Many people who live with Parkinson’s disease know that exercise can improve their quality of life. But most people rely on land-based programs and don’t necessarily know the benefits of aquatic modalities.
Randomized controlled trials have shown that compared to land-based exercise, Parkinson’s patients who exercise in the water show greater increases in motor performance. [i] Also, aquatic exercise has an extremely low fall risk, so it can be an exercise confidence builder.
To support Parkinson’s patients who are interested in aquatic exercise, this is a handy guide of what the research says about the different types of aquatic exercise/therapy available and what benefits you can receive from each type of exercise.
Types of aquatic exercise/aquatic therapy that can be accessed by people with Parkinsons:
Aqua boxing/aqua combat – These are fairly new styles of aqua classes, and we don’t have any research yet to know if they are as effective in the pool as on land for people with Parkinson’s.
Ai Chi – Is an aquatic therapy modality that combines movements from Tai Chi and Qi Gong and adapts them to the pool. Research has shown that Parkinson’s patients who take Ai Chi classes have reduced pain and increased balance and function.[ii]
Aqua Aerobics – Has been shown to improve overall quality of life measures with Parkinson’s.[iii]
Aqua Yoga – Takes traditional yoga postures and adapts them to the pool. While there is no research on aqua yoga for Parkinson’s, land-based yoga has been shown to improve the physical and mental health of this population. We can infer that perhaps aqua yoga would as well.
Aquatic Obstacle Training – Adds objects to the pool floor that have to be navigated and has been shown to reduce gait freezing in Parkinson’s.[iv]
Deep Water Aerobics – Has the advantage of being a no-impact way to exercise, but it has not been shown to have any greater benefits than land-based Parkinson’s programs such as dance or Nordic walking.[v]
Unpredictable Command Technique – Was developed by David Ogden, PT, to “increase somatic awareness, balance, equilibrium, and righting reactions, as well as coordination,” for people living with Parkinson’s disease.[vi] It takes easy and familiar movement patterns and combines them in novel ways with rapid changes to challenge participants’ coordination. Read my article on Unpredictable Command Technique in the pool.
To find aqua exercise for Parkinson’s in your area, reach out to your local pools and see what classes they offer. Try to talk with the instructor before class to share your health needs so they can accommodate you in the best way possible.
* Always check with your health care professional about your specific exercise needs before starting a new program.
This article was originally written for the PunchWorX Parkinson’s Program newsletter in Lakeland, Florida.
References for Aqua Exercise for Parkinson’s Disease
[i] Seyedahmadi, Mohammad, Ahmad Ebrahimi Atri, Hadi Akbari, and Mansour Sahebozamani. 2025. “Can Water Exercise Improve Motor Function in Parkinson’s Disease More Than Land Exercise? A systematic Review and Meta-Analysis.” Physiotherapy Research International.
[ii] Pérez de la Cruz S. Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson’s disease: a randomized clinical trial. Eur J Phys Rehabil Med. 2017 Dec;53(6):825-832.
[iii] Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson’s disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2023 Jan 5;1(1).
[iv] Zhu Z, Yin M, Cui L, Zhang Y, Hou W, Li Y, Zhao H. Aquatic obstacle training improves freezing of gait in Parkinson’s disease patients: a randomized controlled trial. Clin Rehabil. 2018 Jan;32(1):29-36.
[v] Haas AN, Delabary MDS, Passos-Monteiro E, Wolffenbuttel M, Donida RG, Casal MZ, Zanardi APJ, Rodrigues LP, Martinez FG, Peyré-Tartaruga LA. The effects of Brazilian dance, deep-water exercise and nordic walking, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD. Arch Gerontol Geriatr. 2024 Mar;118:105285.
[vi] Aquatic Exercise & Multiple Sclerosis: A Healthcare Professional’s Guide. Salem, et al. Multiple Sclerosis Association of America, 2013.
