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Aquatic Therapy For Parkinson’s Disease

His X500 Swim Spa Heats Up The Idaho Winter With Warm

Aquatic Physical Therapy for Parkinson’s Disease

Its been remarkable, Mark says. After his Parkinsons diagnosis, his doctors recommended aquatic therapy to help him regain his balance. Thats why Mark invested in an Endless Pools® SwimCross® Exercise System, a 15-foot swim spa for his backyard.

After months of daily workouts, my balance is better, without a doubt, Mark now asserts. The swim spa has delivered other benefits too for his wife, his grandchildren, and to help make the long Idaho winters all the more bearable!

After his diagnosis with Parkinson’s disease, Mark turned to aquatic therapy to help him regain and retain his balance. He reports tangible results thanks to his daily aquatic therapy exercises. “My balance is better, without a doubt,” he now reports.

A Prolonged Diagnosis

A few years ago, Mark began experiencing tremors on the left side. Then as things started to progress, he recalls, it started going into some balance issues when I walk stepping off a step or stepping over something, that kind of stuff. And youd move slower, obviously.

It took them about a year and a half to two years to diagnose, he reports, and thats not unusual. A neurodegenerative disorder, Parkinsons disease can take many forms, with a range of possible symptoms. Once he had his official diagnosis, he was ready to act.

Choosing a Therapy Spa

Installing for Easy Access

How Effective Is Aquatic Therapy For Parkinsons Disease

A lot of exercise research has found that aquatic therapy for Parkinsons disease may be quite successful, especially in comparison to other methods of Parkinsons disease workouts and therapies.

Research studies comparing Parkinsons disease aquatic therapy and land-based Parkinsons disease therapy were published in the Archives of Physical Medicine and Rehabilitation in 2011. Researchers concluded that patients receiving aquatic therapy improved their postural stability significantly more.

A study conducted by Brazilian academics was published in the journal Advances in Parkinsons Disease in 2013. The study examined Parkinsons patients before, during, and after aquatic treatment and determined that the patients motor abilities enhanced after Parkinsons disease aqua workouts.

A 2012 research published in Gait & Posture discovered that patients who participated in aquatic training programs improved their hip angle, gait, speed, and stride length. Much more research has confirmed similar findings, suggesting that water treatment and exercise can help Parkinsons sufferers. Some studies have also indicated that water treatment is beneficial for Alzheimers disease and other critical illnesses.

What Is Aquatic Therapy

Aquatic therapy is a specialized type of physical therapy. It usually takes place in a temperature-controlled pool while working one-on-one with a licensed practitioner. Aquatic therapy covers a wide range of water-based therapeutic techniques and exercises for relaxation, fitness, and rehabilitation.

Ok, lets take a closer look at how water therapy can work as a treatment for Parkinsons.

5 Amazing Ways Aquatic Therapy Helps Parkinsons Patients:

Find Your Partner in Parkinsons Physical Therapy with Ageility When you live with PD, building a great support system is everything from finding the right doctor to engaging family and friends on your journey. It also means finding a therapy partner you can trust, one with the expertise to support your unique neurological condition and physical symptoms. This is where Ageilitys Partner in Parkinsons Program can really make an impact in your life. Several of our clinics are located in senior living communities with on-site pools, so you can dive in and experience the benefits of Aquatic Therapy for yourself. Find an Ageility clinic near you to learn more.

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Patients May Experience Stress And Anxiety Initially

Patients who have failed to respond to several medications may have low expectations. Some may be concerned about their ability to be safe in the pool while having a limited range of motion. Being seen in a swimming suit by others can be uncomfortable for many persons who have physical limitations caused by Parkinsons and other diseases.

There are several interventions that can assist people with these difficulties. Other patients testimonials and more data about water treatment might be beneficial. Explaining the treatment pool, Parkinsons disease therapy regimen, and what will happen inside and outside the pool can also be beneficial. In many circumstances, open communication, empathy, and humor may assist patients in overcoming hesitation, shyness, and concern.

How Aquatic Therapy Helps Manage Parkinsons Symptoms

Abernethy Laurels Retirement Community Launches Aquatic Therapy Program

Hydrotherapy treats a wide range of illnesses and orthopedic or chronic disorders. Among them are many conditions related to strength and balance. While aquatic exercise for Parkinsons disease does not reduce all risks of falls which is a key concern among many Parkinsons patients it can be beneficial by strengthening the core and improving muscle memory.

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Aerobic Exercise Stabilizes Motor Progression Helps Cognition

It can not only strengthen muscles, improve balance and posture, and decrease stiffness, but also help people to manage both motor and nonmotor symptoms.

Because the waters buoyancy helps to support a persons weight, patients dont have to expend as much energy keeping their body supported and upright during aquatic therapy. This may be particularly helpful for those who suffer from fatigue.

The waters buoyancy and support can also help PD patients stretch and exercise if they have balance or posture issues that increase the risk of falling on land.

The gentle resistance of the water allows people to practice strengthening exercises without using weights. For those with PD, stronger muscles can improve stability, balance, and posture, which in turn can make it easier to complete daily tasks.

Emotionally, aquatic therapy can help build confidence and contribute to greater independence. The opportunity for socialization can decrease feelings of isolation. The therapy may also reduce stress, as warm water relaxes muscles and relieves tension, soothing both mind and body.

When Bev goes to her water therapy class, she is with others who are affected by PD or other movement disorders. They are able to have meaningful conversations about Parkinsons as well as life outside of the illness.

For more information about aquatic therapy, check out this free, downloadable booklet from the American Parkinson Disease Association.

Is Aquatic Therapy Optimally Prescribed For Parkinsons Disease A Systematic Review And Meta

Article type: Systematic Review

Authors: Carroll, Louise M.a * | Morris, Meg E.b | OConnor, William T.c | Clifford, Amanda M.d

Affiliations: School of Allied Health, Faculty of Education and Health Sciences, Health Sciences Building, University of Limerick, Limerick, Ireland | Healthscope & La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia | Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland | School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland

Correspondence: Correspondence to: Louise M. Carroll, School of Allied Health, Faculty of Education and Health Sciences, Health Sciences Building, University of Limerick, Limerick, V94 T9PX, Ireland. E-mail: .

Keywords: Exercise, hydrotherapy, Parkinsons disease, rehabilitation, review

DOI: 10.3233/JPD-191784

Journal: Journal of Parkinson’s Disease, vol. 10, no. 1, pp. 59-76, 2020

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Does Aqua Therapy Reduce Fear Of Falling Among Parkinsons Patients

The fear of falling dissipates in the water. Gravity, the most dangerous factor for persons with balance disorders, is usually not a problem in the pool. The water buoyancy can reduce the chance of falling significantly. Even when a patient stumbles, the risk of damage is low.

The Aqua pool provides a secure and encouraging environment for rehabilitation and fitness. Patients can engage with physiotherapists with the extra assurance that falling is less probable and that there are bars and other safety precautions to assist them even if they do briefly lose balance.

The buoyancy of water instantly makes someone immersed feel lighter. An offset of up to 80-90 percent of a clients body weight can occur depending on submersion depth. As a result, a 200-pound guy would move as though he weighed just 20-40 pounds. Consequently, his motions would need less strength than if he were making identical moves on land.

Symptoms Of Parkinson’s Disease

Parkinsons Disease Aquatic Therapy

The symptoms of Parkinsons Disease begin insidiously and worsen gradually over time. They typically start on one side of the body, instead of bilaterally, before eventually spreading to involve the opposite side.

The most common symptom recognized by the patient is a tremor of a hand or foot when that limb is at rest. Initially, the tremor and walking difficulty may appear on one side of the body but these signs usually have spread to both sides with time.

The symptoms are but not limited to the following:

resting/pill-rolling tremor

flexed posture, shuffling/festinating gait unsteady posture

difficulty in sleeping

freezing or the sudden inability to move

difficulty with multitasking

loss of volume in speech


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Effectiveness Of Traditional Parkinsons Treatments

The problem with many pharmaceutical treatments currently being used to treat Parkinsons disease is they can lose effectiveness over time. Combined with the side effects of many medications on the market today, a lack of effective drug treatments has patients seeking alternatives to these medications or at least new ways to reduce the dosages of medications they must take.

Water Therapy & Parkinsons Disease

Water-based exercise can help people with Parkinsons by improving balance, mobility, posture and many of the other debilitating symptoms associated with the disease. Exercising in the water gives people with Parkinson’s disease the freedom to move without fear of falling, and enables exercise without joint stress, and strength training without the risk associated with weights.

Balance and posture: The waters buoyancy helps in supporting weak muscles which makes it easier to balance and hold a good posture. When in the water, your body must make continual adjustments to the environment. This improves your sense of where the body is in space, enhancing balance, coordination and posture, as well as motor control.

Mobility and range of motion: As the water physically supports you, it helps prevent stress on joints and muscles and therefore mentally freeing you from the fear of falling so its much easier to move. This helps in increasing both range of motion and overall mobility.

Freezing: Walking on a treadmill in the water requires an exaggerated gait and carrying out a larger range of motion, that helps reduce freezing episodes. Water cycling, boxing and the structured movement in a Circuit program require coordinating the motions of the upper and lower body in the water, boosting communication between the body and brain and can help decrease episodes of freezing.


improve overall motor function

decrease UPDRS scores

reduce tremors

improve flexibility

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Medications For Parkinsons Disease

Physicians treat many Parkinsons patients with a variety of drugs. These medications help patients contend with problems related to walking, movement and the tremors associated with the condition. The American Parkinsons Disease Association has more information on approved medication for Parkinsons patients.

Finding Out More About Parkinsons Disease Exercise Recommendations

Aquatic Therapy

If youd like to see the power of Parkinsons disease physical therapy and aquatic therapy for yourself, request a free informational kit from HydroWorx to learn more about owning or leasing a therapy pool. You can also browse the HydroWorx website to find out more about aquatic therapy research and find other resources that can help clinicians maximize the properties of water and creatively challenge clients with Parkinsons disease.

Bigger is Better: Aquatic Exercise Benefits People with Parkinsons Disease, a free webinar, presented by Cathy Maloney Hills and Christine Shidla on March 21, 2013 from 2 to 3pm EST.

This webinar will provide tools for therapists, personal trainers and group fitness instructors to maximize the properties of water and creatively challenge clients with Parkinsons disease. ICAA Members can watch the webinar on demand here> >


Cathy Maloney-Hills, RPT, is an aquatic physical therapist working for Courage Center at Summit Place Senior Campus, Eden Prairie, MN and Heritage Park Senior Services Center in Minneapolis, MN. She is co-investigator/author for the study and program: Golden Waves® Functional Water Program for Older Adults, University of Nevada, Reno and a co-author of the YMCA Water Fitness for Health.

Page updated on: July 7th, 2020

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Reducing A Fear Of Falling

In water, the fear of falling evaporates. The biggest danger to people with gait and balance issues, gravity, is simply not an issue in the pool. The buoyance of the water can make fear of falling much less. Even if a patient does stumble, the risk of injury is minimal.

Aquatic therapy equipment, such as HydroWorx therapy pools, comes with support bars and other tools to offer added assistance for those who require it. The pool becomes a safe and supportive place for therapy and exercise. Patients can work with physical therapists with the added confidence of knowing falling is less likely and there are bars and other safety protocols in place to help them even if they do lose balance temporarily.

Waters buoyancy immediately renders anyone submerged to feel lighter than he or she would on land. Depending upon the level of submersion, up to 80-90 percent of a clients body weight could be counteracted. Thus, a 200-pound man would move as if he only weighed 20-40 pounds. As a result, his movements would take less effort than if he were doing the same movements in a land-based environment.

Benefits Of Warm Water Exercise For Parkinsons

People living with Parkinsons who exercise regularly reduce the impact and progression of the disease better than those who do not.

Exercising in heated water has some unique properties that enable both therapy and fitness especially for people who cant exercise comfortably on land.

Poor balance, gait and gravity cause fear and injury for many people with Parkinsons. Exercising in water removes the risk of falls and therefore the fear. Water also offers buoyancy which allows for practice of bigger movements to progressively improve the large range of motion.

Simultaneously the turbulence of the water acts to challenge balance and coordination, leading to improved walking and overall stability for daily tasks.

The waters multi-directional resistance helps the individual to maintain or enhance muscular strength and endurance even with gentle movements enabling better focus on movement.

The heat of the water helps sooth and relax the muscles, lessening tremors, reducing rigidity and pain, and giving a feeling of freedom thats not available on land. People living with Parkinsons can stand tall in water with increased back extension, improving their posture.

Hydrostatic pressure is another benefit of exercising in water. Hydrostatic pressure is the force exerted by the water on the body. Hydrostatic pressure can:

  • Reduce swelling
  • Help the heart and boost circulation
  • Reduce sensory input to the brain
  • Reduce the pooling of blood in the extremities


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Treating Patients With Pain Series: Parkinsons Disease

PAIN induced by injury, surgery, inflammation, disease, etc. can be difficult to treat. Exploring natural options to rehab and recovery have proven successful and increasingly popular. This newsletter is the fifth in a series addressing how non-traditional methods, like aquatic therapy, can offer positive results and success in rehabilitation and recovery outcomes for patients dealing with pain.

Parkinsons Symptoms Managed Using Aquatic Therapy

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Independence is a constant concern among Parkinsons patients and their family members, especially as the disease progresses. So they can maintain their independence longer, aquatic therapy specifically assists patients in the following:

  • Maintaining or regaining strength
  • Reducing rigidity
  • Increasing acceptance of physical activity

For Parkinsons patients, aquatic therapy can mitigate the above key concerns so patients can maintain or regain their independence.

Is aquatic therapy safe for Parkinsons? Warm-water therapies with temperatures between 90 and 92 degrees Fahrenheit offer patients the opportunity to work out in a protected environment, offering them reduced rigidity and increased body control. The other benefit of warm-water therapies for Parkinsons patients is a reduction of shivering compared to cold water treatments along with a reduction of pain, which makes exercising more pleasurable.

One study discovered Parkinsons patients experienced significant improvements in postural stability as a result of aquatic therapy. A separate study, conducted in 2012, found patients who participated in aquatics enjoyed improvements in:

Because aquatic therapy is exercise, it can help delay the progression of many symptoms of Parkinsons disease and may be instrumental in reducing the severity of symptoms patients currently experience. Aquatic therapy helps patients maintain a greater quality of life and longer health while living with Parkinsons.

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History Of Water Therapy

Water therapy has been used since ancient times, dating back to 400 BC and potentially earlier. By the 17th and 18th centuries, scientists were considering the chemical components that could make this type of therapy more effective, and by the 19th century there was interest in varying the temperature of the water to improve efficiency. For centuries, natural heated springs and spas were a solution for those suffering a variety of ailments, and doctors prescribed taking the waters to deal with pain and discomfort.

Today, water therapy continues to be a widely recognized form of therapy for many conditions, including Parkinsons disease. In 2005, $46 million was spent on aquatic therapy in the United States and accounted for about 3% of the codes billed to Medicare.

Overview Of Parkinson’s Disease

According to clinical studies, there is an estimated 4 people per 1,000 in Australia who have Parkinson’s disease. There are approximately 80,000 people in Australia living with Parkinson’s disease, with one out of 5 diagnosed before the age of 50. Betterhealth Australia reports that Parkinsons Disease is one of the most common neurodegenerative disorders in Australia and other parts of the world.

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