Aquatic obstacle training improves freezing of gait in Parkinson's disease patients: a randomized controlled trial

Objective: Our aim was to evaluate the effect of aquatic obstacle training on balance parameters in comparison with a traditional aquatic therapy in patients with Parkinson's disease. Design: A randomized single-blind controlled trial. Setting: Outpatients in the rehabilitation department. Subjects: A total of 46 patients with Parkinson's disease in Hoehn-Yahr stage 2-3. Interventions: Participants were randomly assigned to (1) aquatic therapy or (2) obstacle aquatic therapy. All participants undertook aquatic therapy for 30 minutes, five times per week for six weeks. Main measures: The Freezing of Gait Questionnaire, Functional Reach Test, Timed Up and Go test and Berg Balance Scale were assessed at baseline, posttreatment and at six-month follow-up. Results: Both groups of patients had improved primary outcomes after the training program. A between-group comparison of the changes revealed that obstacle aquatic therapy was significantly higher for the Freezing of Gait Questionnaire (after treatment: 8.73.3 vs 6.2 +/- 2.1, P = 0.004; posttest: 7.7 +/- 3.1 vs 5.3 +/- 2.0, P = 0.003) and Timed Up and Go test (after treatment: 17.1 +/- 2.9 vs 13.8 +/- 1.9, P < 0.001; posttest: 16.3 +/- 2.8 vs 12.9 +/- 1.4, P < 0.001). Conclusion: Obstacle aquatic therapy in this protocol seems to be more effective than traditional protocols for gait and balance in patients with Parkinson's disease, and the effect lasts for six months.