TITLE:
Aquatic Physiotherapy and Parkinson’s Disease: Effects on Functional Motor Skills
AUTHORS:
Bruna Yamaguchi, Manoela de Paula Ferreira, Vera Lúcia Israel
KEYWORDS:
Physiotherapy, Parkinson’s Disease, Rehabilitation, Exercise, Hydrotherapy
JOURNAL NAME:
Advances in Parkinson's Disease,
Vol.9 No.1,
February
28,
2020
ABSTRACT: Parkinson’s Disease (PD) is a progressive disease
with motor impairment, and as such requires a multidisciplinary team that
includes physiotherapy. Physiotherapy can stimulate learning ability, motor
recovery, neuroplasticity and neuroprotection. The aquatic physiotherapy (AP)
for PD enables movements to be progressively and safely executed, reducing the
risk of falls. Hence, the objective of this study is to analyze the effects of
an AP program on the functional motor skills of people with PD. This is a
controlled quasi-experimental clinical trial, with blind assessor. The
participants were male and female, diagnosed with PD, Hoehn and Yahr stages 1
to 4 and medical certificate for AP. The exclusion criteria were: not
presenting independent walking; sensorial deficit; contraindications for
attending a heated pool; alterations in levodopa ingestion. The functional
assessments conducted on land were: walking speed test; Five Times Sit to Stand
Test; Mini BESTest, Unified Parkinson’s Disease Rating Scale (UPDRS) for
activities of daily living (ADL); and motor skill parts, evaluated before,
after and 4 months after AP. The aquatic assessment was conducted through the
Aquatic Functional Assessment Scale (AFAS). The participants were allocated in
two groups: Control Group (CG), which did not take part in the pool activities,
and Experimental Group (EG), which was
submitted to AP, throughout 32 twice-a-week, 50-minute-long appointments. Functional exercises were proposed to respect the principles of
specificity and progression regarding complexity in the aquatic activities
through aquatic motor skills learning phases. Groups and times were compared
statistically. At the end of the study, the EG was composed of 11 participants
and the CG 7. There were no differences between the groups at the beginning of
the study. A difference was observed between groups for gait speed in
evaluation 2; difference between assessment 1 and 2 for GE in the ADL and
motor, as well as between assessment 2 and 3 for GE in the motor assessment. CG
presented a decline from assessment 1 and 3. In the aquatic assessment, the EG
had a statistical difference after the intervention. It was observed that the
AP program can modify the aquatic motor skills and the land motor skills of
walking speed, the UPDRS ADL and the UPDRS motor.