Perceptions of aquatic physiotherapy and health‐related quality of life among people with Parkinson’s disease

Abstract

Background Enablers for people with Parkinson's disease (PD) participating in aquatic physiotherapy have been identified, and exercise improves health‐related quality of life (HRQoL) but it is unclear whether all enablers and barriers for aquatic physiotherapy specific to the PD population have been explored. Objective To describe HRQoL in people with PD who have undertaken aquatic physiotherapy, and explore their perceptions and attitudes regarding the programme. Methods Twenty‐one participants who participated in a pilot trial on aquatic physiotherapy were included. Participants completed a survey regarding their experiences. The Parkinson's Disease Questionnaire‐39 (PDQ‐39) and Personal Well‐being Index‐Adult (PWI) were used to quantify HRQoL, whilst focus groups were conducted to explore their perceptions and attitudes. Descriptive statistics were used to summarize HRQoL scores. Focus group data were analysed using the deductive coding method. Results Most participants felt that the aquatic programme was worthwhile (n = 20/21, 95%). However, they had poor overall well‐being (mean 41.6, SD 13.5) and HRQoL (mean 31.0, SD 13.2) as measured by the PWI and PDQ‐39. Several barriers to aquatic therapy including safety when getting dressed, fatigue and transport were identified although many enablers were also identified, including an improvement in function, less falls and group socialization. Conclusions Aquatic physiotherapy was well‐accepted. Participants felt their function improved and felt safe in the water. HRQoL is lower in individuals with PD when compared to Australian norms; thus, interventions to optimize HRQoL need to be explored further. Patient or Public Contribution Patients participated in the aquatic intervention, survey and focus groups.

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“…This study investigated physiotherapists' current practice in using aquatic physiotherapy for people with PD. Only one third of our surveyed physiotherapists reported using aquatic physiotherapy in their treatment of people with PD, which suggests that this is not a well-utilised treatment modality despite recent evidence demonstrating that it might be (Neto et al, 2020;Terrens et al, 2020Terrens et al, , 2021Terrens et al, 2018). This study highlights several barriers to implementing aquatic physiotherapy in practice.…”

“…Treatment choice by the patient on whether they wish to participate in exercises in an aquatic environment also has to be taken into account when considering physiotherapy management of this clientele. Several barriers to participating in aquatic physiotherapy from a patient's perspective have been identified previously, such as fatigue, and safety getting dressed and undressed (Terrens et al, 2021). The study by Terrens et al (2021) was nested within a larger study, and examined healthrelated quality of life and patient perceptions and experiences regarding aquatic physiotherapy.…”

“…Several barriers to participating in aquatic physiotherapy from a patient's perspective have been identified previously, such as fatigue, and safety getting dressed and undressed (Terrens et al, 2021). The study by Terrens et al (2021) was nested within a larger study, and examined healthrelated quality of life and patient perceptions and experiences regarding aquatic physiotherapy. Although the qualitative section of this study only had a small number of participants (n = 13), several barriers were identified using the COM-B system, a framework that illustrates how capability, opportunity, and motivation factors result in behaviour change (Michie et al, 2011), that can help guide future aquatic physiotherapy practice.…”

Effects of LSVT-BIG via telerehabilitation on non-motor and motor symptoms and quality of life in Parkinson’s disease

“…A meta-analysis (20 studies, 2707 PwPD) published in 2020 concluded that people with PD have a worse quality of life than healthy controls [4]. Studies have reported that exercise programs have different effects on quality of life [35][36][37]. There are some researches in the literature demonstrating that LSVT-BIG treatment improves the quality of life [26,38], while some studies have reported no changes [23,39].…”

Impact of Kinesiotherapy and Hydrokinetic Therapy on the Rehabilitation of Balance, Gait and Functional Capacity in Patients with Lower Limb Amputation: A Pilot Study

“…A disadvantage of physical therapy is that incorrect exercise can affect the abutment and its injury. This trend also includes the adaptation of kinesiotherapy to the aquatic environment, which is called hydrokinetic therapy and aims at rehabilitating patients with lower limb conditions and amputations, due to the multiple benefits of practicing in the water environment and taking advantage of materials, equipment and devices designed to be used in immersion [ 33 , 34 , 35 ].…”