Hydrotherapy for Parkinson’s: What the Research Says About Movement in Water

Living with Parkinson’s disease can make movement feel less predictable. Changes in balance, walking, flexibility, strength and confidence may affect everyday activities: from getting out of a chair to moving safely around the home or community.

For some people, hydrotherapy offers a supportive way to keep moving. Exercising in warm water can make movement feel gentler, provide extra support and create opportunities to practise balance and walking with less fear of falling.

But what does the research say? Is aquatic exercise better than land-based therapy? Can hydrotherapy reduce falls? And how can a programme be delivered safely and collaboratively?

What is hydrotherapy?

Hydrotherapy, also called aquatic therapy, is exercise or therapy completed in a pool. The programme may include walking, balance activities, posture exercises, stretching, strengthening, coordination tasks and movements designed around a person’s individual goals.

The water itself creates a different exercise environment:

• Buoyancy can reduce the amount of body weight carried through the joints.
• Water resistance provides gentle challenge as a person moves.
• Hydrostatic pressure may support body awareness and stability.
• Warm water may help some people feel less stiff and more comfortable while moving.
• Slower movement can give a person more time to practise control and coordination.

Hydrotherapy is not a cure for Parkinson’s disease, and it does not replace medication, medical care or an individualised rehabilitation plan. However, it may be a useful part of a broader approach to maintaining movement and participation.

What does the research say about Parkinson’s hydrotherapy?

Research into Parkinson’s hydrotherapy is encouraging, particularly for balance and functional mobility. However, it is important to interpret the findings realistically. Studies have used different pool exercises, session lengths and outcome measures, and many have included relatively small numbers of participants.

A 2020 systematic review and meta-analysis examined 19 studies involving 484 people with Parkinson’s disease. It found that hydrotherapy, either alone or combined with land-based therapy, may improve balance and functional mobility compared with land-based therapy alone or usual care. The researchers did not find a clear improvement in overall motor status or quality of life compared with other treatments.

A separate systematic review of 14 studies involving 472 participants found that aquatic therapy produced positive outcomes for gait, balance and mobility. Improvements were generally comparable to land-based physiotherapy, with a statistically significant advantage for mobility measured by the Timed Up and Go test in favour of aquatic therapy.

These findings suggest that hydrotherapy can be a valuable option: not necessarily because it replaces land-based therapy, but because it may give people another comfortable and motivating way to practise important movement skills.

You can read the research summaries through PubMed’s review of aquatic therapy for Parkinson’s disease and the systematic review of hydrotherapy for balance and mobility.

Potential benefits of movement in water

1. Balance and postural control

Balance changes are common in Parkinson’s disease and can contribute to falls. In a pool, buoyancy and water resistance may create a more forgiving environment for practising weight shifting, reaching, turning and changes in direction.

This does not mean the pool removes all risk. A person still needs appropriate supervision, access to safe entry and exit points, and an exercise plan suited to their abilities. However, the water may allow someone to practise balance challenges that feel too difficult or worrying on land.

A 2023 meta-analysis of long-term outcomes found that hydrotherapy was associated with a sustained improvement in balance. The authors were more cautious about long-term effects on mobility, motor function and quality of life, highlighting why ongoing, goal-focused exercise remains important.

Read the full long-term hydrotherapy research.

2. Gait and functional mobility

Walking may become slower or more effortful for people with Parkinson’s disease. Some people experience freezing, shorter steps, difficulty turning or reduced confidence in busy environments.

Aquatic exercise can provide a useful setting to practise:

• Walking forwards, backwards and sideways
• Larger, more deliberate steps
• Turning and changing direction
• Starting and stopping
• Weight transfer from one leg to the other
• Coordinating arm and leg movements
• Moving while responding to simple cues

The evidence suggests short-term improvements in functional mobility and walking ability for some participants. However, long-term gains may not continue without regular practice. A consistent plan that links pool activities with everyday goals is more likely to support meaningful participation outside the pool.

3. Flexibility and stiffness

Warm water may make stretching and active movement feel more comfortable for some people. The reduced loading through the joints can also make it easier to explore a larger range of movement.

Research comparing aquatic and land-based therapy has reported improvements in flexibility, along with potential benefits for pain and sleep quality. Individual responses vary, so exercises should be adjusted according to fatigue, stiffness, pain, medication timing and safety needs.

4. Confidence and quality of life

Confidence is an important part of rehabilitation. If a person is worried about falling, they may avoid walking, exercise or social activities. Over time, this can lead to reduced fitness and further loss of confidence.

A supportive pool environment may help someone experience successful movement in a way that feels achievable. Completing a turn, taking larger steps or standing with improved control can build confidence that carries into other activities.

The evidence for quality-of-life improvement is mixed. Some studies report small improvements in quality of life, mental wellbeing, pain or sleep, while other reviews have not found a significant difference compared with control treatments. This may be because quality of life is influenced by many factors, including fatigue, mood, social connection, pain, sleep and the level of support available.

Can hydrotherapy reduce fall risk?

Falls are a major concern for many people living with Parkinson’s disease. Hydrotherapy may contribute to fall risk reduction by improving balance, mobility, lower-limb control and confidence.

Some research has reported fewer falls in aquatic therapy groups compared with land-based exercise. However, direct evidence about long-term fall prevention remains limited. Improved balance in the pool does not automatically mean a person will be safe in every home or community situation.

A complete falls strategy may also include:

• Reviewing walking aids and footwear
• Practising transfers and turning
• Identifying home hazards
• Building strength and endurance
• Learning strategies for freezing or hesitation
• Considering medication timing with the treating medical team
• Supporting safe movement in real-world environments

Hydrotherapy can be one part of this broader plan.

How Nurturing Hands supports hydrotherapy programmes

At Nurturing Hands Allied Health, we understand that therapy works best when it fits into real life. Our mobile service supports participants in their homes, schools and workplaces, and we can also support therapy-related goals in suitable community settings such as an accessible pool.

Our model is based on collaboration with your treating Allied Health Professional. Where hydrotherapy is recommended by an external physiotherapist or another appropriate Allied Health Professional, an Allied Health Assistant may support the person to carry out the prescribed programme under that professional’s guidance and supervision.

This may include helping a participant:

• Attend regular pool sessions
• Follow an established exercise programme
• Practise agreed movement strategies
• Build confidence with repetition
• Track progress towards meaningful goals
• Communicate updates with the participant’s broader support team

The Allied Health Assistant does not replace the treating professional. Instead, the AHA helps provide regular, practical support so that therapy recommendations can be carried over into consistent practice.

Our Allied Health Assistant service explains more about this collaborative model.

Can NDIS funding support hydrotherapy?

NDIS funding may support hydrotherapy-related assistance when it is connected to a participant’s approved goals, rehabilitation needs and funding arrangements. Funding is not automatic, and the appropriate support depends on the person’s plan, eligibility, provider arrangements and the recommendations of their treating professionals.

A participant may wish to discuss:

• Whether hydrotherapy supports their individual goals
• Which professional should assess and prescribe the programme
• Whether AHA support is appropriate
• Pool entry, transport and other related costs
• How progress will be documented
• How the service fits within their available budget

Nurturing Hands can work with participants, families, support coordinators, plan managers and external Allied Health Professionals to help create a cohesive therapy experience. Our NDIS therapy support page provides further information about making the most of available therapy funding.

Safety considerations before starting

Before beginning hydrotherapy, speak with the person’s treating medical and Allied Health Professionals. They can consider factors such as cardiovascular health, fatigue, medication effects, blood pressure, seizures, skin integrity, continence, cognition, communication, pool temperature and safe transfers.

The pool should have suitable access, supervision and emergency procedures. It is also important to plan for changing, showering, transport and fatigue after a session.

Hydrotherapy should feel supportive: not like a test. A good programme starts at the person’s current level and progresses gradually.

The key message

The research supports hydrotherapy as a promising option for people living with Parkinson’s disease, particularly for balance and short-term functional mobility. It may also help with flexibility, confidence and selected aspects of quality of life. Evidence about long-term gait, motor function, falls and quality-of-life outcomes is less certain, so realistic goals and ongoing review are essential.

Most importantly, hydrotherapy should be part of a personalised and collaborative plan. With the right professional guidance, regular practice and support that fits around everyday life, movement in water may help a person feel safer, more capable and more confident.

Book your session

Would you like to discuss AHA support for a hydrotherapy programme recommended by your Allied Health Professional?

Book your session with Nurturing Hands, or scan the QR code below to get started.

For more information, visit the Nurturing Hands website or contact our team.

This article is for general information only and does not replace personalised medical, physiotherapy or Allied Health Professional advice.

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Meta description: Discover what research says about hydrotherapy for Parkinson’s, including balance, gait, flexibility, confidence, falls and quality of life.
SEO tags: Parkinson’s hydrotherapy, aquatic exercise benefits, balance and gait, fall risk reduction, quality of life, NDIS therapy funding