THE EFFECTIVENESS OF A SPECIALIZED HYDROTHERAPY-HALLIWICK PROGRAM IN THE TRANSITION FROM SUPINE-SITTING OF CHILDREN WITH CP. A RANDOMIZED CONTROL STUDY

K. Chandolias¹, C. Moscholouri¹, P. Iakovidis², A. Hristara- Papadopoulou², I. Kallistratos²

¹University of Thessaly, Physiotherapy, Lamia, Greece, ²International Hellenic University, Physiotherapy, Thessaloniki, Greece

Background: Halliwick hydrotherapy is a concept that was created by James McMillan, and its focus is to encourage everyone, especially those with physical difficulties, to participate in water activities and move independently in the water. Many studies found a considerable improvement in children that were placed halliwick based hydrotherapy program and also found a correlation between this intervention approach and positive outcomes. Hence, studying its effect versus land interventio, provide sufficient information concerning the treatment children with CP.

Purpose: The aim of this study was to investigate the effect of Halliwick hydrotherapy in combination with land-based therapy, versus only Bobath neurodevelopmental treatment intervention, on transition from supine to sitting and head symmetry in sitting in children with cerebral palsy.

Methods: 54 children with cerebral palsy of different levels of GMFCS participated in the study, in two groups, intervention group - water intervention (N= 28) (1 water and 1 on land treatment) and control group – on land intervention (N=26) (2 treatments on land). The duration of the intervention was 3 months, with a specialized program both in water and on land. All children were assessed via GMFM gross motor function assessment test, parameter B, questions 18-37 and the sitting head angle via the Kinovea software.

Results: Significant improvement was observed in the final assessments after the end of the three-month intervention in both groups. In gross mobility, in parameter B, sitting position, before the intervention the mean value of the intervention group is 69.632 (± 13.1269) while for the control group the mean value is 61.227 (± 20.4681). After the intervention, the mean value of the intervention group is 75.757 (± 12.3766) while for the control group the mean value is 65.308 (± 20.6663). Improvement of parameter B for the water intervention group 6.125% and for the land intervention group 4.081%. In the sitting head angle before the intervention the mean value of the intervention group is 19.36 (± 9.639) while for the control group the mean value is 20.15 (± 11.199). After the intervention, the mean value of the intervention group is 13.93 (± 7.333) while for the control group the mean value is 16.46 (± 9.205). Improvement in sitting head angle for the water intervention group 5.43° and for the land intervention group 3.69°.

Conclusions: It is therefore observed that 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. Investigation in a larger group of children, focused on specific activities, is considered important.

Implications: The addition of adjunctive therapies to the classical rehabilitation of children with cerebral palsy can increase the therapeutic results.

Funding acknowledgements: none

Keywords:
hydrotherapy
cerebral palsy
Halliwick

Topics:
Paediatrics: cerebral palsy
Disability & rehabilitation
Paediatrics: cerebral palsy

Did this work require ethics approval? Yes

Institution: International Hellenic University

Committee: Research Ethics Committee (EHDE)

Ethics number: EC-05/2022