The effectiveness of a specialized hydrotherapy program based on Halliwick concept in the transition from supine to sitting of children with cerebral palsy: a randomised control trial
Keywords:Hydrotherapy, Pediatric physical therapy, Cerebral palsy, Bobath, Halliwick, Sitting position, Symmetry
Background: Halliwick concept focus on people with disabilities, to participate in water activities and move independently. Many studies found a considerable improvement and positive outcomes in children that were included in hydrotherapy programs. The aim of this study was to investigate the Halliwick hydrotherapy in combination with on-land intervention, versus only on-land treatment, on the supine-sitting transition and head symmetry.
Methods: 54 children with cerebral palsy (CP), two groups, the intervention group-water (N=28) (1 water and 1 on land treatment) and the control group-on land (N=26) (2 treatments on land). The duration was 3 months and the assessment via gross motor function measure (GMFM), parameter B, questions 18-37, and head angle via the Kinovea software.
Results: In GMFM before intervention the mean value of the intervention group was 69.632 (±13.1269), while for the control group was 61.227 (±20.4681) and after for intervention group was 75.757 (±12.3766), 6.125% improvement, while for control group was 65.308 (±20.6663), 4.081% improvement. In the sitting head angle before intervention, the mean value of intervention group was 19.36 (±9.639) while for the control group was 20.15 (± 11.199) and after for the intervention group was 13.93 (±7.333), 5.43o improvement, while for control group was 16.46 (±9.205), 3.69o improvement.
Conclusions: The addition of intervention in water in combination with intervention on land in the rehabilitation program of children with cerebral palsy can lead to a statistically significant increase in the effectiveness of the therapeutic program.
Akinola BI, Gbiri CA, Odebiyi DO. Effect of a 10-week aquatic exercise training program on gross motor function in children with spastic cerebral palsy. Glob Pediatr Health. 2019;6:2333794.
Ballington SJ, Naidoo R. The carry-over effect of an aquatic-based intervention in children with cerebral palsy. Afr J Disab. 2018;7:361.
Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005;47:571-6.
Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. Phys Med Rehabil. 2009;1:859-72.
Casey J, Rosenblad A, Rodby-Bousquet E. Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study. Disab Rehab. 2022;44(11):2363-71.
Chandolias K, Konstantinidou E, Bikis E, Hourlia A, Besios T, Tsigaras G. The Effectiveness of 6 Months Hydrotherapy Program Based on Halliwick Concept on the Respiratory System of Down Syndrome Children. J Biosci Med. 2021;9:20-6.
Christodoulaki E, Chandolias K, Hristara-Papadopoulou A. The effect of hydrotherapy–Halliwick concept on the respiratory system of children with cerebral palsy. BAOJ Pediat. 2018;4(3):063.
Chen XL, Yu LP, Zhu Y, Wang TY, Han J, Chen XY, Zhang JH, Huang JL, Qian XL, Wang B. Combined effect of hydrotherapy and transcranial direct-current stimulation on children with cerebral palsy: A protocol for a randomized controlled trial. Medicine (Baltimore). 2021;100(49):e27962.
Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014;383:1240-9.
Cui Y, Xiao D, Ding L, Qiu F, Cong F, Qiu Z. Effects of aquatic therapeutic exercise on motor function and activities for children and youth with cerebral palsy: a systematic review and meta-analysis. Chin J Rehabil Theory Pract. 2021;27:79-92.
Getz M, Hutzler Y, Vermeer A. Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature. Clin Rehabil. 2006;20:927-36.
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;712165.
Hutzler Y, Chacham A, Bergman U, Szeinberg A. Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy. Dev Med Child Neurol. 1998;40:176-81.
Kelly M, Darrah J. Aquatic exercise for children with cerebral palsy. Dev Med Child Neurol. 2005;47:838-42.
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;30:200-8.
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):200-8.
Alotaibi M, Long T, Kennedy E, Bavishi S. The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a literature review. Disabil Rehabil. 2014;36(8):617-27.
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.
Rodby-Bousquet E, Czuba T, Hägglund G, Westbom L. Postural asymmetries in young adults with cerebral palsy. Dev Med Child Neurol. 2013;55(11):1009-15.
Rogers A, Furler BL, Brinks S, Darrah J. A systematic review of the effectiveness of aerobic exercise interventions for children with cerebral palsy: an AACPDM evidence report. Dev Med Child Neurol. 2008;50:808-14.
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.
Thorpe DE, Reilly M, Case L. The effects of an aquatic resistive exercise program on ambulatory children with cerebral palsy. J Aqua Phys Ther. 2005;13:21-34.
Wimalasundera N, Stevenson VL. Cerebral palsy. Pract Neurol. 2016;16:184-94.