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Introduction: The complications from Parkinson’s disease (PD) are directly related to decreased muscle function, balance deficits, and independence loss. Practicing aquatic exercises can minimize these symptoms and slow disease progress. Objective: To develop a Multicomponent Aquatic Training (MAT) protocol for people with PD between stages 1 and 4 of the Hoehn and Yahr scale. Methods: The protocol is for a single blind controlled clinical trial. The sample will comprise of people with PD between stages 1 and 4 in Hoehn and Yahr scale, divided into a control group and MAT group (who will participate in the MAT). Musculoskeletal function, functional mobility, and balance will be the primary outcomes of interest, assessed with an isokinetic dynamometer, the Five-Times-Sit-to-Stand test (FTSST), the Timed “Up and Go” test (TUG), the 6-m gait speed test, the Berg Balance Scale (BBS), and a force platform. Quality of life (QOL), activities of daily living (ADL), and motor aspects will be the secondary outcome measures, assessed with the Parkinson’s Disease Questionnaire (PDQ-39) and Unified Parkinson’s Disease Rating Scale (UPDRS), sections II and III. The MAT will be 12 weeks long, with two 50-min sessions per week. The outcome measures will be assessed before and after the interventions. Discussion: This study is expected to establish parameters to prescribe and monitor a MAT program for people with PD in stages 1 to 4 in the Hoehn and Yahr scale, respecting individual progress and assisting the professionals in their procedure with these people.

AimsTo compare the static and dynamic postural control of people with Parkinson's disease and community old adults.MethodsThirty‐five people were in the Parkinson's disease group (PDG; 12 women, 62.4 ± 11.0 years, 77.9 ± 15.6 kg, 166.5 ± 11.0 cm, 27.9 ± 3.8 kg/m2, 1.9 ± 0.5 Hoehn & Yahr) and 32 were in the old adults group (OAG; 13 women, 69.5 ± 6.0 years, 74.2 ± 12.3 kg, 165.0 ± 8.3 cm, 27.2 ± 4.0 kg/m2). The static balance was measured on a force platform, three 30‐s trials in four conditions: feet side‐by‐side (FSBS) and semi‐tandem stance (ST) positioning, eyes open (EO) and eyes closed (EC). The total sway path length (SPL), sway area (SA), anterior–posterior (APSR) and medial‐lateral (MLSR) sway range of the centre of pressure were obtained. Dynamic balance was assessed using the timed‐up‐and‐go test (TUG). For comparison between groups and repeated‐measures, a mixed‐design ANOVA was carried out and the Mann–Whitney U test to compare TUG between groups. The significance level was set at p ≤ .05.ResultsBetween groups, PDG presented higher mean values for SPL, APSR and SA in feet side‐by‐side eyes open compared to the OAG, for SPL in feet side‐by‐side eyes closed, for SPL and SA in STEO. For repeated‐measures, both groups had higher mean values in the EC condition compared to EO and MLSR compared to APSR. No significant difference was found between groups for TUG.ConclusionBalance disorders are found early in people with Parkinson's disease compared to healthy older adults. Thus, Parkinson's disease seems to advance the process of alterations in the postural control system.

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Parkinson’s disease (PD) is a neurodegenerative, with heterogeneous clinical conditions and motor changes that reduce functioning. Postural instability is one of the motor aspects of disease progression, with a potential increase in the risk of falls, consequently affecting the activities of daily living (ADL). The objective of this study was to verify the influence of a multimodal intervention program (MIP) sequentially applied in aquatic- (AEs) and land-based environments (LEs) on balance, postural control, motor activities, and ADL in people with PD. It is an interventional clinical study with patients in stages 1 to 4 in the Hoehn and Yahr scale, assessed with Berg Balance Scale (BBS), Mini-Balance Evaluation System Test (Mini-BESTest), Unified Parkinson’s Disease Rating Scale (UPDRS) II and III, Dynamic Gait Index (DGI), and quiet stance (QS) analysis in a force platform. The MIP was conducted sequentially with aquatic- (AIs) and land-based interventions (LIs) for 12 weeks each, twice a week, each session lasting 1 hour, and a 12-week interval between interventions. The comparison analysis was made with Friedman ANOVA, and the multiple comparisons with Wilcoxon signed-rank, Bonferroni correction, and effect size ( r ). The sample comprised 18 people with PD ( 66.83 ± 11.74 years). The AI and the full intervention (FI) had a large effect according to BBS. With Mini-BESTest, the LI and FI had a large effect. According to UPDRS II, the MIP improved ADL after LI, with a medium effect, and the motor aspects of UPDRS III improved after LI and FI, with a large effect. DGI was not sensitive in the analyses, with a ceiling effect after FI. No differences were identified in QS analyses. This research identified improved balance, ADL, and motor aspects in people with PD after sequential MIP in AI and LI, indicating that land-based and aquatic interventions are complementary and advantageous to people with PD.