The Effects of Different Aquatic Interventions on Muscle Power, Balance, Endurance, and Functional Skills in Children with Spastic Cerebral Palsy

Abstract

Background: The evidence based practice in CP treatment had been expanded and provided the possibility of newer, safer, and more effective interventions. Many interventions had the potential to improve muscle power, balance, endurance, and functional independence and skills. Aquatic intervention was one of the suggested interventions for children with CP. The recent published studies on different aquatic interventions in children with CP were insufficient and the supportive evidences to determine which of these interventions is more effective were scarce. Results: All groups showed significant improvements in MMT, HGS, MTUG, 1MWT, GMFCS, and FIM after treatment when compared to the baseline measurements (p≤0.05). The MAS did not show any significant improvement in any of the treatment groups (p>0.05). When comparing between groups, improvement of MMT and HGS were respectively higher in the SW (p=0.001) and the AS (p=0.04) groups than in the AP group. Improvement of MTUG was higher in the SW group than in the AP group (p=0.05). Improvement of 1MWT was higher in the AS group than in the AP group (p=0.01). Both FIM transfer and FIM locomotion scores were improved more in the SW (p=0.003 and 0.002 respectively) and the AS (p=0.004 and 0.002 respectively) groups than in the AP group. Conclusions: All interventions were effective in improving strength, balance, endurance, and functional independence and skills of the children with spastic CP, but not effective in reducing muscle tone. The SW and the AS programs were more effective than the AP program in improving muscle strength. The SW program was more effective than the AP program in improving balance. Also, the AS program was more effective than the AP program in improving endurance. Both FIM transfer and FIM locomotion were improved more in the SW and the AS groups than in the AP group.