title: Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson's disease: a randomized controlled pilot study.
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.
  
  
  METHODS
  A randomized single-blind controlled trial.
  
  
  METHODS
  Outpatients.
  
  
  METHODS
  Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5-3.
  
  
  METHODS
  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).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.
authors.affiliation: Department of Physical Medicine and Rehabilitation, S. Raffaele Arcangelo Fatebenefratelli Hospital, Venice, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Volpe
authors.affiliation: Department of Physical Medicine and Rehabilitation, S. Raffaele Arcangelo Fatebenefratelli Hospital, Venice, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Giantin
authors.affiliation: Department of Biomedical Engineering, Scientific Institute of Montescano, Montescano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Maestri
authors.affiliation: Department of Parkinson Disease Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Italy frazzittag62@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
mesh_terms: D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D006875:Hydrotherapy; D008875:Middle Aged; D010045:Outpatients; D010300:Parkinson Disease / Q000150:complications / Q000534:rehabilitation*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D012678:Sensation Disorders / Q000209:etiology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: Balance; Parkinson’s disease; hydrotherapy