Comparative Effects of Land‐Based and Aquatic Physiotherapy on Functional and Neuromuscular Outcomes in the Rigid‐Akinetic Subtype of Parkinson's Disease: A Randomized Clinical Trial

BACKGROUND: Parkinson's disease (PD) leads to motor and neuromuscular impairments, with the rigid-akinetic (RA) subtype progressing more rapidly and affecting daily activities and balance. Beyond medication, strength training can improve disease severity and muscle function. However, research on land-based and aquatic physiotherapy for the RA subtype is limited. The objective of the study was to describe and compare the effects of 12 weeks of land-based physiotherapy (LP) and aquatic physiotherapy (AP) on the motor function of individuals with rigid-akinetic PD. METHODS: Thirty individuals with rigid-akinetic PD were allocated to two groups (LP and AP) and participated in a 12-week intervention. Motor function was assessed using the Unified Parkinson's Disease Rating Scale-Part III (UPDRS III) (primary outcome). Secondary outcomes included trunk strength (explosive and maximal), functional capacity, mobility, flexibility, and balance, assessed through the rate of torque development (RTD) and peak torque (PT) using an isokinetic dynamometer, the Sit-to-Stand test (STS), Timed Up and Go (TUG), the Sit-and-Reach test (SR), and the Berg Balance Scale (BBS), respectively. RESULTS: Both LP and AP groups showed no significant changes in UPDRS III, RTD, PT, or TUG, while STS, SR, and BBS showed significant interactions over time (p < 0.05). RTD intervals between 100 and 300 ms, as well as STS and TUG, were significantly linearly associated with UPDRS scores (p < 0.05). DISCUSSION: The results indicate that while motor function and explosive and maximal muscle strength were not significantly affected by the interventions, functional capacity and balance improved, highlighting the importance of continuing physical training as an integral component of rehabilitation. TRIAL REGISTRATION: Clinical trial registration data are publicly accessible at ClinicalTrials.gov under the identifier NCT05866120.