Is the aquatic thermal environment a suitable place for providing rehabilitative treatment for person with Parkinson’s disease? A retrospective study
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Many authors showed that aquatic physiotherapy could improve quality of life and reduce postural instability and risk of falling in elderly subjects. The aim of this research was to explore if the thermal aquatic environment is a suitable place for rehabilitative training in person with Parkinson disease (PwP) with results comparable to the standard physiotherapy. A retrospective study was conducted on a database of 14 persons with Parkinson who were admitted to a thermal aquatic rehabilitation to undergo treatments made to improve gait and balance impairments. The rehabilitation training consisted of 45-min sessions conducted twice a week, on non-consecutive days, over 4 weeks of functional re-education and kinesitherapy in the thermal pool. Educational and prevention instructions were also given to the patients during each session. Additionally, nutrition (diet), health education, and cognitive behavioral advice were given to our patients by therapists. The clinical characteristics of the sample were age 66 ± 9, disease duration 7 ± 5, and Hoehn and Yahr 1.5 ± 0.5. The statistical analysis showed a statistically significant improvement for the UPDRS p = 0.0005, for The Berg Balance Scale p = 0.0078, for the PDQ8 p = 0.0039, Tinetti p = 0.0068, and for Mini BESTest p = 0.0002. Our data suggest that this intervention could become a useful strategy in the rehabilitation program of PwP. The simplicity of treatment and the lack of side effects endorse the use of thermal aquatic environment for the gait and balance recovery in PwP.
KeywordsParkinson disease Thermal Rehabilitation Water exercises Balance
We thank the Medical Hotel Hermitage Bel Air for making the thermal setting available to our patients.
Compliance with ethical standards
The authors declare that they have no conflict of interest. All authors attest and affirm that the material within has not been and will not be submitted for publication elsewhere.
- Arnold CM, Busch AJ, Schachter CL, Harrison EL, Olszynski WP (2008) A randomized clinical trial of aquatic versus land exercise to improve balance, function, and quality of life in older women with osteoporosis. Physiother Can 60:296–306. https://doi.org/10.3138/physio.60.4.296 CrossRefGoogle Scholar
- Franceschini M, Colombo R, Posteraro F, Sale P (2015) A proposal for an Italian minimum data set assessment protocol for robot-assisted rehabilitation: a Delphi study. Eur J Phys Rehabil Med 51:745–753Google Scholar
- Furnari A, Calabrò RS, Gervasi G, la Fauci-Belponer F, Marzo A, Berbiglia F, Paladina G, de Cola MC, Bramanti P (2014) Is hydrokinesitherapy effective on gait and balance in patients with stroke? A clinical and baropodometric investigation. Brain Inj 28:1109–1114. https://doi.org/10.3109/02699052.2014.910700 CrossRefGoogle Scholar
- Geroin C, Mazzoleni S, Smania N, Gandolfi M, Bonaiuti D, Gasperini G, Sale P, Munari D, Waldner A, Spidalieri R, Bovolenta F, Picelli A, Posteraro F, Molteni F, Franceschini M, Italian Robotic Neurorehabilitation Research Group (2013) Systematic review of outcome measures of walking training using electromechanical and robotic devices in patients with stroke. J Rehabil Med 45:987–996. https://doi.org/10.2340/16501977-1234 CrossRefGoogle Scholar
- Kauffman BE, Kauffman BW (2014) Aquatic therapy. In: A Comprehensive Guide to Geriatric Rehabilitation. Elsevier, pp 517–519Google Scholar
- Kauffman TL, Scott RW, Barr JO, Moran ML (2014) A comprehensive guide to geriatric rehabilitation, 3rd edn. Churchill Livingstone (Elsevier), London, p 624Google Scholar
- Montagna JC, Santos BC, Battistuzzo CR, Loureiro APC (2014) Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors. Int J Clin Exp Med 7:1182–1187Google Scholar
- Morer C, Boestad C, Zuluaga P, Alvarez-Badillo A, Maraver F (2017) Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study. Rev Neurol 65:249–256Google Scholar
- Paoloni M, Bernetti A, Brignoli O et al (2017) Appropriateness and efficacy of Spa therapy for musculoskeletal disorders. A Delphi method consensus initiative among experts in Italy. Ann Ist Super Sanita 53:70–76 http://old.iss.it/binary/publ/cont/ANN_17_01_13.pdf Google Scholar
- Park B-S, Noh J-W, Kim M-Y, Lee LK, Yang SM, Lee WD, Shin YS, Kim JH, Lee JU, Kwak TY, Lee TH, Kim JY, Park J, Kim J (2015) The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study. J Phys Ther Sci 27:3549–3553. https://doi.org/10.1589/jpts.27.3549 CrossRefGoogle Scholar
- Park B-S, Noh J-W, Kim M-Y, Lee LK, Yang SM, Lee WD, Shin YS, Kim JH, Lee JU, Kwak TY, Lee TH, Park J, Kim J (2016) A comparative study of the effects of trunk exercise program in aquatic and land-based therapy on gait in hemiplegic stroke patients. J Phys Ther Sci 28:1904–1908. https://doi.org/10.1589/jpts.28.1904 CrossRefGoogle Scholar
- Sale P, De Pandis MF, Domenica LP et al (2013) Robot-assisted walking training for individuals with Parkinson’s disease: a pilot randomized controlled trial. BMC Neurol 13. https://doi.org/10.1186/1471-2377-13-50
- Stewart Williams J, Kowal P, Hestekin H et al (2015) Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-income countries: results from the WHO study on global AGEing and adult health (SAGE). BMC Med 13:147. https://doi.org/10.1186/s12916-015-0390-8 CrossRefGoogle Scholar
- Stocchi F, Sale P, Kleiner AFR, Casali M, Cimolin V, de Pandis F, Albertini G, Galli M (2015) Long-term effects of automated mechanical peripheral stimulation on gait patterns of patients with Parkinson’s disease. Int J Rehabil Res 38:238–245. https://doi.org/10.1097/MRR.0000000000000120 CrossRefGoogle Scholar
- Volpe D, Giantin MG, Manuela P, Filippetto C, Pelosin E, Abbruzzese G, Antonini A (2017) Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson’s disease: a randomized controlled pilot study. Clin Rehabil 31:1107–1115. https://doi.org/10.1177/0269215516664122 CrossRefGoogle Scholar
- Zhang Y, Wang Y-Z, Huang L-P, Bai B, Zhou S, Yin MM, Zhao H, Zhou XN, Wang HT (2016) Aquatic therapy improves outcomes for subacute stroke patients by enhancing muscular strength of paretic lower limbs without increasing spasticity. Am J Phys Med Rehabil 95:840–849. https://doi.org/10.1097/PHM.0000000000000512 CrossRefGoogle Scholar