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Effects of Water-Based and Callisthenic Exercise on Freezing of Gait, Postural Control, and Functional Independence in Patients With Mild to Moderate Parkinson Disease

Cancela, Jose Maria PhD; Ayan, Carlos PhD; Nascimento, Carla Manuela Crispim PhD; Seijo-Martínez, Manuel PhD

Topics in Geriatric Rehabilitation: April/June 2015 - Volume 31 - Issue 2 - p 152–158
doi: 10.1097/TGR.0000000000000062
Original Articles

Objective: This study aimed to analyze and compare the role of a water-based exercise program versus a combination of water and callisthenic exercises on postural control, functional independence, and freezing of gait (FOG) in patients with mild to moderate Parkinson disease.

Methods: Twenty-five community-dwelling participants with idiopathic Parkinson disease were recruited. Of these, 9 participants took part in a water-based program of physical exercises and the other 16 participants took part in a combined program that consisted of callisthenic exercises plus an aquatic exercise session. Both programs were 16 weeks in duration. The clinical evaluation assessed the festination by means of the FOG score test; postural control was verified by means of the balance test of the short physical performance battery, and the Spanish validated version of the Unified Parkinson's Disease Rating Scale part 2 was used to assess functional independence. Participants were evaluated before and after 16 weeks of both proposed programs.

Results: The results showed improvement in FOG for both groups, although a significant main effect was observed only in the patients who performed the callisthenic exercise plus an aquatic exercise program. Postural control did not show significant improvements after both proposed physical exercise programs as soon as functional autonomy. Our preliminary results suggest that training sessions with the combination of water plus callisthenic exercises may be a useful physical rehabilitation strategy for individuals with mild to moderate Parkinson disease who have FOG.

HealthyFyt Group, Faculty of Sports Science, University of Vigo, Pontevedra, Vigo, Spain (Drs Cancela, Ayan, and Nascimento); Laboratory of Aging and Physical Activity (LAFE), Biosciences Institute, UNESP–Universidade Estadual Paulista, SP, Brazil (Dr Nascimento); and Neurología, Xestión Integrada Pontevedra-Salnés, Pontevedra, Spain (Dr Seijo-Martínez).

Correspondence: Carla Manuela Crispim Nascimento, Laboratory of Aging and Physical Activity (LAFE), Department of Physical Education, Campus Rio Claro, Universidade Estadual Paulista/UNESP, Av 24a, 1515, Rio Claro/SP 13506-900, Brazil (

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the manuscript.

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