Heart Rate Variability Effects in Parkinson’s Disease: Comparison of a High-Intensity Interval Aquatic Exercise and a Multicomponent Aquatic Training

Parkinson’s disease (PD) involves autonomic dysfunction, and heart rate variability (HRV) analysis can reveal related alterations. This study investigated whether two aquatic exercise programs produce distinct acute and chronic adaptations in cardiac autonomic control. In a non-randomized, single-blind clinical trial, 24 individuals with PD completed either a high-intensity interval aquatic exercise (HIIAE) or a multicomponent aquatic training (MAT) for 12 wk, twice weekly. HRV was assessed before, immediately after a single session (acute), and after program completion (chronic). Both interventions increased parasympathetic modulation and reduced sympathetic activity at rest as chronic effects. MAT produced a greater chronic increase in vagal indices, while the HIIAE elicited stronger acute sympathetic responses. Men showed higher HRV indices than women. These findings suggest that different aquatic exercise modalities can beneficially modulate autonomic balance in individuals with PD, supporting aquatic therapy as an effective adjunct in rehabilitation. Registration number on the Brazilian Clinical Trials Registry platform - RBR-3hp5yvh