OBJECTIVE: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson's disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. DESIGN: A randomized single-blind controlled trial. SETTING: Outpatients. SUBJECTS: Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5 to 3. INTERVENTION: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). MAIN MEASURES: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson's Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson's Disease Questionnaire-39. RESULTS: Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change 45.4 SD 64.9 versus 6.9 SD 45.3, p = 0.05), Berg Balance Scale (51.2 SD 3.1 versus 6.0 SD 3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD 10.6 versus 4.1 SD 5.4, p = 0.0001), Falls Efficacy Scale (-5.9 SD 4.8 versus -1.9 SD 1.4, p = 0.003), Parkinson's Disease Quetionnaire-39 (-18.4 SD 12.9 versus -8.0 SD 7.0, p = 0.006) and falls diary (-2.4 SD 2.2 versus -0.4 SD 0.5, p = 0.001). CONCLUSION: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.

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