The safety and feasibility of aquatic physiotherapy on falls and balance in people with Parkinson’s Disease: A pilot randomised control trial

Miss Aan Terrens1,2, Dr Sze-Ee Soh2, A/Prof Prue Morgan2

1Peninsula Health, Melbourne, Australia, 2Monash University, Melbourne, Australia


The primary aim was to determine feasibility of aquatic physiotherapy for clients with Parkinson’s Disease (PD). The secondary aim was to determine whether novel aquatic was more effective than traditional aquatic or land based physiotherapy in improving balance and reducing falls.

All interventions ran for 60 minutes over 12 weeks. Feasibility outcomes were safety, adherence and attrition. Secondary outcome measures included the Unified Parkinson’s Disease Rating Scale motor subsection (UPDRS-III), Berg Balance Scale (BBS), MiniBESTest and modified Falls Efficacy Scale (mFES).

Thirty participants with PD were recruited into the single blind pilot randomised control trial. There were no falls during intervention sessions, however ten participants (33%) reported falls during the study period. No other adverse consequences were reported. No significant differences were found in UPDRS-III or BBS scores post intervention for all groups, but the novel aquatic group improved significantly in the MiniBESTest (p=0.011). The traditional aquatic group demonstrated significant improvements in mFES scores post-intervention (p=0.000) and also reported significantly greater confidence than other groups for mFES, (p=0.000).

Significance of the findings to allied health:
Despite people with PD being a vulnerable population, aquatic physiotherapy may be a feasible treatment option. We observed some promising results for balance and fear of falling following aquatic physiotherapy, but due to the small sample size an appropriately powered study is required to increase confidence in these results.


Fleur Terrens is the coordinator of the Movement Disorder Program within Peninsula Health. She is also a senior physiotherapist within the Movement Disorder Program at Eastern Health. She has an interest in neurological rehabilitation, in particular Parkinson’s Disease, and has worked in this area since graduating from Monash University in 2009. Currently she is undertaking her PhD through Monash University, where she is examining different aquatic physiotherapy techniques and their influence on postural control and balance in people with Parkinson’s Disease.