Lucia Cugusi1, Andrea Manca2, Marco Bergamin3, Andrea Di Blasio4, Marco Monticone5, Franca Deriu2, Giuseppe Mercuro5. 1. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. Electronic address: lucia.cugusi@unica.it. 2. Department of Biomedical Sciences, University of Sassari, Sassari, Italy. 3. Department of Medicine, Sport and Exercise Medicine Division, University of Padova, Italy. 4. Department of Medicine and Aging Sciences, Endocrine Section, 'G. d'Annunzio' University of Chieti - Pescara, Chieti, Italy. 5. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Abstract
QUESTIONS: What are the effects of aquatic exercise on disease severity, (non-)motor impairments, activity performance, fear of falling, and quality of life in people with Parkinson's disease (PD)? Does aquatic exercise have greater effects on these outcomes than other forms of exercise in people with PD? DESIGN: Systematic review and meta-analysis of randomised controlled trials. PARTICIPANTS: People with idiopathic PD. INTERVENTION: Supervised aquatic exercise programs ≥ 2 weeks. OUTCOMES MEASURES: The primary outcomes were disease severity, motor impairments, activity performance, and fear of falling. The secondary outcomes were non-motor impairments and quality of life. RESULTS: Of the 129 identified records, seven trials met the inclusion criteria and six were meta-analysed (159 participants). One trial assessed the effect of aquatic exercise compared with control and found a significant improvement in the Unified Parkinson's Disease Rating Scale Part III (MD -4.6, 95% CI -7.5 to -1.7) in favour of aquatic exercise. Six studies compared aquatic exercise with land-based exercise after intervention (mean 7.2 weeks of training (SD 2.2); 159 participants). The effect of aquatic exercise was superior to land-based exercise on the Berg Balance Scale (MD 2.7, 95% CI 1.6 to 3.9), the Falls Efficacy Scale (MD -4.0, 95% CI -6.1 to -1.8) and the 39-item Parkinson's Disease Questionnaire (MD -6.0, 95% CI -11.3 to -0.6), with no other significant effects identified. The significant benefit on the Berg Balance Scale was maintained at the follow-up assessment (MD 6.3, 95% CI 2.1 to 10.5, 54 participants). CONCLUSION: Aquatic exercise improves motor impairments in people with PD significantly more than no intervention. It also has slightly to moderately greater benefits than land-based exercise on balance capacity, fear of falling, and health-related quality of life. On other outcomes, the benefits of aquatic exercise are similar to those of land-based exercise. TRIAL REGISTRATION: PROSPERO CRD42017077370.
QUESTIONS: What are the effects of aquatic exercise on disease severity, (non-)motor impairments, activity performance, fear of falling, and quality of life in people with Parkinson's disease (PD)? Does aquatic exercise have greater effects on these outcomes than other forms of exercise in people with PD? DESIGN: Systematic review and meta-analysis of randomised controlled trials. PARTICIPANTS: People with idiopathic PD. INTERVENTION: Supervised aquatic exercise programs ≥ 2 weeks. OUTCOMES MEASURES: The primary outcomes were disease severity, motor impairments, activity performance, and fear of falling. The secondary outcomes were non-motor impairments and quality of life. RESULTS: Of the 129 identified records, seven trials met the inclusion criteria and six were meta-analysed (159 participants). One trial assessed the effect of aquatic exercise compared with control and found a significant improvement in the Unified Parkinson's Disease Rating Scale Part III (MD -4.6, 95% CI -7.5 to -1.7) in favour of aquatic exercise. Six studies compared aquatic exercise with land-based exercise after intervention (mean 7.2 weeks of training (SD 2.2); 159 participants). The effect of aquatic exercise was superior to land-based exercise on the Berg Balance Scale (MD 2.7, 95% CI 1.6 to 3.9), the Falls Efficacy Scale (MD -4.0, 95% CI -6.1 to -1.8) and the 39-item Parkinson's Disease Questionnaire (MD -6.0, 95% CI -11.3 to -0.6), with no other significant effects identified. The significant benefit on the Berg Balance Scale was maintained at the follow-up assessment (MD 6.3, 95% CI 2.1 to 10.5, 54 participants). CONCLUSION: Aquatic exercise improves motor impairments in people with PD significantly more than no intervention. It also has slightly to moderately greater benefits than land-based exercise on balance capacity, fear of falling, and health-related quality of life. On other outcomes, the benefits of aquatic exercise are similar to those of land-based exercise. TRIAL REGISTRATION: PROSPERO CRD42017077370.
Authors: Carlos Farinha; Hélder Santos; João Serrano; Bárbara Oliveiros; Fernanda M Silva; Márcio Cascante-Rusenhack; Ana Maria Teixeira; José Pedro Ferreira Journal: Int J Environ Res Public Health Date: 2022-03-13 Impact factor: 3.390