Aquatic Therapy for Freezing of Gait in Parkinson's Disease Patients
Condition: Parkinson Disease; Gait Disorders, Neurologic; Gait Disorder, Sensorimotor
MeSH terms: Parkinson Disease; Nervous System Diseases; Gait Disorders, Neurologic
Study type: Interventional

Summary: 
      Evaluation of the effectiveness of aquatic therapy for the treatment of freezing of gait in
      Parkinson's disease patients undergoing a multidisciplinary and intensive rehabilitation
      treatment.
    

Detailed description: 
      Freezing of gait (FoG) is an often dramatic, disabling episodic gait pattern that is common
      in Parkinson's disease (PD). FoG highly impairs mobility, causes falls, and reduces quality
      of life. Given the limited effectiveness of both the dopaminergic therapy and the deep brain
      stimulation on this symptom, it represents a challenge in the field of rehabilitation. In the
      last years, some studies described the effectiveness of aquatic therapy on balance
      dysfunction in patients with PD, correlating it to the safe conditions offered by the aquatic
      environment and to the physical properties of water. Nevertheless, the issues concerning the
      feasibility and the effectiveness of aquatic therapy for the treatment of FoG have never been
      addressed before. The aquatic environment may act on the sensorial peripheral receptors, thus
      widely stimulating the proprioceptive system. PD patients show an altered processing of the
      proprioceptive information that could potentially underline FoG. The investigators aim at
      investigating the effects of aquatic therapy for the treatment of FoG in PD patients
      undergoing a Multidisciplinary Intensive Rehabilitation Treatment (MIRT), whose effectiveness
      on several motor and functional parameters has been already demonstrated.
    

Intervention name(s): MIRT; MIRT-AT
Intervention type(s): Other; Other
Intervention description(s): MIRT consists of a 4-week rehabilitation program in a hospital setting, which entails four daily sessions of physical therapy for five days and one hour of physical exercise on the sixth day. On the seventh day the patient rests. The duration of each session, including recovery periods, is about one hour. The first session consists of a one-to-one session with a physical therapist. The second session includes aerobic exercises to improve balance and gait, using different devices: a stabilometric platform with visual cues, a treadmill plus and a cycloergometer. The third session consists of occupational therapy, the fourth one includes one hour of speech therapy.; Patients in the MIRT-AT group will undergo the land-based therapy described in MIRT plus three sessions per week (Monday, Wednesday, Friday) of aquatic therapy. On days of aquatic therapy the first session of MIRT was not provided. The aquatic therapy program included aerobic exercises and physical activities to improve balance, motor skills, coordination and joints mobility. The water sessions were divided into 3 phases: i) Warm Up Exercises, ii) Central session Training, iii) Cool-down.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment