Can Water Exercise Improve Motor Function in Parkinson's Disease More Than Land Exercise? A Systematic Review and Meta‐Analysis

ABSTRACT Background and Purpose Research findings on the effects of land‐based and water‐based exercises on motor performance in people with Parkinson's disease (PD) are conflicting, and despite the known beneficial effects of exercise in these individuals, it is unclear which of these exercise protocols is more beneficial. Therefore, this study aimed to systematically evaluate the effects of exercise on land and water on the performance of people with PD. Methods Randomized controlled clinical trials related to the motor performance of people with PD were identified by searching the Science Direct, PubMed, Scopus, and Google Scholar databases and analyzed using CMA v4 software. Of 94 studies based on the inclusion and exclusion criteria, eight English articles were included in the comprehensive review. Results The meta‐analysis revealed a significant difference in the motor performance of people with PD between the land‐ and water‐based exercise groups (CI 95%, −0.135 to −0.649; MD = −0.392). Discussion Water‐based exercises may offer greater improvements in motor performance compared to land‐based exercises in individuals with PD. Therefore, in addition to conventional exercises, exercising in water could help enhance the motor function of these people, and therapists can incorporate it into their exercise programs.