Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
J Physiother. 2019 Apr;65(2):65-74. doi: 10.1016/j.jphys.2019.02.003. Epub 2019 Mar 21.
What are the effects of aquatic exercise on disease severity, (non-)motor impairments, activity performance, fear of falling, and quality of life in people with Parkinson's disease (PD)? Does aquatic exercise have greater effects on these outcomes than other forms of exercise in people with PD?
Systematic review and meta-analysis of randomised controlled trials.
People with idiopathic PD.
Supervised aquatic exercise programs ≥ 2 weeks.
The primary outcomes were disease severity, motor impairments, activity performance, and fear of falling. The secondary outcomes were non-motor impairments and quality of life.
Of the 129 identified records, seven trials met the inclusion criteria and six were meta-analysed (159 participants). One trial assessed the effect of aquatic exercise compared with control and found a significant improvement in the Unified Parkinson's Disease Rating Scale Part III (MD -4.6, 95% CI -7.5 to -1.7) in favour of aquatic exercise. Six studies compared aquatic exercise with land-based exercise after intervention (mean 7.2 weeks of training (SD 2.2); 159 participants). The effect of aquatic exercise was superior to land-based exercise on the Berg Balance Scale (MD 2.7, 95% CI 1.6 to 3.9), the Falls Efficacy Scale (MD -4.0, 95% CI -6.1 to -1.8) and the 39-item Parkinson's Disease Questionnaire (MD -6.0, 95% CI -11.3 to -0.6), with no other significant effects identified. The significant benefit on the Berg Balance Scale was maintained at the follow-up assessment (MD 6.3, 95% CI 2.1 to 10.5, 54 participants).
Aquatic exercise improves motor impairments in people with PD significantly more than no intervention. It also has slightly to moderately greater benefits than land-based exercise on balance capacity, fear of falling, and health-related quality of life. On other outcomes, the benefits of aquatic exercise are similar to those of land-based exercise.
PROSPERO CRD42017077370.
水上运动对帕金森病患者的疾病严重程度、（非）运动障碍、活动能力、跌倒恐惧和生活质量有什么影响？水上运动对帕金森病患者的这些结果的影响是否大于其他形式的运动？
系统评价和随机对照试验的荟萃分析。
特发性帕金森病患者。
监督性水上运动方案≥2 周。
主要结局是疾病严重程度、运动障碍、活动能力和跌倒恐惧。次要结局是非运动障碍和生活质量。
在 129 项已确定的记录中，有 7 项试验符合纳入标准，其中 6 项进行了荟萃分析（159 名参与者）。一项试验评估了与对照组相比水上运动的效果，发现水上运动对帕金森病评定量表第三部分（统一帕金森病评定量表第三部分）有显著改善（MD-4.6，95%置信区间-7.5 至-1.7）。六项研究在干预后比较了水上运动与陆地运动（平均 7.2 周的训练（SD 2.2）；159 名参与者）。水上运动的效果优于陆地运动，表现在伯格平衡量表（MD 2.7，95%置信区间 1.6 至 3.9）、跌倒效能量表（MD-4.0，95%置信区间-6.1 至-1.8）和 39 项帕金森病问卷（MD-6.0，95%置信区间-11.3 至-0.6），没有发现其他显著效果。在随访评估中，伯格平衡量表的显著获益仍保持（MD 6.3，95%置信区间 2.1 至 10.5，54 名参与者）。
水上运动显著改善帕金森病患者的运动障碍，比不干预更有效。它在平衡能力、跌倒恐惧和健康相关生活质量方面的获益也略高于或中度高于陆地运动。在其他结果方面，水上运动的益处与陆地运动相似。
PROSPERO CRD42017077370。
