BACKGROUND AND PURPOSE: Parkinson's disease (PD) is a progressive, neurodegenerative disorder with approximately 60,000 new diagnoses in America each year. Deficits commonly include movement dysfunction, which frequently lead to limitations in activities of daily living (ADLs). The purpose of this systematic review was to identify the effectiveness of aquatic therapy for the treatment of balance, gait, and quality of life (QoL) measure deficits in individuals with PD. METHODS: PubMed and Embase databases were systematically searched in October 2017 and September 2018. The following inclusion criteria were applied: (1) participants diagnosed with PD; (2) aquatic therapy compared with any other form of therapeutic exercise and/or no therapeutic exercise; (3) outcomes related to gait, balance, and/or QoL; and (4) involved randomization. The PEDro scale was used to grade the risk of bias. The Cohen d effect sizes were calculated for within-group change and between-group change. RESULTS: Ten studies met the inclusion criteria with PEDro scores ranging from 4 to 8 of 10 points. In total, there were 45 comparisons between the experimental, aquatic intervention, and a control. Sixteen comparisons demonstrated significant effects within the aquatics group, and 14 demonstrated significant effects between the aquatic and control interventions in favor of aquatics. Large effects were found for balance, quality of life, and gait, with balance demonstrating the greatest number of significant within-group and between-group effects of the 3 outcomes. There were no significant between-group effects in favor of the control. DISCUSSION AND CONCLUSIONS: Aquatic physical therapy may be effective at improving balance, gait, and QoL in individuals diagnosed with PD. Definitive conclusions are limited at this time based on current availability of evidence. Specific modes of aquatic physical therapy treatment that is more beneficial than another, as well as frequency, duration, and intensity dosing cannot be made based on current evidence.

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