Land Plus Aquatic Therapy Versus Land-Based Rehabilitation Alone for the Treatment of Balance Dysfunction in Parkinson Disease: A Randomized Controlled Study With 6-Month Follow-Up

Grazia Palamara, Francesco Gotti, Roberto Maestri, Rossana Bera, Roberto Gargantini, Fabiola Bossio, Ilaria Zivi, Daniele Volpe, Davide Ferrazzoli, Giuseppe Frazzitta

Research output: Contribution to journalArticle


Objectives: To assess whether a specific land-based physical intervention with the inclusion of aquatic therapy is more effective than land-based rehabilitation alone for the treatment of balance dysfunction in patients with Parkinson disease (PD), immediately after therapy and at 6 months' follow-up. Design: Randomized controlled study with 6-month follow-up. Setting: A PD and brain injury rehabilitation department in a general hospital. Participants: Patients (N=34) with moderate-stage PD. Intervention: Seventeen patients underwent a land-based rehabilitation protocol called multidisciplinary intensive rehabilitation treatment (MIRT), and 17 underwent MIRT plus aquatic therapy (MIRT-AT). Main Outcome Measures: The primary outcome measure was the Berg Balance Scale (BBS); secondary outcome measures were the Unified Parkinson Disease Rating Scale parts II and III (UPDRS II/III) and the Timed Up and Go (TUG) test. These measures were assessed in both groups at admission, at discharge, and after 6 months. Results: BBS improved after treatment in both groups. Even though no statistically significant difference between groups was observed at each observation time, BBS scores at follow-up were significantly higher than at baseline in MIRT-AT patients. Both groups also showed an improvement in UPDRS II/III and TUG at the end of treatment compared with baseline, but these findings were lost at the 6-month follow-up. Conclusions: Aquatic therapy added to land-based rehabilitation could provide a contribution to the treatment of balance dysfunction in patients with moderate-stage PD.

Original languageEnglish
Pages (from-to)1077-1085
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Publication statusPublished - Jun 2017



  • Ataxia
  • Hydrotherapy
  • Parkinson disease
  • Physical and rehabilitation medicine
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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