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Parkinson's disease (PD) is a chronic, progressive, neurological disorder that affects coordination and movement due to a loss of neurons and a decrease in dopamine-producing brain cells. Several studies have already shown that exercise is vital for maintaining function in patients living with PD.
More recently, research is focusing on aquatic (water) exercises as an excellent exercise medium for people living with Parkinson’s disease. Aquatic exercise offers all the benefits of land exercise plus several other advantages.
According to movement specialist Maryanne Haggerty, aquatic therapy is especially helpful for PD as it addresses several troublesome symptoms, namely muscles spasms, contractures, rigidity, tremors and postural instability.
She adds that adapting aquatic exercises to each individual’s PD symptoms during treatment sessions can help to control these symptoms. However, she stresses that using aquatic techniques is also dependent on an individual’s response to exercise, what stage of PD is involved, and the interaction of his/her medication with exercise.
Do your homework
As with any exercise programme, get permission from your doctor before starting with aquatic exercises as they form part of rehabilitative medicine. Make sure your instructor or physiotherapist is suitably qualified to offer aquatic therapy and that he or she has knowledge of PD.
Ask your local PD support group about qualified aquatic therapists as there are various qualifications in this field. At the least, they should be trained in basic first aid, cardiopulmonary resuscitation and community water safety. This will then ensure he/she can devise the most effective exercises and monitor you to make adaptations, if necessary, as your illness progresses.
In addition, physical therapist Steve Seneda of The Peter B. Lewis Aquatic Center recommends finding an aquatic therapy centre that offers “a large, heated therapy pool with a safe ramp for walkers, wheelchairs, water walking and therapy”.
Benefits
If you have PD, the main focus of aquatic exercise will be to enhance and improve your mobility, balance and posture. Here are some of the benefits:
• Since water’s buoyancy decreases body weight by as much as 90%, it provides extra support for exercising and reduces the likelihood of falls.
• The gravity-reduced environment of water enhances movement freedom and bigger movements, thereby increasing functional strength and promoting a progressively wider range of motion.
• Water naturally provides forces of resistance and turbulence, which challenge coordination and balance.
• Exercising in warm water provides a soothing thermal effect, which may alter muscle tone, relax muscles and reduce pain/stiffness.
• Heightened body awareness through continually adjusting to the dynamic water environment may enhance motor control during walking and reduce postural instability.
• Exercising in a heated pool is surprisingly accessible – even people who use a walker or cane are able to walk in the water using just a floatation device.
• Water exercises can provide an effective full-body cardiovascular workout with or without various floatation and other devices such as hand buoys, pool noodles and kick boards.
• Exercises range from stretching the shoulders and upper spine and improving trunk flexibility to strengthening legs using lifts, squats, hamstring curls and ankle extensions.
Some tips on starting out:
• If you’re unsure about your safety in water, ask your aquatic instructor to assess beforehand how well you can float and right yourself in water that is waist or chest deep. (This would include walking forward, backwards and sideways in water, submerging your face and blowing bubbles as well as floating firstly on your back and then on your face before coming up to a standing position).
• Save time (and energy) by putting your swimsuit under your clothes before your session.
• If you get cold easily, invest in aqua fitness or aquatic sports clothing to keep you warm. Wearing aqua socks/shoes while in the pool and shower areas will protect your feet and prevent slipping.
• Take care not to become uncomfortably cold – if you have “goose bumps” and are shivering the water is too cold. Cool water temperature can cause your blood pressure to drop suddenly and lead to fainting.
• Start out slowly if it’s your first aquatic exercise session and especially if you haven’t been active for some time. Don’t overdo it – it’s fine to exercise for only 15 minutes in the beginning.
• Aim to work up progressively to doing aquatic exercise 4-5 times a week for at least 30-40 minutes at a time.
• Listen to your body – don’t be afraid to take a break or pause if certain movements cause discomfort.
• Stop if you feel dizzy, rigid or experience pain. Ask your aquatic instructor for assistance if necessary.
• Bring additional dopamine medication for your PD, in case you need it.
• After your session, get out of the pool slowly. If you experience any weakness, stiffness or dizziness, sit down until your body readjusts to being on land.
• Regardless of the stage of PD you’re in, always warm up and cool down properly, know your limits and focus on exercising safely.
More recently, research is focusing on aquatic (water) exercises as an excellent exercise medium for people living with Parkinson’s disease. Aquatic exercise offers all the benefits of land exercise plus several other advantages.
According to movement specialist Maryanne Haggerty, aquatic therapy is especially helpful for PD as it addresses several troublesome symptoms, namely muscles spasms, contractures, rigidity, tremors and postural instability.
She adds that adapting aquatic exercises to each individual’s PD symptoms during treatment sessions can help to control these symptoms. However, she stresses that using aquatic techniques is also dependent on an individual’s response to exercise, what stage of PD is involved, and the interaction of his/her medication with exercise.
Do your homework
As with any exercise programme, get permission from your doctor before starting with aquatic exercises as they form part of rehabilitative medicine. Make sure your instructor or physiotherapist is suitably qualified to offer aquatic therapy and that he or she has knowledge of PD.
Ask your local PD support group about qualified aquatic therapists as there are various qualifications in this field. At the least, they should be trained in basic first aid, cardiopulmonary resuscitation and community water safety. This will then ensure he/she can devise the most effective exercises and monitor you to make adaptations, if necessary, as your illness progresses.
In addition, physical therapist Steve Seneda of The Peter B. Lewis Aquatic Center recommends finding an aquatic therapy centre that offers “a large, heated therapy pool with a safe ramp for walkers, wheelchairs, water walking and therapy”.
Benefits
If you have PD, the main focus of aquatic exercise will be to enhance and improve your mobility, balance and posture. Here are some of the benefits:
• Since water’s buoyancy decreases body weight by as much as 90%, it provides extra support for exercising and reduces the likelihood of falls.
• The gravity-reduced environment of water enhances movement freedom and bigger movements, thereby increasing functional strength and promoting a progressively wider range of motion.
• Water naturally provides forces of resistance and turbulence, which challenge coordination and balance.
• Exercising in warm water provides a soothing thermal effect, which may alter muscle tone, relax muscles and reduce pain/stiffness.
• Heightened body awareness through continually adjusting to the dynamic water environment may enhance motor control during walking and reduce postural instability.
• Exercising in a heated pool is surprisingly accessible – even people who use a walker or cane are able to walk in the water using just a floatation device.
• Water exercises can provide an effective full-body cardiovascular workout with or without various floatation and other devices such as hand buoys, pool noodles and kick boards.
• Exercises range from stretching the shoulders and upper spine and improving trunk flexibility to strengthening legs using lifts, squats, hamstring curls and ankle extensions.
Some tips on starting out:
• If you’re unsure about your safety in water, ask your aquatic instructor to assess beforehand how well you can float and right yourself in water that is waist or chest deep. (This would include walking forward, backwards and sideways in water, submerging your face and blowing bubbles as well as floating firstly on your back and then on your face before coming up to a standing position).
• Save time (and energy) by putting your swimsuit under your clothes before your session.
• If you get cold easily, invest in aqua fitness or aquatic sports clothing to keep you warm. Wearing aqua socks/shoes while in the pool and shower areas will protect your feet and prevent slipping.
• Take care not to become uncomfortably cold – if you have “goose bumps” and are shivering the water is too cold. Cool water temperature can cause your blood pressure to drop suddenly and lead to fainting.
• Start out slowly if it’s your first aquatic exercise session and especially if you haven’t been active for some time. Don’t overdo it – it’s fine to exercise for only 15 minutes in the beginning.
• Aim to work up progressively to doing aquatic exercise 4-5 times a week for at least 30-40 minutes at a time.
• Listen to your body – don’t be afraid to take a break or pause if certain movements cause discomfort.
• Stop if you feel dizzy, rigid or experience pain. Ask your aquatic instructor for assistance if necessary.
• Bring additional dopamine medication for your PD, in case you need it.
• After your session, get out of the pool slowly. If you experience any weakness, stiffness or dizziness, sit down until your body readjusts to being on land.
• Regardless of the stage of PD you’re in, always warm up and cool down properly, know your limits and focus on exercising safely.
