Evaluation of the Effects of Aquatic Therapy on Activities of Daily Living, Walking, Balance, Posture, Pain, and Depression in Parkinson's Patients

Summary

Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as bradykinesia, tremors, and postural instability, as well as various non-motor symptoms. Conventional land-based rehabilitation is standard; however, aquatherapy-utilizing water's buoyancy, hydrostatic pressure, and viscosity-offers a promising alternative to improve balance and mobility while reducing fall risks. This study aims to evaluate the effects of aquatherapy on gait, balance, posture, freezing of gait, activities of daily living (ADL), pain, and depression in Turkish PD patients. This is a prospective, single-blind, randomized controlled trial involving 42 patients at Ankara City Hospital. Participants will be divided into two groups: * Group 1 (Control): Home-based exercise program (5 days/week for 6 weeks). * Group 2 (Intervention): Home-based exercises plus supervised aquatherapy (3 sessions/week, 45 minutes each, in a 30-32°C pool). The study utilizes high-tech objective measurements and validated scales: * Gait \& Posture: Zebris Gait Analysis (spatiotemporal parameters) and Diers Formetric 4D (topographical posture analysis). * Balance: HUR-Smart Balance device and the Berg Balance Scale. * Clinical Scales: PDQ-39 (quality of life), Freezing of Gait Questionnaire, Falls Efficacy Scale, MMSE (cognitive), Beck Depression Inventory, and VAS (pain). This research is noteworthy as the first aquatherapy study among Turkish PD patients to utilize a large sample size and standardized aquatic exercise protocols. It seeks to provide a comprehensive analysis of both motor and non-motor improvements, potentially establishing aquatherapy as a superior adjunctive treatment for enhancing functional independence in Parkinson's patients. Primary hypothesis or outcome measure : Parkinson's Disease Questionnaire-39 . PDQ-39 is a patient-reported outcome measure designed to evaluate the health-related quality of life in Parkinson's patients across eight specific domains, including mobility, activities of daily living, and emotional well-being.

Eligibility

Inclusion Criteria:

* Having a diagnosis of Idiopathic Parkinson's Disease between the ages of 40-80 and consenting to the treatment.
* Being regularly followed by a neurologist and having a stable medical treatment regimen for at least 3 months.
* Having a disease stage between 1-3 according to the Modified Hoehn-Yahr Staging Scale (MHY).
* A score of 24 or higher on the Mini-Mental State Examination (MMSE).
* Being able to verticalize independently and ambulate with or without assistance.

Exclusion Criteria:

* Having orthopedic, rheumatological, or non-Parkinson's neurological disorders that affect functional status.
* Having a medical treatment regimen that has been modified within the last 3 months.
* Presence of Atypical Parkinson's Disease.
* Visual impairment.
* Presence of dementia.
* Decompensated cardiac or respiratory failure.
* Diabetes insipidus.
* Presence of systemic infection.
* Impaired skin integrity or the presence of skin infections.
* Increased sensitivity to inhaled steam or water chemicals.
* History of epilepsy or asthma.
* Urinary or fecal incontinence.
* Refusal to participate in or consent to the treatment.

Conditions3

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