Professional Documents
Culture Documents
Parkinson’s
Disease
PT Clerici Ilaria
No conflicts of interest to declare
INDEX
• Relative density
• Buoyancy
• Hydrostatic pressure
• Viscosity
• Thermodynamics
1. DENSITY and SPECIFIC GRAVITY
DENSITY is the ratio between the mass of a substance (kg) and the
space it occupies ( m³)
Muscles 1,8
Bones 1,05
« When a body is
partially or totally
immersed in a fluid it is
buoyed up by a force
equal to the weight
(volume) of the fluid
that is displaced by the
body»
Buoyancy is the upward thrust of water acting on body
STERNUM
Increased hydrostatic
pressure
Stroke volume
increases
Cardiac output
increases
Becker and Cole 1997
1. CARDIOVASCULAR SYSTEM: details
For thermoneutral immersion
Cardiopulmonary
receptor
EFFECTS BENEFITS
- Increased blood circulation to - Decreased pain
the muscles - Decreased joint effusion
- Increased heart rate - Improved range of motion and
- Increased respiratory rate flexibility
- Increased general muscle - Increased strenght and
metabolism coordination
- Decreased blood pressure - Improved ease of ambulation
- Decreased sensitivity of and activities of daily living
sensory nerve endings - Improved mood
- General muscle relaxation - Increased feeling of well-being
HYDROTHERAPY
PART 3
Hydrotherapy in
Parkinson’s
Disease: Why?
Scientific evidences
PARKINSON’S DISEASE
• Chronic and progressive
neurodegenerative disease
• Clinical hallmarks: rigidity,
bradykinesia (or akinesia),
tremor at rest
• Gait problems: shuffling gait,
freezing
• Balance disfunctions
• Postural deformities
(anterocollis, Pisa Syndrome,
camptocormia)
• Cognitive decline
LINKING PROPERTIES AND
REHABIITATION
WATER PROPERTIES
HYDROTHERAPY
STATE OF ARTS
• No descriptive reviews
• No systematic reviews
• No meta-analysis
• Few studies differently disegned
STATE OF ARTS
WHAT ABOUT PARKINSON’S
DISEASE?
• 11 patients with PD (H&Y 2 and 3)
randomly assigned to two groups:
• Trunk mobilization
• Trunk segmental coordination
• Muscle recruitment according to muscle
imbalance, EMG assessment, botulinum toxin
injection
• Trunk proprioception
SPECIFIC EXERCISES FOR POSTURAL
ALTERATIONS
SPECIFIC EXERCISES FOR BALANCE
• Limits of stability
• Postural control
• Ankle and hip strategies
• Perturbation and water turbolence
• Water resistance
• Obstacles and function
SPECIFIC EXERCISES FOR
BALANCE
SPECIFIC EXERCISES FOR FREEZING
• Weight shifting
• Coordination
• Gait patterns
• Turning strategies
SPECIFIC EXERCISES FOR
FREEZING
THIRD PHASE: COOLDOWN
• MIRT protocol designs hydrotherapy intervention mainly for patients presenting: freezing of
gait, postural alterations and balance impairments
• MIRT-Hydrotherapy consists of 3 phases: body warm up, training and cooldow activities.
Patients are treated according to specif protocols (freezing, postural alteration, balance
deficits)
Thanks for your
attention