Aquatic Therapy and Parkinson's

As the second most common movement disorder, Parkinson's disease is a chronic progressive condition that impacts an estimated 1 million Americans. The main motor characteristics of Parkinson's include tremors (rhythmic shaking movements), stiffness and rigidity, and bradykinesia (slowness of movement.)

Typically people who develop Parkinson's disease do not do so until after the age of 50, however a percentage (approximately 10%) of people living with Parkinson's disease develop symptoms sooner, which is diagnosed as Early Onset Parkinson's.

The motor deficits can lead to difficulty with activities in daily living, difficulty in ambulation, and balance deficits, putting people living with Parkinson's disease at a higher risk for falling. New advances in diagnostic information, pharmacological and neurosurgical interventions, and complimentary treatments such as physical therapy are providing people with Parkinson's disease the opportunity to maintain and improve their quality of life.

There is extensive evidence that shows that people with Parkinson's disease who participate regularly in exercise have better mobility and maintain better balance than those that do not. As a clinician who has treated people with Parkinson's disease in both the inpatient and outpatient settings, I have seen this difference first hand.

Unfortunately the difficulties with moving that are associated with Parkinson's, as well as the increased fall risk and associated fear of falling, often lead to people with Parkinson's disease avoiding movement and exercise. This leads to weaker muscles, smaller available ranges of motion, worse balance, and therefore a quicker progression of deficits and a greater loss of independence.

Why does aquatic therapy help?

Aquatic exercises and therapy offer unique opportunities to people with Parkinson's to participate in an exercise program that decreases many of the difficulties they may face in a land-based program.

The buoyancy of the water can have a substantial impact on a person's fear of falling, as gravity becomes much less of an issue in the pool. With the decreased impact of gravity, a person feels much lighter in the water than they do out of it, allowing movement to be performed in the water with less effort than it takes on land. These combined factors allow for the performance of bigger movements and progressively larger ranges of motion, and exercises involving large ranges of motion combined with rotational and diagonal movements are some of the most effective in counteracting the disease related motor deficits in Parkinson's including tremors, rigidity, and bradykinesia.

As strength and range of motion improve in the aquatic setting, many patients begin to see a carryover to their movements on land and can begin progressing to land-based therapy and exercise programs, where they can continue to participate in progressive exercises for strength, range of motion, and balance to improve their independence with ambulation and activities of daily living.

Many people with Parkinson's benefit from a period of care with a physical therapist, followed by discharge to a structured home exercise or maintenance program that may include a combination of aquatic and/or land based exercises that may be performed either at home or in another facility, either individually or within a group. As Parkinson's is a progressive condition, individuals may benefit from periodic follow ups with their physical therapist to assess any changes in their mobility and to ensure that their exercise program continues to meet their needs for independence and quality of life.


(This article is not intended to diagnosis or treat any disease. A diagnosis of Parkinson's requires clinical examination and evaluation by a physician. If you are experiencing some of the signs and symptoms of Parkinson's disease, it is recommended that you schedule an appointment with your physician for further evaluation.)


Kelly Wright-Fraser, PTA