{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T02:43:54Z","timestamp":1772765034029,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfeicoamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: The complications from Parkinson\u2019s disease (PD) are directly related to decreased muscle function, balance deficits, and independence loss. Practicing aquatic exercises can minimize these symptoms and slow disease progress. Objective: To develop a Multicomponent Aquatic Training (MAT) protocol for people with PD between stages 1 and 4 of the Hoehn and Yahr scale. Methods: The protocol is for a single blind controlled clinical trial. The sample will comprise of people with PD between stages 1 and 4 in Hoehn and Yahr scale, divided into a control group and MAT group (who will participate in the MAT). Musculoskeletal function, functional mobility, and balance will be the primary outcomes of interest, assessed with an isokinetic dynamometer, the Five-Times-Sit-to-Stand test (FTSST), the Timed \u201cUp and Go\u201d test (TUG), the 6-m gait speed test, the Berg Balance Scale (BBS), and a force platform. Quality of life (QOL), activities of daily living (ADL), and motor aspects will be the secondary outcome measures, assessed with the Parkinson\u2019s Disease Questionnaire (PDQ-39) and Unified Parkinson\u2019s Disease Rating Scale (UPDRS), sections II and III. The MAT will be 12 weeks long, with two 50-min sessions per week. The outcome measures will be assessed before and after the interventions. Discussion: This study is expected to establish parameters to prescribe and monitor a MAT program for people with PD in stages 1 to 4 in the Hoehn and Yahr scale, respecting individual progress and assisting the professionals in their procedure with these people.<\/jats:p>","DOI":"10.3390\/ijerph19031727","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T05:42:33Z","timestamp":1643866953000},"page":"1727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multicomponent Aquatic Training (MAT) Program for People with Parkinson\u2019s Disease: A Protocol for a Controlled Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Juliana","family":"Siega","sequence":"first","affiliation":[{"name":"Department of Physical Education, The Federal University of Paran\u00e1, Coronel Francisco H. dos Santos, 100, Curitiba 81531-980, Parana, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dielise Debona","family":"Iucksch","sequence":"additional","affiliation":[{"name":"Department of Physical Education, The Federal University of Paran\u00e1, Coronel Francisco H. dos Santos, 100, Curitiba 81531-980, Parana, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera Lucia","family":"Israel","sequence":"additional","affiliation":[{"name":"Department of Physical Education, The Federal University of Paran\u00e1, Coronel Francisco H. dos Santos, 100, Curitiba 81531-980, Parana, Brazil"},{"name":"Department of Prevention and Rehabilitation in Physical Therapy, The Federal University of Paran\u00e1, Cora\u00e7\u00e3o de Maria, 92, Curitiba 80210-132, Parana, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1176\/jnp.14.2.223","article-title":"An Essay on the Shaking Palsy","volume":"14","author":"Parkinson","year":"2002","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_2","unstructured":"GBD 2016 Parkinson\u2018s Disease Collaborators (2018). Global, regional, and national burden of Parkinson\u2019s disease, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol., 17, 939\u2013953."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, progression, and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"ref_5","unstructured":"Capato, T.T.C., Domingos, J.M.M., and Almeida, L.R.S. (2015). Vers\u00e3o em Portugu\u00eas da Diretriz Europeia de Fisioterapia Para a DP, Omnifarma."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.11606\/issn.2317-0190.v23i4a137672","article-title":"A multidisciplinaridade na redu\u00e7\u00e3o da levodopa na pessoa com doen\u00e7a de Parkinson avan\u00e7ada","volume":"23","author":"Yamaguchi","year":"2016","journal-title":"Acta Fisiatr."},{"key":"ref_7","unstructured":"Rieck, M. (2016). Farmacogen\u00e9tica Dos Efeitos Adversos Induzidos Pelo Tratamento Com Levodopa Na DP. [Ph.D. Thesis, Universidade Federal do Rio Grande do Sul]."},{"key":"ref_8","first-page":"59","article-title":"Is Aquatic Therapy Optimally Prescribed for Parkinson\u2019s Disease? A Systematic Review and Meta-Analysis","volume":"10","author":"Carroll","year":"2019","journal-title":"J. Park. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1093\/ageing\/afm054","article-title":"Multi-modal exercise programs for older adults","volume":"36","author":"Baker","year":"2007","journal-title":"Age Ageing"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jphys.2019.02.003","article-title":"Aquatic exercise improves motor impairments in people with Parkinson\u2019s disease, with similar or greater benefits than land-based exercise: A systematic review","volume":"65","author":"Cugusi","year":"2019","journal-title":"J. Physiother."},{"key":"ref_11","unstructured":"American College of Sports Medicine (2014). ACSM\u2019s Guidelines for Exercise Testing and Prescription, American College of Sports Medicine. [9th ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1177\/0269215520943660","article-title":"Effects of water-based exercise on functioning and quality of life in people with Parkinson\u2019s disease: A systematic review and meta-analysis","volume":"34","author":"Neto","year":"2020","journal-title":"Clin. Rehabil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.pmrj.2018.09.031","article-title":"The effects of hydrotherapy on balance, functional mobility, motor status, and quality of life in patients with Parkinson disease: A systematic review and meta-analysis","volume":"18","author":"Pinto","year":"2019","journal-title":"PM&R"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ctim.2018.10.023","article-title":"Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson\u2019s disease: A randomized clinical trial with a 3-month follow-up","volume":"42","author":"Silva","year":"2018","journal-title":"Complement. Ther. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.apmr.2017.01.025","article-title":"Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of balance dysfunction in Parkinson\u2019s disease: A randomized, controlled study with 6-month follow-up","volume":"98","author":"Palamara","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","first-page":"825","article-title":"Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson\u2019s disease: A randomized clinical trial","volume":"53","year":"2017","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e7586","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: Guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"ref_18","unstructured":"APPP (2021, November 01). Associa\u00e7\u00e3o Paranaense dos Portadores de Parkinsonismo. Available online: https:\/\/www.appp.com.br\/quem-somos\/."},{"key":"ref_19","first-page":"42","article-title":"Hydrotherapy: Application of an Aquatic Functional Assessment Scale (AFAS) in Aquatic Motor Skills Learning","volume":"4","author":"Israel","year":"2014","journal-title":"Am. Int. J. Contemp. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1044\/1092-4388(2008\/018)","article-title":"Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage","volume":"51","author":"Kleim","year":"2008","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jocn.2009.11.014","article-title":"Lower extremity isokinetic muscle strength in patients with Parkinson\u2019s disease","volume":"17","author":"Durmus","year":"2010","journal-title":"J. Clin. Neurosci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.2522\/ptj.20090394","article-title":"Reliability of ankle isometric, isotonic, and isokinetic strength and power testing in older women","volume":"90","author":"Webber","year":"2010","journal-title":"Phys. Ther."},{"key":"ref_23","unstructured":"Keus, S., Munneke, M., Graziano, M., Paltamaa, J., Pelosin, E., Domingos, J., Br\u00fchlmann, S., Ramaswamy, B., Prins, J., and Struiksma, C. (2014). European Physiotherapy Guideline for Parkinson\u2019s Disease, ParkinsonNet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: A test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/ageing\/26.1.15","article-title":"Comfortable and maximum walking speed of adults aged 20\u201379 years: Reference values and determinants","volume":"26","author":"Bohannon","year":"1997","journal-title":"Age Ageing"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.apmr.2004.11.005","article-title":"Validating the Berg Balance Scale for patients with Parkinson\u2019s disease: A key to rehabilitation evaluation","volume":"86","author":"Qutubuddin","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"494","DOI":"10.2522\/ptj.20150249","article-title":"Comparison of the Fullerton Advanced Balance Scale, Mini-BESTest, and Berg Balance Scale to Predict Falls in Parkinson Disease","volume":"96","author":"Schlenstedt","year":"2016","journal-title":"Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/BF02260863","article-title":"The development and validation of a short measure of functioning and well being for individuals with Parkinson\u2019s disease","volume":"4","author":"Peto","year":"1995","journal-title":"Qual. Life Res."},{"key":"ref_29","first-page":"17","article-title":"Fisioterapia na DP: Uma breve revis\u00e3o","volume":"46","author":"Santos","year":"2010","journal-title":"Rev. Bras. Neurol."},{"key":"ref_30","first-page":"83","article-title":"Escalas cl\u00ednicas para avalia\u00e7\u00e3o de pacientes com DP","volume":"19","author":"Meneses","year":"1996","journal-title":"Doen\u00e7a de Parkinson: Aspectos Cl\u00ednicos e Cir\u00fargicos"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/ptj\/pzz003","article-title":"Land Plus Aquatic Therapy Versus Land-Based Rehabilitation Alone for the Treatment of Freezing of Gait in Parkinson Disease: A Randomized, Controlled Study","volume":"99","author":"Clerici","year":"2019","journal-title":"Phys. Ther."},{"key":"ref_32","first-page":"102","article-title":"Aquatic physical therapy for Parkinson\u2019s disease","volume":"2","author":"Zotz","year":"2013","journal-title":"Adv. Park. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jbmt.2021.03.021","article-title":"Parkinson\u2019s disease and multicomponent aquatic exercise: Effects on motor aspects, functional mobility, muscle function and aquatic motor skills","volume":"27","author":"Siega","year":"2021","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.neuroimage.2011.06.014","article-title":"Changes occur in resting state network of motor system during four weeks of motor skill learning","volume":"58","author":"Ma","year":"2011","journal-title":"NeuroImage"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e47129","DOI":"10.4025\/actascihealthsci.v42i1.47129","article-title":"Decoding the aquatic motor behavior: Description and reflection on the functional movement","volume":"42","author":"Iucksch","year":"2020","journal-title":"Acta Sci. Health Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/TGR.0000000000000039","article-title":"Effect of the Ai-Chi Method on Functional Activity, Quality of Life, and Posture in Patients With Parkinson Disease","volume":"30","author":"Villegas","year":"2014","journal-title":"Top. Geriatr. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.exger.2015.02.013","article-title":"Effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults","volume":"64","author":"Kanitz","year":"2015","journal-title":"Exp. Gerontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1590\/S0103-51502010000300008","article-title":"Ai Chi: Efeitos do relaxamento aqu\u00e1tico no desempenho funcional e qualidade de vida em idosos","volume":"23","author":"Cunha","year":"2010","journal-title":"Fisioter. Mov."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1727\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:13:11Z","timestamp":1760134391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1727"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,2]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19031727"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19031727","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,2]]}}}