Influence of Aquatic Therapy in Children and Youth with Cerebral Palsy: A Qualitative Case Study in a Special Education School

The glamor of and insights regarding hydrotherapy, from simple immersion to advanced computer-assisted exercises: A narrative review

Water-based therapy has been gaining attention in recent years and is being widely used in clinical settings. Hydrotherapy is the most important area of water-based therapy, and it has distinct advantages and characteristics compared to conventional land-based exercises. Several new techniques and pieces of equipment are currently emerging with advances in computer technologies. However, comprehensive reviews of hydrotherapy are insufficient. Hence, this study reviewed the status quo, mechanisms, adverse events and contraindications, and future prospects of the use of hydrotherapy. This study aims to comprehensively review the latest information regarding the application of hydrotherapy to musculoskeletal diseases, neurological diseases, and COVID-19. We have attempted to provide a "take-home message" regarding the clinical applications and mechanisms of hydrotherapy based on the latest evidence available.

Aquatic therapy for spastic cerebral palsy: a scoping review

BACKGROUND

Cerebral palsy (CP) is a group of dysfunction syndrome. Spastic CP is the most common form of CP. As a specific treatment, aquatic therapy (AT) can improve spasticity, increase range of motion, and increase muscle strength due to its particular properties.

OBJECTIVES

This article aims to review the research status of AT in patients with spastic CP.

METHODS

We conducted a wide-ranging review of all existing literature on using AT to intervene with spastic CP from 10 databases from the earliest to May 2024. It follows the methodological framework for conducting a scoping review proposed by the Joanna Briggs Institute. The physical, physiological, and social-psychological functions were summarized and analyzed.

RESULTS

18 articles were included and analyzed. The gross motor ability of patients with spastic CP improved significantly after AT, and walking efficiency was improved; muscle strength showed significant improvement, enhancing the ability to perform daily activities and quality of life. Aerobic forms of exercise are a commonly used treatment for AT, and five weekly interventions are the most effective. Notably, functional improvements were correlated with child age, CP type, and gross motor function classification system grade.

CONCLUSIONS

AT can improve the gross motor function, cardiopulmonary function, daily living, and social communication ability of patients with spastic CP. This scoping review can be used as a starting point for future research on AT for children with spastic CP to design the most efficient exercise regimen.

Aquatic Therapy in Children and Adolescents with Disabilities: A Scoping Review

Globally, around 1 in 10 children aged 0-17 years have moderate-to-severe disabilities. The aquatic environment provides hydrostatic and hydrodynamic characteristics that make exercise and therapy feasible for children and adolescents with disabilities. The objective of this scoping review is to understand the extent and type of evidence in relation to the use of aquatic therapy in children and adolescents with disabilities. The eligibility criteria were as follows: participants-children and/or adolescents with disabilities aged from 6 to 18 years old; concept-aquatic therapy interventions; context-any available setting. The databases searched included MEDLINE, CINAHL, EMBASE, PsycINFO, AMED, Eric, Scopus, Web of Science, Epistemonikos, and one register, Cochrane Central Register of Controlled Trials. In total, 52 reports met the inclusion criteria. Most of the studies included children/adolescents with autism spectrum disorder (ASD; 46.7%)-442 participants in 21 studies in total. The majority of interventions were based on aquatic exercise (35%). Most often, interventions were conducted for 8 weeks, with 2 sessions a week lasting 60 min. The most common type of intervention for children and adolescents with ASD and Down syndrome was swimming. Participants with attention deficit hyperactivity disorder, neuromuscular disorders, and cerebral palsy were more often treated with aquatic exercises. This scoping review could guide practitioners, clinicians, and researchers on what type, setting, and content of aquatic therapy interventions, including exercise types, intervention duration, number of sessions, frequency, facility, and provider, are used with children and adolescents with disabilities.

Design and validation of AQUA CHILD-Pre-aquatic questionnaire assessing child development

PURPOSE

We developed a proxy questionnaire for parents of children with Developmental Delay (DD) to provide comprehensive information for instructors about the child's functioning before participating in aquatic activities. This dedicated information will enable a high-quality treatment plan to promote the child's functioning in everyday life.

METHODS

Based on the International Classification of Functioning, Disability, and Health (ICF) Coreset development and linking rules method, a set of questions was constructed in a preliminary process. A draft version was sent to instructors and parents in Israel. Seventy-five questionnaires from instructors and 25 from parents returned to the statistical analysis procedure. Reliability and face validity were analyzed by experts.

RESULTS AND CONCLUSIONS

The questionnaire showed high validity and reliability for its purposes and allowed self-completion by the parents.

Acupuncture and Acupoints for Managing Pediatric Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Acupuncture is frequently used to manage pediatric cerebral palsy (CP), yet updated evidence is needed to guide future research and clinical practice.

METHODS

Seven databases were searched from 1994 to 26 June 2023. Randomized controlled trials (RCTs) involving body, scalp, or ear acupuncture for managing CP, excluding acupoint injection, catgut embedding, electro-acupuncture, or laser acupuncture, were included.

RESULTS

Twenty RCTs with 1797 participants were analyzed. Acupuncture groups had better improvements in gross motor function measure (GMFM) scores by 5% (mean difference: 5.93, 95% CI: 3.67-8.19, p < 0.001, I2 = 57%); a 16% higher probability to yield prominent improvement in effectiveness rate (ER) (risk ratio: 1.16, 95% CI: 1.08-1.25, p < 0.001, I2 = 0%); and better outcomes in the Modified Ashworth Scale (MAS) (standardized mean difference [SMD]: 0.3, 95%, CI: 0.11-0.49, p < 0.001, I2 = 0%), the Berg Balance Scale (BBS) (SMD: 2.48; 95% CI: 2.00-2.97, p < 0.001, I2 = 72%) and ADL (SMD: 1.66; 95% CI: 1.23-2.08, p < 0.001, I2 = 91%). Studies with eight core acupoints identified from all ninety-five acupoints had better ER.

CONCLUSIONS

Acupuncture, especially using core acupoints, may be effective for managing symptoms in children with CP.

Supporting Infants' Motor Development through Water Activities: A Preliminary Case-Control Study

The first twelve months of an infant's life are the most dynamic time in the development of motor activities. Water activities can positively stimulate the motor skills, visual perception, and cognitive abilities of infants. The purpose of this study was to evaluate the motor development of infants aged 3-12 months participating in water activities. Participants in the study included 43 infants aged 3-12 months who attended water activities classes at Warsaw City swimming pools (n = 21) and infants not attending any classes (n = 22). Two methods of assessing motor development were used in the study: the Alberta Infant Motor Scale (AIMS) and the Early Motor Development Questionnaire (EMQ). The raw scores of the AIMS test and the EMQ questionnaire were statistically significantly different (p < 0.05) in both groups between the first and second examinations. In contrast, there was a statistically significant improvement in motor development measured by AIMS and expressed in percentiles (p = 0.002) and in percentiles for Polish children (p = 0.030) in the water group. The age-independent total score of the EMQ before and after the intervention did not change significantly (p = 0.149). The water environment has the potential to support the motor development of infants aged 3-12 months.

Comprehensive rehabilitation of patients with movement disorders with spastic forms of cerebral palsy

Until now, there is no radical method of treating children with cerebral palsy, which allows us to consider scientific research in this direction reasonable and promising.The aim of the research: to study the effect of exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback on the indicators of motor skills in children with spastic cerebral palsy.Materials and methods. We conducted an open, non-randomized, prospective, comparative, controlled study in pairs (each participant in the main group corresponds to a participant in the control group). The study involved 53 patients aged 4–12 years with cerebral palsy: the intervention group (group 1: n = 27 (13 boys, 14 girls)) and the control group (group 2: n = 26 (11 boys, 15 girls)), comparable in terms of gender, age and severity of movement disorders. Characteristics of the medical intervention: group 1 – botulinum toxin type A (BTA, for exercising against the background of relative muscular normotonus) + exercise therapy + exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback (BFB); group 2 – BTA + exercise therapy. Duration of the study: 2019–2020. The difference between groups in terms of motor skills on the day of hospitalization and after completion of the training program (10 sessions each) was determined. Motor skills were assessed according to the GMFM-66/88 (Gross Motor Function Measure) table using the “Scales for measuring global motor functions”.Results. The inclusion of additional exercises on the mini-simulator “Kinesioplatformswing” with biofeedback in the rehabilitation of patients with movement disorders with spastic cerebral palsy (BTA + exercise therapy) in comparison with the control group. However, the question of the long-term effects of such training remains open and requires further study.