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A comparison between aquatic and land-based physical exercise on postural sway and quality of life in people with Parkinson’s disease: a randomized controlled pilot study

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Abstract

Purpose

The objective of this pilot study was to compare the effects of water-based exercise to conventional land-based exercise on postural sway and quality of life in people with Parkinson’s disease.

Methods

Twenty people (male) with Parkinson’s disease were randomly divided into two groups of ten. Both groups carried out an 8-week (three sessions per week) physical exercise protocol. Postural sway and quality-of-life parameters of two groups were measured in pre- and post-intervention sessions.

Results

The between-group analyses indicate a greater reduction and thus improvement in the mean velocity of sway (p = 0.01) and an increase in the quality-of-life scores (p < 0.001) in the water-based group compared to land based.

Conclusions

Water-based exercises were more beneficial than land-based exercises when considering improvements to postural stability and the quality of life of those with Parkinson’s disease. The aquatic therapy is a promising intervention in the rehabilitative care of people with Parkinson’s disease.

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References

  1. De Lau LM, Breteler MM (2006) Epidemiology of Parkinson’s disease. The Lancet Neurology. 5(6):525–535

    Article  PubMed  Google Scholar 

  2. Kwakkel G, de Goede CJ, van Wegen EE (2007) Impact of physical therapy for Parkinson’s disease: a critical review of the literature. Parkinsonism Relat Disord 13(Suppl 3):S478–S487

    Article  PubMed  Google Scholar 

  3. van der Kolk NM, King LA (2013) Effects of exercise on mobility in people with Parkinson’s disease. Mov Disord 28(11):1587–1596

    Article  PubMed  Google Scholar 

  4. Jankovic J (2008) Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 79(4):368–376

    Article  CAS  PubMed  Google Scholar 

  5. Wood BH, Bilclough JA, Bowron A, Walker RW (2002) Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry 72(6):721–725

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lo RY, Tanner CM, Albers KB, Leimpeter AD, Fross RD, Bernstein AL et al (2009) Clinical features in early Parkinson disease and survival. Arch Neurol 66(11):1353–1358

    Article  PubMed  Google Scholar 

  7. Ruhe A, Fejer R, Walker B (2010) The test-retest reliability of centre of pressure measures in bipedal static task conditions–a systematic review of the literature. Gait Posture 32(4):436–445

    Article  PubMed  Google Scholar 

  8. Almeida IAD, Terra MB, Oliveira MRD, Silva RAD Jr, Ferraz HB, Santos SMS (2016) Comparing postural balance among older adults and Parkinson’s disease patients. Motriz Rev de Educ Física 22(4):261–265

    Article  Google Scholar 

  9. Chung KA, Lobb BM, Nutt JG, McNames J, Horak F (2010) Objective measurement of dyskinesia in Parkinson’s disease using a force plate. Mov Disord 25(5):602–608

    Article  PubMed  PubMed Central  Google Scholar 

  10. Doná F, Aquino CC, Gazzola JM, Borges V, Silva SM, Ganança FF et al (2016) Changes in postural control in patients with Parkinson’s disease: a posturographic study. Physiotherapy 102(3):272–279

    Article  PubMed  Google Scholar 

  11. Menant JC, Latt MD, Menz HB, Fung VS, Lord SR (2011) Postural sway approaches center of mass stability limits in Parkinson’s disease. Mov Disord 26(4):637–643

    Article  PubMed  Google Scholar 

  12. Nonnekes J, de Kam D, Geurts AC, Weerdesteyn V, Bloem BR (2013) Unraveling the mechanisms underlying postural instability in Parkinson’s disease using dynamic posturography. Expert Rev Neurother 13:1303–1308

    Article  CAS  PubMed  Google Scholar 

  13. Dibble LE, Addison O, Papa E (2009) The effects of exercise on balance in persons with Parkinson’s disease: a systematic review across the disability spectrum. J Neurol Phys Ther 33(1):14–26

    Article  PubMed  Google Scholar 

  14. Tomlinson CL, Herd CP, Clarke CE, Meek C, Patel S, Stowe R et al (2014) Physiotherapy for Parkinson’s disease: a comparison of techniques. Cochrane Database Syst Rev 2014(6):2815

    Google Scholar 

  15. Hass CJ, Buckley TA, Pitsikoulis C, Barthelemy EJ (2012) Progressive resistance training improves gait initiation in individuals with Parkinson’s disease. Gait Posture 35(4):669–673

    Article  PubMed  Google Scholar 

  16. Lima LO, Scianni A, Rodrigues-de-Paula F (2013) Progressive resistance exercise improves strength and physical performance in people with mild to moderate Parkinson’s disease: a systematic review. J Physiother 59(1):7–13

    Article  PubMed  Google Scholar 

  17. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J et al (2012) Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med 366(6):511–519

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. de Dreu MJ, van der Wilk AS, Poppe E, Kwakkel G, van Wegen EE (2012) Rehabilitation, exercise therapy and music in patients with Parkinson’s disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life. Parkinsonism Relat Disord 18(suppl 1):S114–S119

    Article  PubMed  Google Scholar 

  19. Duchesne C, Lungu O, Nadeau A, Robillard ME, Boré A, Bobeuf F et al (2015) Enhancing both motor and cognitive functioning in Parkinson’s disease: aerobic exercise as a rehabilitative intervention. Brain Cogn 99:68–77

    Article  CAS  PubMed  Google Scholar 

  20. Hackney ME, Earhart GM (2009) Effects of dance on movement control in Parkinson’s disease: a comparison of Argentine tango and American ballroom. J Rehabil Med 41(6):475–481

    Article  PubMed  PubMed Central  Google Scholar 

  21. Giladi N (2009) Mobility and exercise in movement disorders. Parkinsonism Relat Disord 15(Suppl 3):S46–S48

    Article  PubMed  Google Scholar 

  22. Ayán Pérez C, Cancela JM (2013) Effectiveness of water-based exercise in people living with Parkinson’s disease: a systematic review. Eur Rev Aging Phys Act 11:107

    Article  Google Scholar 

  23. Vivas J, Arias P, Cudeiro J (2011) Aquatic therapy versus conventional land-based therapy for Parkinson’s disease: an open-label pilot study. Arch Phys Med Rehabil 92(8):1202–1210

    Article  PubMed  Google Scholar 

  24. Kargarfard M, Chitsaz A, Azizi S (2012) Effects of an 8-week aquatic exercise training on balance in patients with Parkinson’s disease. J Isfahan Med Sch 30(178):141–150

    Google Scholar 

  25. Suomi R, Koceja DM (2000) Postural sway characteristics in women with lower extremity arthritis before and after an aquatic exercise intervention. Arch Phys Med Rehabil 81(6):780–785

    Article  CAS  PubMed  Google Scholar 

  26. Devereux K, Robertson D, Briffa NK (2005) Effects of a water-based program on women 65 years and over: a randomised controlled trial. Aust J Physiother. 51(2):102–108

    Article  PubMed  Google Scholar 

  27. 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(4):296–306

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Katsura Y, Yoshikawa T, Ueda SY, Usui T, Sotobayashi D, Nakao H et al (2010) Effects of aquatic exercise training using water-resistance equipment in elderly. Eur J Appl Physiol 108(5):957–964

    Article  PubMed  Google Scholar 

  29. Elbar O, Tzedek I, Vered E, Shvarth G, Friger M, Melzer I (2013) A water-based training program that includes perturbation exercises improves speed of voluntary stepping in older adults: a randomized controlled cross-over trial. Arch Gerontol Geriatr 56(1):134–140

    Article  PubMed  Google Scholar 

  30. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17(5):427–442

    Article  CAS  PubMed  Google Scholar 

  31. Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease (2003) The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations. Mov Disorders 18(7):738

    Article  Google Scholar 

  32. De Boer AGEM, Wijker W, Speelman JD, De Haes JCJM (1996) Quality of life in patients with Parkinson’s disease: development of a questionnaire. J Neurol Neurosurg Psychiatry 61(1):70–74

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ghaem H, Haghighi AB, Zeighami B, Dehghan A (2010) Validity and reliability of the Persian version of the Parkinson disease quality of life (PDQL) questionnaire. J Kerman Univ Med Sci 17(1):49–58

    Google Scholar 

  34. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC et al (2007) Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 116(9):1094

    Article  PubMed  Google Scholar 

  35. Wheat JS, Haddad JM, Fedirchuk K, Davids K (2014) Effects of textured socks on balance control during single-leg standing in healthy adults. Proc Eng 72:120–125

    Article  Google Scholar 

  36. Bigelow KE (2008) Identification of key traditional and fractal postural sway parameters to develop a clinical protocol for fall risk assessment in older adults. The Ohio State University, Columbus

    Google Scholar 

  37. Raymakers JA, Samson MM, Verhaar HJ (2005) The assessment of body sway and the choice of the stability parameter(s). Gait Posture 21(1):48–58

    Article  CAS  PubMed  Google Scholar 

  38. Stevens JP (2009) Applied multivariate statistics for the social sciences. Routledge, New York

    Google Scholar 

  39. Volpe D, Giantin MG, Maestri R, Frazzitta G (2014) Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study. Clin Rehabil 28:1210–1217

    Article  PubMed  Google Scholar 

  40. Brefel-Courbon C, Desboeuf K, Thalamas C, Galitzky M, Senard JM, Rascol O et al (2003) Clinical and economic analysis of spa therapy in Parkinson’s disease. Mov Disord 18(5):578–584

    Article  PubMed  Google Scholar 

  41. Kawasaki M (2009) The effects of aquatic exercise on balance outcomes in individuals with Parkinson’s disease: 1705: Board# 55 May 27 2: 00 PM-3: 30 PM. Med Sci Sports Exerc 41(5):102

    Article  Google Scholar 

  42. Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM (1996) Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans Biomed Eng 43(9):956–966

    Article  CAS  PubMed  Google Scholar 

  43. Rocchi L, Chiari L, Cappello A, Horak FB (2006) Identification of distinct characteristics of postural sway in Parkinson’s disease: a feature selection procedure based on principal component analysis. Neurosci Lett 394(2):140–145

    Article  CAS  PubMed  Google Scholar 

  44. Ickenstein GW, Ambach H, Klöditz A, Koch H, Isenmann S, Reichmann H et al (2012) Static posturography in aging and Parkinson’s disease. Front Aging Neurosci 4:20

    Article  PubMed  PubMed Central  Google Scholar 

  45. Chrischilles EA, Rubenstein LM, Voelker MD, Wallace RB, Rodnitzky RL (2002) Linking clinical variables to health-related quality of life in Parkinson’s disease. Parkinsonism Relat Disord 8(3):199–209

    Article  PubMed  Google Scholar 

  46. Morris DM (2010) Aquatic therapy to improve balance dysfunction in older adults. Topics Geriatr Rehabil 26(2):104–119

    Article  Google Scholar 

  47. Kluding P, McGinnis PQ (2006) Multidimensional exercise for people with Parkinson’s disease: a case report. Physiother Theory Pract 22(3):153–162

    Article  PubMed  Google Scholar 

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Acknowledgements

The work completed here was a Research Project which was co-registered by the Azad University of Khorasgan and Musculoskeletal Research Center, Isfahan University of Medical Sciences, Iran (Registration code: IR.IAU-KH.REC.1392.392345). This Project had no source fund.

Author information

Authors and Affiliations

  1. School of Physical Education and Sport Sciences, Khorasgan Branch, Azad Islamic University, Isfahan, Iran

    Reza Shahmohammadi & Gholam-Reza Sharifi

  2. Biomechanics Research Group, School of Engineering, University of Nottingham, Nottingham, UK

    Jonathan M. A. Melvin

  3. Musculoskeletal Research Center, No. 320, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Hezar Jerib St., Isfahan, Iran

    Ebrahim Sadeghi-Demneh

Authors
  1. Reza Shahmohammadi
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  2. Gholam-Reza Sharifi
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  3. Jonathan M. A. Melvin
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  4. Ebrahim Sadeghi-Demneh
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Correspondence to Ebrahim Sadeghi-Demneh.

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The authors have no conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Shahmohammadi, R., Sharifi, GR., Melvin, J.M.A. et al. A comparison between aquatic and land-based physical exercise on postural sway and quality of life in people with Parkinson’s disease: a randomized controlled pilot study. Sport Sci Health 13, 341–348 (2017). https://doi.org/10.1007/s11332-017-0363-8

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  • DOI: https://doi.org/10.1007/s11332-017-0363-8

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