Parkinson's disease results from a decrease in dopamine production in the brain. This debilitating disease limits full range of movement. Tremors make it difficult for the patient to walk or move with coordination. As the disease progresses, muscle function is gradually lost. Aquatic exercise helps to ease the burden of movement. Water also provides a vehicle for relaxation, playfulness and general spiritual uplifting. Aquatic therapy improves the muscle spasms, contractures, rigidity, tremors and postural instability of Parkinson's disease, according to Maryanne Haggerty of the Aquatic Therapy and Rehab Institute.
Benefits of Exercise in Water
The buoyancy of water aids the Parkinson's patient by creating the sense of easy movement. Water promotes range of motion and increases muscle function, according to the American Parkinson Disease Association. Exercising in warm water also provides a soothing environment and allows patients to tolerate movement. Warm water might alter muscle tone and relieve pain. Aquatic exercises allow muscles to relax and lengthen, reducing stiffness, reports the association.
Motor Control
Movement in water enhances body awareness, which leads to better postural tension. The American Parkinson Disease Association reports that water exercise might improve motor control for walking and that the slowing of movement created by water allows for muscular response time.
Safety Issues
Participants should seek medical advice before beginning an aquatic exercise program. Programs will generally require the Parkinson's patient to provide a medical release form. Energy depletion is a major concern when beginning an exercise program. Many patients begin exercise in a very deconditioned state. Large amounts of energy are expended in the aquatic program. As an example, the American Parkinson Disease Association reports that seven times more energy is expended to breath standing in neck-deep water than standing on land. The association recommends exiting the pool very slowly and allowing time to check for dizziness, stiffness, weakness or rigidity.
Water Temperature
Drugs used to treat Parkinson's might cause low blood pressure. Water temperature should be monitored carefully so that swings in blood pressure do not affect the patient. Water that is too cool can cause a sudden drop in blood pressure. Those suffering with Parkinson's disease normally have a very fragile nervous system that can exhibit swift and sudden changes, according to the association.
Balance Issues
A patient's ability to do water exercise will depend on the stage of disease progression he experiences, according to Haggerty. Poor balance or postural balance problems are a highlight of the disease. Flotation devices such as inner tubes do not help the Parkinson's patient, reports the association, which recommends that the aquatic program instructor test patients prior to beginning the exercise program. These tests include forward, backward and side step water walking; submerging the face and blowing bubbles; floating on the back, then standing upright and floating face down, then standing upright. The tests will indicate how much assistance the patient will require for the program.
Aquatic Routines
The association recommends a warm-up of forward, backward and side step water walking for eight to 10 minutes. Upper body exercises increase range of motion for the shoulders and upper spine. Upper body stretching then includes holding stretches for 15 to 30 seconds. Trunk flexibility starts without equipment for the beginner then proceeds to the use of kick boards and hand buoys. Spine stretching then includes holding the stretches for 15 to 30 seconds. Lower extremity conditioning encompasses squats, hamstring curls, hip flexion and extension, knee flexion and extension, hip adduction and abduction, and knee adduction and abduction. Lower extremity stretches for 15 to 30 seconds include quad stretch, low back stretch and calf stretch. Exercises are then done for the face, neck and hands.
