Underwater gait analysis in Parkinson’s disease

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

“…Overall, gait disorders appear in early in PD. They are characterized by (i) decreases in gait speed, stride length, and arm swing amplitude (Lewek et al 2010;Volpe et al 2017) and (ii) increases in cadence, double support time, arm swing amplitude, swing time asymmetry (Yogev et al 2007), and variability in stride time and swing time (Baltadjieva et al 2006;Mirek et al 2007;Svehlík et al 2009;Lewek et al 2010;Volpe et al 2017). From a behavioral point of view, the gait showing results from the inability of PD patients to generate sufficient stride length and arm swing amplitude (i.e., gait hypokinesia) even though cadence control remains intact (Morris et al 1994;Hausdorff 2009), whereas the increased variability in temporal parameters from an alteration of the internal cueing mechanism needed to walk in a rhythmic fashion (Sheridan and Flowers 1990;Morris et al 1994;Ebersbach et al 1999;Schaafsma et al 2003).…”

Is Aquatic Therapy Optimally Prescribed for Parkinson’s Disease? A Systematic Review and Meta-Analysis

“…Not specified ("sessions were designed with a gradual increase in difficulty") The level of immersion at which study participants exercised in water were waist depth [62] or the mamillary line [61,65] Adverse events, participants involvement and economic evaluation…”

“…Firstly, reporting bias was identified in five studies that failed to indicate time periods over which participants were recruited. [30,60,61,65,69] Relevant data such as loss of patients to follow-up and the inclusion of intention-to-treat analysis was omitted in six trials [29,60,62,[65][66][67] thus, outcome reporting bias in these studies may have founded misleading, positive results of the effectiveness of aquatic therapy. Trials included were small with only seven studies [30-32, 62, 66-68] including a power and sample size calculation, while five studies were documented pilot studies.…”

“…Trials included were small with only seven studies [30-32, 62, 66-68] including a power and sample size calculation, while five studies were documented pilot studies. [60,61,65,68,69] The limited effects of aquatic therapy over land-based physiotherapy for gait variables such as gait variability, step amplitude, turn time and cadence may have been associated with an insufficiently powered trial. [29,60] Only one low quality study, [60] which conducted testing during the "OFF" medication phase was suitable for inclusion in the meta-analysis making it difficult to establish if there was an overall difference in results when comparing to "ON" medication testing.…”

“…The characteristics and mechanisms by which aquatic therapy can optimally contribute to impairments present in PD, and the extent to which these improvements may last over time await further investigated. The inclusion of outcome measurement tools evaluating underwater movements, such as 3D motion gait analysis[61] Is aquatic therapy optimally prescribed for Parkinson's disease? a systematic review and meta-analysis33 would help to strengthen our understanding of the specific features and benefits of aquatic therapy for PD.…”