The benefits of hydrotherapy to patients with spinal cord injuries

Abstract

BackgroundMany patients with spinal cord injury (PWSCI) lead sedentary lifestyles, experiencing poor quality of life and medical challenges. PWSCI don’t like to participate in land-based-exercises because it’s tedious to perform the same exercises, decreasing their rehabilitative compliance and negatively impacting their well-being. An alternative exercise environment and exercises may alleviate boredom, enhancing compliance.ObjectivesDiscuss the benefits of hydrotherapy to PWSCI concerning underwater gait-kinematics, thermoregulatory and cardiovascular responses and spasticity.MethodologyA literature surveillance was conducted between 1998 and 2017, through the Crossref meta-database and Google Scholar, according to the PRISMA procedures. Key search words were water-therapy, aquatic-therapy, hydrotherapy, spinal cord injury, rehabilitation, human, kinematics, underwater gait, cardiorespiratory, thermoregulation and spasticity. The quality of each paper was evaluated using a modified Downs and Black Appraisal Scale. The participants were records pertaining to PWSCI and hydrotherapy. The outcomes of interest were: hydrotherapy interventions, the impact of hydrotherapy on gait-kinematics, thermoregulation during water submersion and cardiorespiratory function of PWSCI. Omitted records included: non-English publications from before 1998 or unrelated to hydrotherapy and PWSCI. The record screening admissibility was performed as follows: the title screen, the abstract screen and the full text screen.ResultsLiterature search identified 1080 records. Upon application of the exclusion criteria, 92 titles, 29 abstracts and 17 full text records were eligible. Only 15 records were selected to be included in this clinical commentary. Evidence shows a paucity of randomised control trials (RCT) conducted in this field.ConclusionHydrotherapy improves PWSCI underwater gait-kinematics, cardiorespiratory and thermoregulatory responses and reduces spasticity.

Supporting front crawl swimming in paraplegics using electrical stimulation: a feasibility study

“…Finally, [18] reported a significant reduction of muscle spasticity with a reduced dosage of baclofen after hydrotherapy. Additionally, [11] found several other studies showing an increased range of motion for the lower extremities and reduced spasticity.…”

“…Besides paraplegic swimming, aquatic therapy (e.g aqua jogging, aquarobics or underwater treadmill training) is used for incomplete SCI rehabilitation. There are currently three systematic reviews of the benefits of aquatic therapy to patients with SCI published in [11][12][13]. All three reviews state that the current research quality is low due to the lack of randomized controlled trials in the specific field of clinical rehabilitation.…”

Stem Cell Conditioned Medium Treatment for Canine Spinal Cord Injury: Pilot Feasibility Study

“…Procedures involving active movement such as hydrotherapy (under-water treadmill), balance exercises, sitting-standing position training or turns, all included in our rehabilitation plan, may improve signal transmission in nerves, stimulate muscle memory and inhibit muscle atrophy or fibrosis [ 46 ]. Hydrotherapy helps to improve core stability, muscle strength, endurance and cardiorespiratory functions [ 56 ]. Rats showed significant improvement in balance, excitability and locomotion when they underwent locomotion exercises such as “cycling” and treadmill walking after induced SCI [ 57 ].…”

The health benefits of exercise therapy for patients with Down syndrome: A systematic review

“…The authors wish to acknowledge the study of Ellapen et al (2017) that reviewed the common upper limb injuries to wheelchair users and Ellapen et al (2018) that described the benefits of hydrotherapy to spinal cord injured patients. These studies serve as a catalyst for this article.…”