Aquatic physical therapy for Parkinson’s disease


One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alternatives for PD carriers. Aim: To analyze the effects of the Halliwick Concept hydrotherapy in acquisition of motor skills in Parkinson’s disease (PD) patients. Methods: A clinical, qualitative method was used to evaluate 7 volunteers (59.85 ± 7.92 years of age, both male and female), who were in II and III stages of PD according to the Hoehn & Yar Scale. The participants were evaluated in the start and end of the interventions phase, and then the evaluation was conducted interventions in a heated pool (32?C - 34?C) twice a week, each session lasting approximately 30 minutes, totaling 10 sessions. The Halliwick Principles’ 3-phase 10-point methods were used for acquisition of aquatic motor skills. Results: They indicate an improvement in their ability to float in prone and supine positions (P = 0.04*) and longitudinal rotation in the bipedal position. Conclusion: The activation of motor control improved the motor skills of the participants.

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Zotz, T. , Souza, E. , Israel, V. and Loureiro, A. (2013) Aquatic physical therapy for Parkinson’s disease. Advances in Parkinson's Disease, 2, 102-107. doi: 10.4236/apd.2013.24019.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Alfieri, F.M., Teodori, R.M. and Guirro, R.R.J. (2006) Estudo baropodométrico em idosos submetidos à interven??o fisioterapêutica. Fisioterapia em Movimento, 19, 67-74.
[2] O’Sullivan, S.B. (2004) Fisioterapia: Avalia??o e Tratamento. 2nd Edition, Editora Manole Ltda, Rio de Janeiro.
[3] Bloem, B.R., Van Vugt, J.P. and Beckley, D.J. (2001) Postural instability and falls in Parkinson’s disease. Advances in Neurology, 87, 209-223.
[4] Navarro, F.M. and Arag?o, F.A. (2005) Influências do envelhecimento, do tempo de evolu??o da doen?a e do estado cognitivo sobre episódios de quedas, em uma popula??o parkinsoniana. Revista Brasileira de Fisioterapia, 6, 250-254.
[5] Miyai, I., Fujimoto, Y., Ueda, Y., Yamamoto, H., Nozaki, S., Saito, T. and Kang, J. (2000) Treadmill training with body weight support: Its effect on Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 81, 849-852.
[6] Gobbi, L.T., Oliveira-Ferreira, M. D., Caetano, M.J., Lirani-Silva, E.; Barbieri, F.A., Stella, F. and Gobbi, S. (2009) Exercise programs improve mobility and balance in people with Parkinson’s disease. Parkinsonism & Related Disorders, 15, S49-S52.
[7] Scandalis, T.A., Bosak, A.; Berliner, J.C.; Helman, L.L. and Wells, M.R. (2001) Resistence training and gait function in patients with Parkinson’s disease. American Journal of Physical Medicine & Rehabilitation, 80, 38-43.
[8] Jessop, R.T., Horowicz, C. and Dibble, L.E. (2006) Motor learning and Parkinson disease: Refinement of movement velocity and endpoint excursion in a limit of stability balance task. Neurorehabilitation and Neural Repair, 20, 459-467.
[9] Vivas, J., Arias, P. and Cudeiro, J. (2011) Aquatic therapy versus Conventional Land-Based Therapy for Parkinson’s Disease: An open-label pilot study. Archives of Physical Medicine and Rehabilitation, 92, 1202-1210.
[10] Katsura, Y., Yoshikawa, T., Ueda, S.Y., et al. (2010) Effects of aquatic exercise training using water-resistance equipment in elderly. European Journal of Applied Physiology, 108, 957-964.
[11] Israel, V.L. and Pardo, M.B.L. (2000) Hidroterapia: Proposta de um programa de ensino no trabalho com o lesado medular em piscina aquecida. Fisioterapia em Movimento, 13, 111-127.
[12] Gnoato, T.G., Viana, J., Sabino, J., Cruz, L., Loureiro, A.P.C. and Cidade, L. (2009) Aquatic physical therapy approach, using the Halliwick Concept, for improvement of aquatic motor skills, among Parkinson’s disease patients. 18th WFN World Congress on Parkinson’s Disease, Miami Beach, 2009
[13] Ruoti, R.G., Morris, D.M. and Cole, A.J. (2000) Reabilita??o aquática. Manole, S?o Paulo.
[14] Barbosa, A.D., Camargo, de C.R., Arruda, E. de S. and Israel, V.L. (2006) Avalia??o fisioterapêutica aquática. Fisioterapia em Movimento, 19, 135-147.
[15] Resende, S.M., Rassi, C.M. and Viana, F.P. (2008) Efeitos da hidroterapia na recupera??o do equilíbrio e preven??o de quedas em idosas. Revista Brasileira Fisioterapia, 12, 53-57.
[16] Turato, E.R. (2003) Tratado de metodologia da pesquisa clínico-qualitativa: Constru??o teórico-epistemológica, discuss?o comparada e aplica??o nas áreas da saúde e humanas. Vozes, Rio de Janeiro.
[17] Hoehn, M.M. and Yahr, M.D. (1967) Parkinsonism: Onset, progression and mortality. Neurology, 17, 573-581.
[18] Lambeck, J. and Stanat, F.C. (2001) The Halliwick method. Part 1 and Part 2. AKMA, 15, 39-41.
[19] Avelar, N.C., Bastone, A.C., Alcantara, M.A. and Gomes, W.F. (2010) Effectiveness of aquatic and non-aquatic lower limb muscle endurance training in the static and dynamic balance of elderly people. Revista Brasileira Fisioterapia, 14, 229-236.
[20] Arnold, C.M. and Faulkner, R.A. (2010) The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis. Journal of Aging and Physical Activity, 18, 245-260.
[21] Arnold, C.M., Busch, A.J., Schachter, C.L., Harrison, E.L. and Olszynski, W.P. (2008) A randomized clinical trial of aquatic versus land exercise to improve balance, function, and quality of life in older women with osteoporosis. Physiotherapy Canada, 60, 296-306.
[22] Roth, A.E., Miller, M.G., Ricard, M., Ritenour, D. and Chapman, B.L. (2006) Comparisons of static and dynamic balance following training in aquatic and land environments. Journal of Sport Rehabilitation, 15, 299-311.
[23] Gago, I.F. and Seco, J.C. (2008) Programa de fisioterapia mejora a largo plazo las habilidades motoras en pacientes con enfermidad de Parkinson. Revista Iberoamericana de Fisioterapia y Kinesiologia, 11, 81-92.
[24] Mello, M.P.B. and Botelho, A.C.G. (2010) Correla??o das escalas de avalia??o utilizadas na Doen?a de Parkinson com aplicabilidade na fisioterapia. Fisioterapia em Movimento, 23, 121-127.
[25] Association of Swinning Therapy (2000) Nata??o para deficientes. 2nd Edition, Manole, S?o Paulo.
[26] Andrade, C.H.S., Silva, B.F. and Corso, S.D. (2010) Efeitos da hidroterapia no equilíbrio de indivíduos com doen?a de Parkinson. Conscientiae Saúde, 9, 317-323.
[27] Ayán, C. and Cancela, J.M. (2012) Feasibility of 2 different water-based exercise training programs in patients with Parkinson’s disease: A pilot study. Archives of Physical Medicine and Rehabilitation, 93, 1709-1714
[28] Ayán, C. and Cancela, J.M. (2012) Effects of aquatic exercise on persons with Parkinson’s disease: A preliminary study. Science & Sports, 27, 300-304.
[29] Hartley, G.W., Schwiering, L., Shapiro, S. and Longfellow G. (2010) The effects of aquatic physical therapy on functional mobility in a sedentary patient with osteoarthritis, Parkinson disease, and depression. Journal of Aquatic Physical Therapy, 18, 2-9.
[30] Reuter, I., Engelhardt, M., Stecker, K. and Baas, H. (1999) Therapeutic value of exercise training in Parkinson’s disease. Medicine & Science in Sports & Exercise, 31, 1544-1549.

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