Scoping review: how do the properties of heated water influence the prescription of aquatic physical exercises to develop motor skills in people with Parkinson's disease?

Purpose. Aquatic intervention seems to influence the motor skills of people with Parkinson's disease (PD). However, little is known about the transference of these motor skills to the land environment, as well as the use of the therapeutic properties of water. The study aim was to identify the aquatic intervention strategies considering the properties of water for the development of motor skills in PD. Methods. With the PRISMA and Cochrane checklist, a systematic review was conducted involving 7 databases with randomized and nonrandomized studies from 2010 to July 2020. The prescription and description of aquatic physical exercise data were extracted and summarized, and the use of physical and thermal properties of heated water was analysed. Results. Overall, 13 studies involving 307 participants (Hoehn and Yahr scale 1-4) met the inclusion criteria. In accordance with the Jadad scale, 7 studies were classified as low-quality (score 0-2), whereas 6 were categorized as high-quality (score 3). All the selected studies concentrated on aquatic physical exercise programs developed by the researchers who focused on transferring motor skills - such as mobility and functional reach, balance, motor aspects, activities of daily living, quality of life, and gait - to the land environment. Conclusions. Aquatic intervention strategies can be adequately prescribed as beneficial to motor skill training in PD. The analysis of the physical and thermal properties of heated water is useful to systematize prescription parameters depending on the characteristics of the PD patient and the heated aquatic environment.