Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aquatic therapy is effective in improving motor activity in patients with Parkinson’s disease.

STUDY DESIGN: A systematic review of three English language primary studies, one of which published in 2011 and two in 2017.

DATA SOURCES: Three randomized control trials (RCT); two single blind and one controlled, open-pilot trial published in peer-reviewed journals analyzing if aquatic therapy is effective in improving motor activity in patients with Parkinson’s disease. Articles were found on PubMed.

OUTCOMES MEASURED: The outcome measured was motor activity using the Unified Parkinson’s Disease Rating Scale (UPDRS) section III.

RESULTS: All three studies found that aquatic therapy significantly improved motor activity when compared to traditional land-based therapy in Parkinson’s diseased patients. Carroll et al. study showed a mean change from baseline for the aquatic therapy group in motor activity at 6 weeks and no mean change from baseline the control group. When comparing the two groups, there was a clinically significant change, p=0.01(Carroll LM, Volpe D, Morris ME, Saunders J, Clifford AM. Arch Phys Med Rehabil. 2017;98(4):631-638. doi: S00039993(17)30002-3 [pii]). Vivas et al. study did a follow-up ANOVA that showed participants in the water-group, from pretest to posttest, changed significantly in the UPDRS, motor aspect, compared to participants in the land-based group. Between the groups there was a statistically significant difference in the water-group, with a p-value of 0.001 (Vivas J, Arias P, Cudeiro J. Arch Phys Med Rehabil. 2011;92(8):1202-1210. doi: 10.1016/j.apmr.2011.03.017 [doi]). Perez de la Cruz et al. study found that the experimental group had significant differences post-treatment in improved motor activity, with a p value P<0.001, compared to the control group where no improvement was seen (Perez de la Cruz S. Eur J Phys Rehabil Med. 2017;53(6):825-832. doi: 10.23736/S1973- 9087.17.04647-0 [doi]).

CONCLUSIONS: The evidence presented in this review shows that aquatic therapy does improve motor activity in individuals with Parkinson’s disease. Significant results were found in each article, however, due to limitations, including small sample sizes, further research should be done to confirm these findings.

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