Treating balance in Parkinson’s disease : hydrotherapy versus land-based therapy

Abstract

Parkinson’s disease (PD) is a neurodegenerative disorder that cannot be cured. However, treatments and medications might help to relieve symptoms (Mayo Clinic, 2017). Neither land-based therapy PD (Morris, Martin & Schenkman, 2010) nor hydrotherapy (Zotz, Souza, Israel & Loureiro, 2013) do cure PD, however, physical therapy is known by many researchers that it improves movement and relieves pain which therefore can increase independence and quality of life (Hubert, 2011). The aim of this study was to examine the effects of hydrotherapy in comparison to land- based physical therapy on balance among patients with PD. The following question was put forward: When comparing the effects on balance in patients with Parkinson’s disease, is hydrotherapy better than land-based therapy? The population of interest for this study were people diagnosed with PD. The main intervention was hydrotherapy while the comparison group was land-based therapy. The outcome was the effects on balance. A thorough search was conducted in order to choose the most appropriate studies to be critically appraised. Nine studies were chosen which met the criteria applied, of which 6 were RCTs, 2 Systemic Reviews and 1 Systemic and Meta-analysis. Inclusion criteria included articles published after 2007, peer-reviewed and studies that focus on balance as an outcome. Exclusion criteria include unpublished articles, not in English, abstract only and any other neurological disorder. The critical appraisal tool used was the Critical Appraisal Skills Programme (CASP) tool (2017). The findings validated that physical exercise is a non-pharmacological treatment that helps patients with PD to improve their balance, where hydrotherapy can be more effective than land-based therapy since it makes the individual more flexible in water. Lastly, recommendations for practice, education, policy development and research were considered. Diverse approaches for the distribution of findings were also deliberate. The most important recommendation put forward was to educate the general public about the importance of physical activity among people diagnosed with PD.