The Effect of Water-based Exercise on Balance and Quality of Life Compared to Land-Based Exercise and Usual Care in Parkinson's Patients: A Systematic Review and Meta-Analysis

چکیده مقاله

Background and Aim: Parkinson's disease is one of the most important diseases related to the nervous system in adults, which has become the second most dangerous disease after Alzheimer's disease. The purpose of this study is a systematic and meta-analysis review of studies that have examined the effect of water-based exercise on balance and quality of life in patients with Parkinson's disease.
Methods: This is a systematic review and meta-analysis of studies on people with idiopathic Parkinson's disease. Search for Persian language articles was done in Sid and Magiran databases, and for English language articles was done in Science direct, PubMed, Scopus, and Google Scholar databases without time limit until April 2021 with keywords related to "Parkinson", "quality of life", "balance". Only clinical trials in adult Parkinson's patients were included in this review, that comparing water-based exercise versus daily care or land-based exercise. The main variables were balance and quality of life in Parkinson's patients. The mean difference (MD) was calculated with 95% confidence interval (CI) and heterogeneity was assessed using I² test. To analyze the data, Cochran Institute Rev Man 4.5 software was used.
Results: Based on the inclusion and exclusion criteria, 2 Persian articles and 9 English articles out of 161 studies were comprehensively reviewed. The number of Parkinson's patients in the balance studies was 294 and in the quality of life studies was 116. The age of the participants ranged from 47 to 71 years (mean 63.2 years). The duration of the sessions ranged from 45 to 60 minutes, the number of sessions per week varied from 2 to 5 sessions and the duration of the training period was from 4 to 12 weeks. The results of meta-analysis showed that water-based exercise compared to land-based exercise at 39 PDQ scale caused a slightly significant difference in quality of life between Parkinson's patients (-0.15 to -9.76), 95% CI, -4.96 MD. Also, water-based exercise compared to land-based exercise (in balance component with BBS Berg balance scale) caused a significant difference (2.10 to 6.08) 95% CI, 4.09 MD.
Conclusion: Water-based exercise is more effective in improving balance and quality of life in people with Parkinson's than land-based exercise and routine care. Therefore, in addition to daily exercise on land, exercise in water can help increase the quality of life and balance of these patients and therapists can use it in exercise programs for patients.