Background: Individuals with Parkinson disease (PD) present balance and functional mobility disabilities that negatively affect the quality of life (QOL).
Objective: To systematically review the effects of hydrotherapy on balance, functional mobility, QOL, and motor status in patients with PD.
Design: Systematic review and meta-analysis.
Participants: A total of 484 participants were included. The mean age of participants ranged from 54 to 78 years. The average duration of PD ranged from 3 to 10 years.
Methods: MEDLINE (PubMed), Embase, Cochrane CENTRAL, SCOPUS, Scielo, Physiotherapy Evidence Database (PEDro), and Google Scholar were searched from inception to December 2017. Randomized controlled trials (RCT), non-RCT, and pre-post studies were included.
Main outcome measurements: Berg Balance Scale; Timed Up and Go test; Parkinson's disease quality of life and Short Form-36 Health Survey; Unified Parkinson Disease Rating Scale-Part III.
Results: A total of 19 studies were identified, including eight RCTs, three non-RCTs, and eight pre-post studies. Our meta-analysis showed a moderate quality of evidence for positive effects of hydrotherapy combined or not with land-based therapy on balance (133 patients; MD = 2.00 [95% CI, 0.56 to 3.43; I2 0%, P = .01]) and functional mobility (133 patients; MD = -1.08 [95% CI, -1.99 to -0.18; I2 8%, P = .02]). However, hydrotherapy combined or not with land-based therapy did not improve QOL (76 patients; MD = -6.35 [95% CI, -13.04 to 0.33; I2 7%, P = .06]) and motor status (140 patients; MD = -1.11 [95% CI, -3.27 to 1.04; I2 0%, P = .31). The risk of bias across the included RCTs was low.
Conclusions: Hydrotherapy, combined or not with other therapies, may improve balance and functional mobility of patients with PD when compared to land-based therapy alone or usual care.
Level of evidence: Level I.
© 2018 American Academy of Physical Medicine and Rehabilitation.