Aquatic High-Intensity Interval Training for Parkinson's Disease

NCT ID: NCT07264114

Last Updated: 2025-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-10

Study Completion Date

2026-04-10

Brief Summary

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This randomized, single-center, parallel-group superiority trial will evaluate the effect of an 8-week aquatic High-Intensity Interval Training (HIIT) program on balance, physical function, and sarcopenia-related outcomes in individuals with Parkinson's disease (PD). The intervention aims to deliver Tabata-style aquatic HIIT (3 sessions/week) in a therapeutic pool to determine adherence and preliminary efficacy compared with standard care (no structured exercise program).

Detailed Description

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Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms that impair quality of life. Pharmacological treatments alleviate motor symptoms but leave residual motor and non-motor complications and carry long-term adverse effects. Non-pharmacological therapies-particularly exercise-improve motor and non-motor outcomes via mechanisms such as enhanced dopamine release, corticostriatal plasticity, and increased BDNF after vigorous exercise. HIIT (including Tabata protocols) has emerging evidence for benefit in PD but land-based HIIT can be limited by balance deficits and fall risk. Aquatic HIIT may provide a safer environment (buoyancy, reduced joint load, natural resistance) and improve adherence.

This single-center trial will recruit 56 participants (aged 55-75) with PD (Hoehn \& Yahr stages 2-3) and balance difficulty to be randomized 1:1 to aquatic HIIT (n=28) or control (standard care; n=28). The intervention comprises 8 weeks of supervised Tabata-format aquatic sessions (20s high intensity/10s rest ×8 cycles per set; warm-up and cool-down included) three times weekly. Primary endpoints include changes in Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), skeletal muscle mass by BIA, and handgrip strength from baseline to Week 8 (primary endpoint), with safety follow-up to Week 12. Secondary endpoints include PDQ-39, PSQI, adherence, and adverse events monitored with CTCAE criteria.

Conditions

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Parkinson Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly allocate to intervention group or control group and will be examined in the same way.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

None (Open Label) for participants and care providers; Single (Outcomes Assessor) for functional tests; Blinded data analysis."

Study Groups

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Aquatic HIIT group

The participants in the experimental group will undertake supervised aquatic high-intensity interval exercise 3×/week for 8 weeks (Tabata method). Each session consists of a 10-min warm-up, Tabata sets (20s maximal-effort aquatic exercises-e.g., water running, jumping jacks, resistance with foam dumbbells/paddles-followed by 10s rest, 8 cycles/set; total set=4 min), and a 5-min cool-down.

Intensity monitored using Borg RPE scale (6-20), target 15-17 ("hard" to "very hard") during work phases to ensure HIIT delivery. RPE recorded at end of each set with real-time feedback (e.g., "push harder" if \<15). Validated in PD trials; RPE 15-17 ≈80-90% max HR in water (HR optional).

Pool depth waist-to-chest (≈1.2-1.4 m), temp 32-34 °C. Delivered in indoor therapeutic pool of Pardis Institute by certified specialists. Standard medical care continues. Adherence via attendance logs; \>20% missed = non-adherent.

Group Type EXPERIMENTAL

Aquatic HIIT with adherence/support package

Intervention Type BEHAVIORAL

The participants in the behavioral component will receive the same supervised aquatic HIIT program described above plus structured behavioral/support measures to maximize adherence and safety. These include: an initial individual education session explaining benefits/risks and protocol; supervised real-time feedback during each session from exercise specialists; flexible scheduling options to accommodate participants; weekly review of attendance and brief motivational follow-up (phone call or in-person) for participants with missed sessions; individualized adjustments to intensity/duration based on participant feedback and safety; and documentation of reasons for non-attendance. All behavioral/support activities are delivered by trained research staff and exercise physiologists and are recorded in session logs. (These measures are drawn from the protocol's adherence and retention strategies.)

Control group

Patients allocated to the control group will receive their usual clinical management for Parkinson's disease, including pharmacological therapy as prescribed by their neurologist, and will not participate in any structured exercise program during the 8-week study period. Low-intensity daily activities and usual physical routines are permitted. Control participants will be advised to maintain their standard treatment regimen and customary activity patterns during the trial.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Aquatic HIIT with adherence/support package

The participants in the behavioral component will receive the same supervised aquatic HIIT program described above plus structured behavioral/support measures to maximize adherence and safety. These include: an initial individual education session explaining benefits/risks and protocol; supervised real-time feedback during each session from exercise specialists; flexible scheduling options to accommodate participants; weekly review of attendance and brief motivational follow-up (phone call or in-person) for participants with missed sessions; individualized adjustments to intensity/duration based on participant feedback and safety; and documentation of reasons for non-attendance. All behavioral/support activities are delivered by trained research staff and exercise physiologists and are recorded in session logs. (These measures are drawn from the protocol's adherence and retention strategies.)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* PD stages 2-3 based on Hoehn and Yahr classification system
* Balance difficulty (BBS score \<45)
* Reduced motor function
* Sarcopenia (per EWGSOP2 criteria)
* Age ≥ 55
* Permission from their doctors to participate
* Absence of a history of myocardial infarction within the past 3 months
* Capacity to provide informed consent to participate in the study

Exclusion Criteria

* Cardiac instability (angina, decompensated congestive heart failure, severe arteriovenous stenosis, uncontrolled arrhythmias, etc.)
* Active infection or acute medical illness
* Hemodynamic instability
* Labile glycemic control
* Inability to exercise (e.g. lower extremity amputation with no prosthesis)
* Severe musculoskeletal pain at rest or with minimal activity
* Inability to sit, stand or walk unassisted (walking device such as cane or walker allowed)
* Shortness of breath at rest or with activities of daily living
Minimum Eligible Age

55 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pardis Specialized Wellness Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mohammad Ali Tabibi, Dr

Role: STUDY_DIRECTOR

Pardis Specialized Wellness Institute

Central Contacts

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Nasrin Salimian

Role: CONTACT

+98913251202

Mohammad Ali Tabibi, Dr

Role: CONTACT

+989133184624

References

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Harpham C, Gunn H, Marsden J, Bescos Garcia R, Connolly L. Home-based high-intensity interval training for people with Parkinson's: Protocol for the HIIT-Home4Parkinson's randomized, controlled feasibility study. Health Sci Rep. 2024 Jan 7;7(1):e1800. doi: 10.1002/hsr2.1800. eCollection 2024 Jan.

Reference Type BACKGROUND
PMID: 38192731 (View on PubMed)

Kathia MM, Duplea SG, Bommarito JC, Hinks A, Leake E, Shannon J, Pitman J, Khangura PK, Coates AM, Slysz JT, Katerberg C, McCarthy DG, Beedie T, Malcolm R, Witton LA, Connolly BS, Burr JF, Vallis LA, Power GA, Millar PJ. High-intensity interval versus moderate-intensity continuous cycling training in Parkinson's disease: a randomized trial. J Appl Physiol (1985). 2024 Sep 1;137(3):603-615. doi: 10.1152/japplphysiol.00219.2024. Epub 2024 Jul 15.

Reference Type BACKGROUND
PMID: 39008618 (View on PubMed)

Volpe D, Giantin MG, Maestri R, Frazzitta G. Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson's disease: a randomized controlled pilot study. Clin Rehabil. 2014 Dec;28(12):1210-7. doi: 10.1177/0269215514536060. Epub 2014 Jun 3.

Reference Type BACKGROUND
PMID: 24895382 (View on PubMed)

Hande D, Shinde S, Dhumale A, Kale HY. Effects of Aquatic-Based Resistance, Balance, and Proprioceptive Training on Ankle-Foot Malalignments in Postmenopausal Obese Women. Cureus. 2025 Jul 8;17(7):e87571. doi: 10.7759/cureus.87571. eCollection 2025 Jul.

Reference Type BACKGROUND
PMID: 40786333 (View on PubMed)

Li Y, Zhuang R, Zhang J, Liu X. The effect of different exercise training modes on improving quality of life in patients with Parkinson's disease: a network analysis. Front Neurol. 2025 Jul 2;16:1601080. doi: 10.3389/fneur.2025.1601080. eCollection 2025.

Reference Type BACKGROUND
PMID: 40672448 (View on PubMed)

Pezzini JV, Trevisan DD, Dominiak Soares VH, Gauer LE, Lima MMS. Sleep Quality in Parkinson Disease: Clinical Insights and PSQI Reliability Assessment. Sleep Sci. 2024 Oct 23;18(2):e147-e154. doi: 10.1055/s-0044-1791235. eCollection 2025 Jun.

Reference Type BACKGROUND
PMID: 40672893 (View on PubMed)

Berardi A, Galeoto G, Valente D, Conte A, Fabbrini G, Tofani M. Validity and reliability of the 12-item Berg Balance Scale in an Italian population with Parkinson's disease: A cross sectional study. Arq Neuropsiquiatr. 2020 Jul;78(7):419-423. doi: 10.1590/0004-282X20200030. Epub 2020 Jun 8.

Reference Type BACKGROUND
PMID: 32520233 (View on PubMed)

Petkus AJ, Foreman RP, Pilgrim M, Kim A, Hong E, Fisher BE, Van Horn JD, Wing D, Jakowec MW, Schiehser DM, Petzinger GM. Longitudinal associations between physical performance and cognition in individuals with Parkinson's disease. Clin Park Relat Disord. 2025 Jul 17;13:100370. doi: 10.1016/j.prdoa.2025.100370. eCollection 2025.

Reference Type BACKGROUND
PMID: 40756809 (View on PubMed)

Yilmaz M, Atik-Altinok Y, Seyidoglu Yuksel D, Acarer A, Bozkurt D, Savas S, Sarac ZF, Akcicek F. Evaluation of sarcopenia and phase angle in elderly patients with Parkinson's Disease. Int J Neurosci. 2025 Apr;135(4):488-495. doi: 10.1080/00207454.2024.2310180. Epub 2024 Feb 1.

Reference Type BACKGROUND
PMID: 38275120 (View on PubMed)

Villafane JH, Valdes K, Buraschi R, Martinelli M, Bissolotti L, Negrini S. Reliability of the Handgrip Strength Test in Elderly Subjects With Parkinson Disease. Hand (N Y). 2016 Mar;11(1):54-8. doi: 10.1177/1558944715614852. Epub 2016 Jan 14.

Reference Type BACKGROUND
PMID: 27418890 (View on PubMed)

Cugusi L, Manca A, Bergamin M, Di Blasio A, Monticone M, Deriu F, Mercuro G. Aquatic exercise improves motor impairments in people with Parkinson's disease, with similar or greater benefits than land-based exercise: a systematic review. J Physiother. 2019 Apr;65(2):65-74. doi: 10.1016/j.jphys.2019.02.003. Epub 2019 Mar 21.

Reference Type BACKGROUND
PMID: 30904467 (View on PubMed)

Yang Y, Wang G, Zhang S, Wang H, Zhou W, Ren F, Liang H, Wu D, Ji X, Hashimoto M, Wei J. Efficacy and evaluation of therapeutic exercises on adults with Parkinson's disease: a systematic review and network meta-analysis. BMC Geriatr. 2022 Oct 21;22(1):813. doi: 10.1186/s12877-022-03510-9.

Reference Type BACKGROUND
PMID: 36271367 (View on PubMed)

Gamborg M, Hvid LG, Dalgas U, Langeskov-Christensen M. Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. Acta Neurol Scand. 2022 May;145(5):504-528. doi: 10.1111/ane.13579. Epub 2022 Jan 8.

Reference Type BACKGROUND
PMID: 34997759 (View on PubMed)

Other Identifiers

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PA25PKD-2-01

Identifier Type: -

Identifier Source: org_study_id

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