they met the diagnosis criteria (Hoehn & Yagr scale or physician diagnosed) and aquatic exercise was the main intervention. Articles were excluded if they were not available in English. Results: Of 19 articles, there were eleven randomized controlled trials, one nonrandomized controlled trial, one case control study, five cohort studies, and one case study. Participant age ranged from 60 to 76 and overall inclusion criteria was 19-95 or older. Sample sizes ranged from 1 to 46 participants and 437 individuals were analyzed. Treatment duration was 3-4 up to 16 weeks with session frequency being 1-2 sessions up to 5 per week. Session length ranged from 35 to 60 minutes. A range of aquatic exercises and techniques were used to address multiple impairment areas. Various outcome measures were used to assess effectiveness of treatment. Conclusions: The evidence suggests an aquatic exercise program may effectively address deficits in quality of life, functional mobility, balance, posture, pain, and mood. Studies reported that aquatic activities are safe, enjoyable, & feasible interventions without adverse events or exacerbation of symptoms. Variability between studies was found with randomization, intervention parameters, population, and outcome measures for documenting changes.