Exercise Physiology

Hydrotherapy for Parkinson’s Disease and Balance

A clear guide to water-based exercise for people with Parkinson's disease, how warm water and buoyancy support balance, and what a Physiotherapy session looks like.

Hydrotherapy for Parkinson’s Disease and Balance
A Physiotherapist supervising warm-water exercise for an older adult with Parkinson's disease.

Article by Aathi Thirunanthakumar, Physiotherapist at Croydon Park

Parkinson’s Disease (PD) is a progressive neurological disorder that affects your movement. Common symptoms include tremor, slow movement (bradykinesia), postural imbalance, and slurred speech. The combination of these symptoms can ultimately affect one’s strength, balance and endurance, thereby reducing the quality of life in individuals.

Currently, evidence suggests that aerobic and strength training programs improves the quality of life of people with PD. It has been used as a key component of PD rehabilitation. Evidence also supports the use of hydrotherapy as a form of exercise that provide similar benefits to conventional exercise in PD.

Hydrotherapy offers an alternate method of rehabilitation through its advantages mentioned below:

Temperature: Warm temperatures of water can facilitate loosening/relaxation of muscles and joint, reducing pain and stiffness.

Buoyancy: The buoyancy of the water offloads weight-bearing, making it easier to put move limbs and perform functional tasks such as walking, squatting, standing.

Viscosity: There will be a natural resistance felt against movements through the water, which can facilitate muscle strengthening.

In individuals with PD, these features of hydrotherapy allow for increased confidence and safety to exercise compared to land exercises. A systematic review in 2019 analysed the effects of hydrotherapy vs land based exercise in patients with PD.

Exercising 2-3 times/week in the water was shown to improve balance, fear of falling, and quality of life when compared to land exercises (walking, cycling, stretching, strengthening exercises).

If you know of someone with PD, you can tell them all about the positive effects of hydrotherapy. If you would like to know more, please feel free to give us a call and chat to one of our physiotherapists.

References

Cugusi, L. et. al. (2019). Aquatic exercise improves motor impairments in people with Parkinson’s disease, with similar or greater benefits than land-based exercise: a systematic review. Journal of Physiotherapy, 65(2), p. 65-74. https://doi.org/10.1016/j.jphys.2019.02.003

 

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CLINICALLY REVIEWED BY

Kieran Doyle

APA Titled Musculoskeletal Physiotherapist APAM MACP
MMuscPhysio, GradCertMuscPhysio, MPhty, BAppSc(Ex&SpSc)

NATIONAL HEAD OF CLINICAL DEVELOPMENT (PHYSICAL REHABILITATION),
OPTIMUM HEALTH SOLUTIONS

With over 18 years of experience across Australia and the United Kingdom, Kieran is an APA Titled Musculoskeletal Physiotherapist, a qualification held by fewer than 1 in 10 physios, with a background spanning private practice, sports medicine, and complex neurological rehabilitation. He reviews all musculoskeletal content for clinical accuracy.

Kieran Doyle
Common questions

Frequently asked questions

For most people with Parkinson's disease, supervised hydrotherapy is a safe and low-impact form of exercise. A Physiotherapy assessment is the right first step, especially if you have a recent fall history, cardiac concerns, open wounds, or skin sensitivity. The water itself lowers fall risk because losing balance means sinking, not dropping.
General exercise guidance for Parkinson's disease points to two to three supervised sessions a week. The 2019 Journal of Physiotherapy review found that regular aquatic exercise improved balance, confidence around falls, and quality of life. Most people start at the lower end and build up with their Physiotherapist.
No. Hydrotherapy for Parkinson's disease is done in chest-deep or waist-deep water with a Physiotherapist supervising, and many sessions never leave the shallow end. The focus is on standing balance, walking, and strengthening work, not swimming strokes. Pool steps and handrails are used throughout.
Hydrotherapy does not reverse Parkinson's disease, and no single exercise approach has been shown to halt progression for everyone. What the evidence shows is that regular supervised exercise, including aquatic exercise, can support balance, confidence, and quality of life, which often matters most day to day.
Medicare may cover some Physiotherapy sessions under a GP Chronic Disease Management plan, which can include hydrotherapy. NDIS participants with relevant funding may also access hydrotherapy through Physiotherapy or Exercise Physiology line items. Your Physiotherapist or our reception team can confirm what applies to your situation.
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