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Parkinson's is Better with Water...

Aquatic therapy offers several benefits compared to land-based therapies for patients with Parkinson's disease (PD).

Here is a short comparison based on recent literature:

1. Motor Impairments:

Aquatic Therapy: A systematic review and meta-analysis found that aquatic exercise significantly improved motor impairments in PD patients, as measured by the Unified Parkinson's Disease Rating Scale Part III (UPDRS III).[1]

Land-Based Therapy: While land-based exercises also improve motor function, the improvements in motor impairments were not as pronounced as those seen with aquatic therapy.[1]

2. Balance and Fear of Falling:

Aquatic Therapy: Aquatic exercise showed superior benefits in improving balance, as measured by the Berg Balance Scale, and reducing fear of falling, as measured by the Falls Efficacy Scale.[1-2]

Land-Based Therapy: Land-based exercises also improve balance and reduce fear of falling, but the effects were less significant compared to aquatic therapy.[1-2]

3. Quality of Life:

Aquatic Therapy: Aquatic exercise was associated with greater improvements in health-related quality of life, as measured by the 39-item Parkinson's Disease Questionnaire (PDQ-39).[1-2]

Land-Based Therapy: Land-based exercises also improve quality of life, but the improvements were not as substantial as those seen with aquatic therapy.[1-2]

4. Functional Mobility:

Aquatic Therapy: Studies have shown that aquatic therapy can significantly improve functional mobility, as measured by the Timed Up and Go (TUG) test and the 6-Minute Walk Test.[3-4]

Land-Based Therapy: Land-based exercises also improve functional mobility, but the benefits are comparable to those of aquatic therapy.[3-4]

5. Pain Management:

Aquatic Therapy: Aquatic therapy, including programs like Ai Chi, has been shown to significantly reduce pain perception in PD patients.[5]

Land-Based Therapy: Land-based exercises also reduce pain, but the reduction is less significant compared to aquatic therapy.[5]

In summary, aquatic therapy offers unique advantages over land-based therapies for Parkinson's patients, particularly in improving motor impairments, balance, fear of falling, quality of life, and pain management. These benefits are supported by recent systematic reviews and randomized controlled trials.[1-5]


  1. Cugusi L, Manca A, Bergamin M, et al. Aquatic Exercise Improves Motor Impairments in People With Parkinson's Disease, With Similar or Greater Benefits Than Land-Based Exercise: A Systematic Review. Journal of Physiotherapy. 2019;65(2):65-74. doi:10.1016/j.jphys.2019.02.003.

  2. Osborne JA, Botkin R, Colon-Semenza C, et al. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Physical Therapy. 2022;102(4):pzab302. doi:10.1093/ptj/pzab302.

  3. Palamara G, Gotti F, Maestri R, et al. Land Plus Aquatic Therapy Versus Land-Based Rehabilitation Alone for the Treatment of Balance Dysfunction in Parkinson Disease: A Randomized Controlled Study With 6-Month Follow-Up. Archives of Physical Medicine and Rehabilitation. 2017;98(6):1077-1085. doi:10.1016/j.apmr.2017.01.025.

  4. Volpe D, Giantin MG, Maestri R, Frazzitta G. Comparing the Effects of Hydrotherapy and Land-Based Therapy on Balance in Patients With Parkinson's Disease: A Randomized Controlled Pilot Study. Clinical Rehabilitation. 2014;28(12):1210-7. doi:10.1177/0269215514536060.

  5. Pérez de la Cruz S. Effectiveness of Aquatic Therapy for the Control of Pain and Increased Functionality in People With Parkinson's Disease: A Randomized Clinical Trial. European Journal of Physical and Rehabilitation Medicine. 2017;53(6):825-832. doi:10.23736/S1973-9087.17.04647-0.

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