The effects of water-based exercise on postural control in children with spastic cerebral palsy

Abstract

Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

Muscle Activity and Co-Activation of Gait Cycle during Walking in Water and on Land in People with Spastic Cerebral Palsy

“…Moreover, a few internal and external factors impact on the results, such as body immersion in water may contribute to postural control [35], and walking speed is known to influence muscle activity and muscle co-activation [36]. This current study, the self-selected speed of individuals with CP on the ground is obviously faster than in water (Table 2); thus, this may lead to higher muscle co-activation on land during the loading response.…”

The effect of hydrotherapy on the functioning and quality of life of children and young adults with cerebral palsy

“…Properties of water, such as buoyancy, facilitate the exercise without pain, as in relation to the exercise programs on land, the friction of the joints and the risk of falls are reduced. The results showed a significant improvement in gross mobility and more specifically the quality and distance of gait and static standing position [6][7][8][9][10]14] . There was also an improvement in the cardiorespiratory system in endurance, balance, fluidity of movement and range of motion [9] .…”

“…According to the results of this study, a group hydrotherapy program is beneficial for adolescents with CP, as it improves the performance of participants in walking and leads to cardiorespiratory adjustments during exercise. The study of Kim and Shin [14] investigated the effect of hydrotherapy in children with spastic CP. Participants were 20 children with CP (aged 3-7 years), who attended a 40minute weekly hydrotherapy session for eight weeks.…”

Feasibility of Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Framework for Aquatic Activities: A Scoping Review

“…In two articles the researchers defined their intervention as "aquatic physical therapy" (APT) [8,27]. The use of well-known AT approaches was mainly based on the Halliwick approach (20 studies) in various ways, i.e., swimming, treatment, playing individually or in a group [9,10,14,40,41,[43][44][45][46]49,50,52,60,62,63,71,73,[75][76][77]79,83], with one study testing the effects of the Watsu technique along with conventional AT [96]. Twelve studies based their research on swimming or on the promotion of swimming abilities, including various swimming learning programs and the adapted swimming exercises, in groups or individuals [7,50,59,64,65,79,81,89,90,93,98,99].…”