Document Type : Original Article

Authors

1 MSc, Department of Physical Education, Isfahan University, Isfahan, Iran,

2 PHD, Associate Professor, Department of physical Education, Isfahan University, Isfahan, Iran

3 MD, Associate Professor, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Abstract
Background: Parkinson is a chronic, degenerative and destructive disease of the nervous system that is caused by the destruction of dopaminergic neurons that reside in the substantia nigra of the midbrain. It often happens in the ages of between 50 and 60 and one of its characteristics is the lack of balance. The goal by this present research was to study the effect of balance training in water on the patients with PD.
Materials and Methods: The present semi-experimental study used a pretest-posttest control group design. The study population included patients referred to the Hospital of Alzahra. 36 men patients with Parkinson that were non-randomly selected and randomly divided into experimental (n=20) and control (n=16) groups. The experimental group in addition to medication, performed activity in water 3 times/ week, 60 minutes for 12 weeks whereas control subjects were treated only by medication and routine activities performed. Before intervention and three months after the intervention, the patient's balance was assessed by BBS. Data using ANCOVA (P<0.05) and SPSS 19 software was analyzed.
Results: In comparison with the control group, the intervention group balance scores after 12 weeks of balance training in the water were greatly improved(49/1 to 53/70).
Conclusion: Findings showed that balance training in water can be used as useful and effective method to improve balance and in turn daily functioning of PD patients. According to the severity of disease in patients participating in this study (I-III), the results can be extended only to this group of patients.

Keywords

Main Subjects

1.         Salgado S, Williams N, Kotian R, Salgado M. An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease. Brain Sciences. 2013;3(1):87-100.
2.         Chuang C-S, Su H-L, Cheng F-C, Hsu S-h, Chuang C-F, Liu C-S. Quantitative evaluation of motor function before and after engraftment of dopaminergic neurons in a rat model of Parkinson's disease. Journal of biomedical science. 2010;17(1):9.
3.         AlDakheel A, Kalia LV, Lang AE. Pathogenesis-targeted, disease-modifying therapies in Parkinson Disease. Neurotherapeutics. 2014;11(1):6-23.
4.         emsaki G, chitsaz a, shayegannezhad v, molavi h, askari k. Comparison of cognitive functions in patients with Parkinson's disease and normal subjects. Journal of Research in Rehabilitation Sciences. 2013;1(1):289-97.
5.         Canning CG, Allen NE, Dean CM, Goh L, Fung VS. Home-based treadmill training for individuals with Parkinson’s disease: a randomized controlled pilot trial. Clinical Rehabilitation. 2012;26(9):817-26.
6.         Greenfield J, Bosanquet FD. The brain-stem lesions in Parkinsonism. Journal of Neurology, Neurosurgery & Psychiatry. 1953;16(4):213-26.
7.         Hughes AJ, Daniel SE, Blankson S, Lees AJ. A clinicopathologic study of 100 cases of Parkinson's disease. Archives of Neurology. 1993;50(2):140.
8.         Fahn S. Description of Parkinson's disease as a clinical syndrome. Annals of the New York Academy of Sciences. 2003;991(1):1-14.
9.         Morris ME, Iansek R, Kirkwood B. A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease. Movement Disorders. 2009;24(1):64-71.
10.       Ellis T, de Goede CJ, Feldman RG, Wolters EC, Kwakkel G, Wagenaar RC. Efficacy of a physical therapy program in patients with Parkinson’s disease: a randomized controlled trial. Archives of physical medicine and rehabilitation. 2005;86(4):626-32.
11.       Hass CJ, Waddell DE, Fleming RP, Juncos JL, Gregor RJ. Gait initiation and dynamic balance control in Parkinson’s disease. Archives of physical medicine and rehabilitation. 2005;86(11):2172-6.
12.       Hirsch MA, Toole T, Maitland CG, Rider RA. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson’s disease. Archives of physical medicine and rehabilitation. 2003;84(8):1109-17.
13.       Tarsy D. Initial treatment of Parkinson’s disease. Current treatment options in neurology. 2006;8(3):224-35.
14.       Giroux ML. Parkinson disease: managing a complex, progressive disease at all stages. Cleveland Clinic journal of medicine. 2007;74(5):313-4.
15.       somayeh g, masoud n. Effect of water treatment techniques on fatigue in patients with multiple sclerosis.
Journal of Mazandaran University of Medical Sciences. 2009;30(2):81-71.
16.       Cider Å, Schaufelberger M, Sunnerhagen KS, Andersson B. Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure. European Journal of Heart Failure. 2003;5(4):527-35.
17.       Vivas J, Arias P, Cudeiro J. Aquatic therapy versus conventional land-based therapy for Parkinson's disease: an open-label pilot study. Archives of physical medicine and rehabilitation. 2011;92(8):1202-10.
18.       Chu KS, Eng JJ, Dawson AS, Harris JE, Ozkaplan A, Gylfadóttir S. Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomized controlled trial. Archives of physical medicine and rehabilitation. 2004;85(6):870-4.
19.       Ayan C, Cancela J, Gutierrez-Santiago A, Prieto I. Effects of two different exercise programs on gait parameters in individuals with Parkinson's disease: a pilot study. Gait & posture. 2014;39(1):648-51.
20.       Coelho M, Ferreira JJ. Late-stage Parkinson disease. Nature Reviews Neurology. 2012;8(8):435-42.
21.       Volpe D, Giantin MG, Maestri R, Frazzitta G. Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study. Clinical rehabilitation. 2014;28(12):1210–7.
22.       Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson's disease: A systematic review and meta‐analysis. Movement Disorders. 2008;23(5):631-40.
23.       Cakit BD, Saracoglu M, Genc H, Erdem HR, Inan L. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease. Clinical Rehabilitation. 2007;21(8):698-705.
24.       Johnson L, Putrino D, James I, Rodrigues J, Stell R, Thickbroom G, et al. The effects of a supervised Pilates training program on balance in Parkinson’s disease. scientific research. 2013;2:58-61
25.       Esculier J-F, Vaudrin J, Beriault P, Gagnon K, Tremblay LE. Home-based balance training programme using wii fit with balance board for parkinson's disease: A pilot study. Journal of Rehabilitation Medicine. 2012;44(2):144-50.
26.       Hackney ME, Earhart GM. Tai Chi improves balance and mobility in people with Parkinson disease. Gait & posture. 2008;28(3):456-60.
27.       Smania N, Corato E, Tinazzi M, Stanzani C, Fiaschi A, Girardi P, et al. Effect of balance training on postural instability in patients with idiopathic Parkinson’s disease. Neurorehabilitation and Neural Repair. 2010;24(9):826-34.
28.       Conradsson D, Löfgren N, Ståhle A, Hagströmer M, Franzén E. A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial. BMC neurology. 2012;12(1):111.
29.       Keus S, Bloem B, Hendriks E, Bredero-Cohen A, Munneke M. Practice Recommendations Development Group. Evidence-based analysis of physical therapy in Parkinson’s disease with recommendations for practice and research. Mov Disord. 2007;22(4):451-60.
30.       Payton OD. Manual of physical therapy: Churchill Livingstone; 1989.
31.       Kawasaki M. The  effect of aquatic exercise on balance outcomes in individuals with Parkinson disease. Medical and Science in Sport and exercise 2009;41(5):102.
32.       Reuter I, Engelhardt M. Exercise training and Parkinson's disease: placebo or essential treatment? The physician and Sportsmedicine. 2002;30(3):43.
33.       Shumway-Cook A, Woollacott M. Motor control: theory and practical applications1996. 99-116 p.
34.       Frazzitta G, Balbi P, Maestri R, Bertotti G, Boveri N, Pezzoli G. The beneficial role of intensive exercise on Parkinson disease progression. American Journal of Physical Medicine & Rehabilitation. 2013;92(6):523-32.
35.       Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease. The Lancet Neurology. 2013;12(7):716-26.