Interest of Hydrophysiotherapy Care in Parkinson Disease's Motor and Non-motor Symptoms

Interest of Hydrophysiotherapy Care in Parkinson Disease's Non-motor Symptoms

Parkinson Disease (PD) is a neurodegenerative disorder who begin around 55 years old, characterized by brain's backmatter's dopamine neuron destruction, involved in motor control. Diagnosis is made with presence of 3 of 4 disease's cardinal sign: bradykinesia, rigidity, resting tremor, walking troubles. Treatments enhance patient's quality of life, but do not allow to stop disease's evolution, who is specific depending on a lot of factors. For some years, PD's non motor symptoms (NMS) - in particular pain, anxiety, depression, sleep disorders - have been highlighted and turn out to impair sometimes quality of life even though motor symptoms are controlled. This project's main aim is to evaluate if aquatic environment's care lead to an advantage on PD's NMS, symptoms currently underestimated, insufficiently in care and having a harmful influence on quality of life. Collaboration of the University Hospital (Neurology Dpt), the Physical Medicine and Rehabilitation Regional Institute, Grand Nancy Thermal, and France Parkinson Association, will allow in this way to offer on PD's NMS, postural control impairments, and walking troubles an alternative or further non-pharmacological therapy.

Inclusion Criteria, patient:

• having get a complete information on study's organization and having given written informed consent,
• affiliated to a social security system,
• suffering from Parkinson's disease (stage 2 or 3 of Hoehn and Yahr),
• with motor fluctuation lower than 25% of awaked time,
• with dyskinesia lower than 25% of awaked time (according to MDS-UPDRS scale),
• with stable pharmacological treatment during the 30 days before study,
• already benefiting of a physiotherapy.

Exclusion Criteria, patients:

• receiving treatment by apomorphine or Duodopa pump,
• benefiting of brain stimulation,
• taking occasionally benzodiazepine,
• with dementia (MDS-UPDRS 1.1 score > 3),
• having had a sprain on a lower limb joint 3 months or less before the beginning of study,
• having head trauma consequences,
• having vertebrae pain,
• with freezing,
• having skin trouble leading to a contraindication of aquatic activities,
• concerned by L. 1121-5, L. 1121-7 and L 1121-8 articles of French public health code.