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

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), 5.43^o improvement, while for control group was 16.46 (±9.205), 3.69^o 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.