Aquatic Therapy for Gross Motor Function in Patients with Cerebral Palsy: A Systematic Review
Keywords:Cerebral palsy, Aquatic therapy, Gross motor function
Cerebral palsy results from damage to the brain. Aquatic therapy is a therapeutic exercise performed in water. The purpose of this review was to examine the effectiveness of aquatic therapy on gross motor function in patients with cerebral palsy A literature search of eight online electronic databases was conducted to find relevant studies published in English between January 2005 and January 2022 using a search strategy. The collected research articles were assessed for quality of the evidence by 3 authors. The risk of bias was assessed, and the data were independently extracted using consensus in evaluating and selecting studies. If there is any disagreement, a joint consideration is concluded. The results showed that analysis and synthesis include the studies consisting of three randomised controlled trials, two case series, two case studies, one non-randomized controlled trial, and one quasi-experimental study that met the inclusion criteria. The total number of participants was 94. Most of them suffered from spastic cerebral palsy with Gross Motor Function Classification System level III (children walk using a hand-held mobility device in most indoor settings). Aquatic therapy was shown to be beneficial for patients with cerebral palsy. Further studies should involve CP across the GMFCS and type.
Bax M, Goldstein M, Rosenbaum P, Leviton A. Proposed definition. Dev Med Child Neurol 2005; 08: 571-576.
Palisano RJ, Chiarello LA, Orlin M, Oeffinger D, Polansky M, Maggs J, Bagley A, Gorton G. Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy. Dev Med Child Neurol 2011; 53(2): 142-149.
Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8-14.
Hirsh AT, Gallegos JC, Gertz KJ, Engel JM, Jensen MP. Symptom burden in individuals with cerebral palsy. J Rehabil Res Dev 2010; 47(9): 863.
Novak I, Mcintyre S, Morgan C, Campbell L, Dark L, Morton N, Stumbles E, Wilson SA, Goldsmith S. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol 2013; 55(10): 885-910.
Toussaint HM, Hollander AP, van den Berg C, Vorontsov AR. Biomechanics of swimming. In: Garrett WE, Kirkendall DT, editor. Exercise and sport science. Philadelphia: Lippincott, Williams and Wilkins; 2000.
Dumas H, Francesconi S. Aquatic therapy in pediatrics: annotated bibliography. Phys Occup Ther Pediatr 2011; 20(4): 63-78.
Mortimer R, Privopoulos M, Kumar S. The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: a systematic review. J Multidiscip Healthc 2014; 7: 93-104.
Fragala‐Pinkham M, Haley SM, O’Neil ME. Group aquatic aerobic exercise for children with disabilities. Dev Med Child Neurol 2008; 50(11): 822-827.
McManus BM, Kotelchuck M. The effect of aquatic therapy on functional mobility of infants and toddlers in early intervention. Pediatr Phys Ther 2007; 19(4): 275-282.
Kelly M, Darrah J. Aquatic exercise for children with cerebral palsy. Dev Med Child Neurol 2005; 47(12): 838-842.
Getz M, Hutzler Y, Vermeer A. Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature. Clin Rehabil 2006; 20(11): 927-936.
Blohm, D. Effectiveness of aquatic interventions for children with cerebral palsy: systematic review of the current literature. In Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews. York: Centre for Reviews and Dissemination (UK); 2011.
Gorter JW, Currie SJ. Aquatic exercise programs for children and adolescents with cerebral palsy: What do we know and where do we go?. Int J Pediatr 2011: 1-7.
Jorgić, B, Dimitrijević L, Aleksandrović M, Okičić T, Madić D, Radovanović D. The swimming program effects on the gross motor function, mental adjustment to the aquatic environment, and swimming skills in children with cerebral palsy: A pilot study. Specijalna edukacija i rehabilitacija 2012; 11(1): 51-66.
Roostaei M, Baharlouei H, Azadi H, Fragala-Pinkham MA. Effects of aquatic intervention on gross motor skills in children with cerebral palsy: a systematic review. Phys Occup Ther Pediatr 2017; 37(5): 496-515.
Akers J, Aguiar-Ibáñez R, Baba-Akbari A. Systematic reviews: CRD’s guidance for undertaking reviews in health care. York, UK: Centre for Reviews and Dissemination, University of York; 2009.
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377-384.
Critical Appraisal Skills Programme. Case Control Study Checklist. [Internet]. 2013 [cited in 1 April, 2022]. Available from: http://www.casp-uk.net/.
Chrysagis N, Douka A, Nikopoulos M, Apostolopoulou F, Koutsouki D. Effects of an aquatic program on gross motor function of children with spastic cerebral palsy. Biol Exerc 2009; 5(2): 13-25.
Retarekar R, Fragala-Pinkham MA, Townsend EL. Effects of aquatic aerobic exercise for a child with cerebral palsy: single-subject design. Pediatr Phys Ther 2009; 21(4): 336-344.
Ballaz L, Plamondon S, Lemay M. Group aquatic training improves gait efficiency in adolescents with cerebral palsy. Disabil Rehabil 2011; 33(17-18): 1616-1624.
Dimitrijević L, Aleksandrović M, Madić D, Okičić T, Radovanović D, Daly D. The effect of aquatic intervention on the gross motor function and aquatic skills in children with cerebral palsy. J Hum Kinet 2012; 32: 167-174.
Getz M, Hutzler Y, Vermeer A, Yarom Y, Unnithan V. The effect of aquatic and land-based training on the metabolic cost of walking and motor performance in children with cerebral palsy: A pilot study. Int Sch Res Notices 2012; 1-8.
Jorgic B, Dimitrijevic L, Aleksandrovic M, Okicic T, Madic D, Radovanovic D. The swimming program effects on the gross motor function, mental adjustment to the aquatic environment, and swimming skills in children with cerebral palsy: A pilot study. Spec Edukac Rehabil 2012; 11(1): 51-66.
Declerck M, Feys H, Daly D. Benefits of swimming for children with cerebral palsy: a pilot study. Serbian J Sports Sci 2013; 7(2): 57-69.
Fragala-Pinkham MA, Smith HJ, Lombard KA, Barlow C, O’Neil ME. Aquatic aerobic exercise for children with cerebral palsy: a pilot intervention study. Physiother Theory Pract 2014; 30(2): 69-78.
Lai CJ, Liu WY, Yang TF, Chen CL, Wu CY, Chan RC. Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. J Child Neurol 2015; 30(2): 200-208.
Wang HY, Yang YH. Evaluating the responsiveness of 2 versions of the gross motor function measure for children with cerebral palsy. Arch Phys Med Rehabil 2006; 87(1): 51-56.
Grosse SJ. Water freedom for all: the Halliwick method. Int. J. Aquat. Res. Educ 2010; 4(2): 198-207.
Sakzewski L, Carlon S, Shields N, Ziviani J, Ware RS, Boyd RN. Impact of intensive upper limb rehabilitation on quality of life: a randomized trial in children with unilateral cerebral palsy. Dev Med Child Neurol 2012; 54(5): 415-423.
Brunton LK, Rice CL. Fatigue in cerebral palsy: a critical review. Dev Neurorehabil 2012; 15(1): 54-62.
Ennis, E. The effects of a physical therapy-directed aquatic program on children with autism spectrum disorders. J Aquatic Phys Ther 2011; 19(1): 4-10.
Anttila H, Autti-Rämö I, Suoranta J, Mäkelä M, Malmivaara A. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr 2008; 8(1): 1-10.
Martin S. Teaching motor skills to children with cerebral palsy and similar movement disorders: A guide for parents and professionals. 1st ed. Maryland: Woodbine hourse; 2006.
Tripp F. Krakow K. Effects of an aquatic therapy approach (Halliwick-Therapy) on functional mobility in subacute stroke patients: a randomized controlled trial. Clin Rehabil 2014; 28(5): 432-439.
How to Cite
Copyright (c) 2022 Health Science Journal of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.