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

Condition(s) studied

Investigational drug(s) / intervention(s)

Aquatherapy: The specific aquatic exercise protocol for Group 2, conducted in a 120 cm deep therapy pool at 30-32°C, includes the following exercises: Gait and Mobility: Water walking (forward and backward) and side-stepping. Dynamic Balance: Forward and lateral lunges, and single-leg stance/balance drills. Lower Extremity Strengthening: Hip kicks performed at the pool wall (flexion, extension, and abduction) and standing knee raises. Upper Body and Coordination: Arm raises (multi-directional) and deep-water cycling movements. Home Exercise Component: In addition to aquatic sessions, patients will continue land-based exercises including posture correction, flexibility/stretching, balance-coordination training, and strengthening.

home exercise: Group 1 patients will be prescribed a home exercise program at least 5 days per week for a duration of 6 weeks

Study 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

Primary outcome measure(s)

• Parkinson's Disease Questionnaire-39 — From enrollment to the end of treatment at 6 weeks
  Patients' quality of life will be evaluated using the Parkinson's Disease Questionnaire-39 (PDQ-39).The PDQ-39 is a 39-item questionnaire that covers eight distinct dimensions of functioning and well-being. The domains include: Mobility , Activities of Daily Living, Emotional Well-being , Stigma, Social Support, Cognition, Communicatio, Bodily Discomfort.The questionnaire uses a 5-point Likert response format where patients rate their experiences from "never" (0) to "always" (4). For each of the eight dimensions, a score is calculated and normalized to a 0-100 scale using the formula:Dimension Score = (Sum of Item Scores / Maximum Possible Score for Dimension) × 100 each dimension the minimum possible score is 0 and the maximum possible score is 100 after normalization. Considering the entire PDQ-39, the raw total score ranges from 0 to 156, where 0 represents the best possible quality of life and 156 the worst possible quality of life.

Trial sites (2)

More Ankara City Hospital Bilkent trials in Turkey

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