Daniele Volpe1, Maria Giulia Giantin1, Roberto Maestri2, Giuseppe Frazzitta3. 1. Department of Physical Medicine and Rehabilitation, S. Raffaele Arcangelo Fatebenefratelli Hospital, Venice, Italy. 2. Department of Biomedical Engineering, Scientific Institute of Montescano, Montescano, Italy. 3. Department of Parkinson Disease Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Italy frazzittag62@gmail.com.
Abstract
OBJECTIVE: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson's disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. DESIGN: A randomized single-blind controlled trial. SETTING: Outpatients. SUBJECTS:Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5-3. INTERVENTION: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). MAIN MEASURES: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson's Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson's Disease Questionnaire-39. RESULTS:Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (-5.9 SD4.8 vs. -1.9 SD1.4, p = 0.003), Parkinson's Disease Quetionnaire-39 (-18.4 SD12.9 vs. -8.0 SD7.0, p = 0.006) and falls diary (-2.4 SD2.2 vs. -0.4 SD0.5, p = 0.001). CONCLUSION: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.
RCT Entities:
OBJECTIVE: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson's disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. DESIGN: A randomized single-blind controlled trial. SETTING: Outpatients. SUBJECTS: Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5-3. INTERVENTION: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). MAIN MEASURES: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson's Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson's Disease Questionnaire-39. RESULTS: Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (-5.9 SD4.8 vs. -1.9 SD1.4, p = 0.003), Parkinson's Disease Quetionnaire-39 (-18.4 SD12.9 vs. -8.0 SD7.0, p = 0.006) and falls diary (-2.4 SD2.2 vs. -0.4 SD0.5, p = 0.001). CONCLUSION: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonianpatients with moderate stage of disease.
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