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D.D. Iucksch1, J. Siega1, A. Silva1, B. Yamaguchi1, V. Israel2
1Federal University of Paraná, Physical Education Graduate Course, Curitiba, Brazil, 2Federal University of Paraná, Physical Therapy and Physical Education Graduate Course, Curitiba, Brazil
Background: Parkinson's disease (PD) is a neurodegenerative disease that mainly affects dopaminergic neurons in the mesencephalic black substance. Its progressive outcomes include motor and non-motor changes, which are reflected in daily activities of persons with PD. Of the several possibilities to manage motor symptoms of the disease, Hydrotherapy uses physiological benefits of the heated water physical properties with therapeutic exercise, generating positive outcomes for the motor impairments that are common in PD.
Purpose: To verify the effects of a 12-week Hydrotherapy program on the motor symptoms of persons with PD.
Methods: Quasi-experimental, quantitative, simple blind study (blind evaluator), in which a group of people with PD underwent Hydrotherapy, recruited for convenience. The research is approved by the Ethics Committee of the Federal University of Paraná, Curitiba-PR, complies with Resolution 466/12 of the National Health Council of Brazil, under registration 66781417.4.0000.0102 and Proof Number 2,200,372. Participants were assessed pre- and post-intervention using the PD Hoehn & Yahr staging scale and the UPDRS section III (motor symptoms) scale. Hydrotherapy exercises (Aquatic Physical Therapy program) took place for 12 weeks with a frequency of two weekly meetings. Each intervention lasted for one hour (10 minutes to assess initial and final vital signs and 50 minutes of immersion in a heated pool at 33º C). A program of aquatic therapeutic exercises have been proposed, based on Israel’s five phases for motor learning, focused on gaining muscle strength, body balance and functional mobility. UPDRS III was evaluated by comparing the initial and final evaluation using the paired t-test or Wilcoxon test. Shapiro-Wilk test was used to evaluate if distribution was normal. The statistics software SPSS 20.0 was used, adopting a value of p <0.05.
Results: 18 participants, 11 (61.1%) male and 7 (38.9%) female, with an average age of 66.72 ± 11.76 years were enrroled for this study. On the Hoehn & Yahr scale, 2 participants (11.11%) were classified in stage 1, 6 participants (33.33%) in stage 2, 4 participants (22.22%) in stage 3, and 6 participants (33 , 33%) in stage 4. There was a significant improvement (p = 0.03) in motor symptoms in the post-intervention assessment (12.04 ± 4,56 points), compared to the pre-intervention assessment (17.89 ± 8,33 points).
Conclusion(s): The suggested Aquatic Physical Therapy program was able to improve motor symptoms in a group of persons with PD.
Implications: The Aquatic Physical Therapy program included physical exercises for muscle strength, body balance and functional mobility through the training of motor skills such as sitting and standing, walking in different directions, as well as muscle power through strength training performed at high speed and activities for static and dynamic balance. As a result, there was an overall improvement in the motor symptoms of participants with PD, which indicates that Hydrotherapy might be a safe treatment that allows skill transferring for daily life activities for this population.
Funding, acknowledgements: This study was partially financed by Coordenação Aperfeiçoamento Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.
Keywords: Parkinson’s Disease, Hydrotherapy, Physical Therapy
Topic: Neurology: Parkinson's disease
Did this work require ethics approval? Yes
Institution: Federal University of Paraná, Brazil
Committee: Research Ethics Committee of the Federal University of Paraná, Brazil
Ethics number: 2200372
All authors, affiliations and abstracts have been published as submitted.
