The effects of Halliwick aquatic exercises on gross motor function of children aged from 3 to 5 years with spastic cerebral palsy

Abstract

Background and Study Aim. Cerebral palsy is a broad term for a variety of non-progressive, resulting in physical impairment, movement dysfunction, and poor posture. The purpose of the study was to compare the effectiveness in the Halliwick aquatic exercise versus conventional land-based therapy on gross motor function of children aged from 3 to 5 years with spastic cerebral palsy. Material and Methods. In this randomized controlled trial, (n=34) children diagnosed with spastic Cerebral palsy were randomly assigned into either the Halliwick concept group (n=17) or active control (conventional exercising group) (n=17). A physiotherapist performed the sessions with participants  three times a week, 45 minutes duration over 12 weeks. An independent pediatric rehabilitation specialist assessed the children’s gross motor function using the gross motor function measures (sitting, crawling and kneeling, standing, walking, running, and jumping). Results. After the intervention, both Halliwick concept group and conventional exercising group significantly improved activities of sitting, crawling & kneeling, standing and walking, running and jumping. Besides, the estimate of the effect of the Halliwick exercises on sitting, standing and walking, running & jumping activities was more clinically significant than conventional exercises, with sitting; MD = -0.06 [95%, CI; -0.19 to 0.32], standing; MD = 0.14 [95%, CI; -0.15-0.31], and walking, running & jumping activities; MD = -0.09 [95%, CI; -0.11 to 0.20]. None of the between-group differences for any remaining outcomes was significant. Conclusion. Aquatic exercises based on the Halliwick concept are better than conventional exercises to improve sitting, standing and walking, running and jumping activities in children aged 3 to 5 years with spastic cerebral palsy.