Deep Brain Stimulation and Swimming Performance
A Randomized Within-Person Crossover Study
Citation Manager Formats
Make Comment
See Comments

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective To determine whether deep brain stimulation (DBS) causes swimming impairment, we systematically compared swimming ability between DBS on vs off in 18 patients.
Methods We conducted a randomized blinded crossover study, comparing swimming ability between DBS on vs off, within participants. Participants swam 3 laps of front crawl and 3 laps of breaststroke. Prespecifed primary outcomes were proportion of lap completed, lap time, and Aquatic Skills Proficiency Assessment (ASPA) score. Prespecified secondary outcomes were a qualitative description of marked changes observed.
Results Eighteen participants with Parkinson disease (n = 13), essential tremor (n = 3), Tourette syndrome (n = 1), or posttraumatic brain injury proximal tremor (n = 1), treated with posterior subthalamic area (n = 15) or globus pallidus interna (n = 3) DBS were assessed. There was no significant effect of DBS on/off status on any outcome measure for front crawl or breaststroke. Three participants showed changes in both qualitative and quantitative assessments. Of these, 1 participant displayed reduction in swimming ability: impairment in all outcomes with DBS on, normalizing with DBS off (the same individual as previously reported). The participant displayed difficulty coordinating limb movement as well as postural control. Two participants showed improvements in lap time and ASPA scores with DBS on.
Conclusion Overall DBS did not impair swimming performance, although 1 patient demonstrated a stimulation-induced drowning hazard. There were no anatomic or clinical features unique to the individual with swimming impairment. Patients should be warned about the possibility of DBS-induced drowning hazard and should swim with capable supervision after DBS.
Classification of Evidence This study provides Class IV evidence that for patients with implanted DBS electrodes, the stimulation on condition, compared with stimulation off, did not significantly impair swimming performance. A formal assessment of unblinding would have been helpful.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Class of Evidence: NPub.org/coe
- Received July 9, 2020.
- Accepted March 5, 2021.
- © 2021 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
The Nerve!: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Related Articles
- No related articles found.