Hydrotherapy for Children with Cerebral Palsy: Difference between revisions

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<p><b>Original Editor </b>- Your name will be added here if you created the original content for this page.
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== Description   ==
<h2> Description<br />  </h2>
 
<p>'Hydrotherapy' also known as 'Aquatic Therapy' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydorstatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change <span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Becker 2009">Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;amp;amp;amp;R; 2009,1;9:859-72</span>. The bouyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Morris DM">Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.</span>.&nbsp;<br />  
'Hydrotherapy' also known as '[https://www.physio-pedia.com/Aquatherapy Aquatic Therapy]' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydrostatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change<ref>Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;R; 2009,1;9:859-72</ref>. The buoyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training<ref>Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.</ref>.&nbsp;<br>  
</p>
 
<h2> Indication<br />  </h2>
== Benefits    ==
<p>Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is:&nbsp;  
 
</p>
Hydrotherapy is indicated in children with cererbal palsy. The main benefits of aquatic therapy are:&nbsp;  
<ul><li>Provides resistance  
 
</li><li>Encourages a wider range of movement and opposition  
*Water provides resistance in all planes and directions
</li><li>Alleviates stress and tension  
*Encourages a wider range of movement and opposition  
</li><li>Reduces pain and tension in muscles and joints  
*Alleviates stress and tension  
</li><li>Protects against injury  
*Reduces pain and tension in muscles and joints  
</li><li>Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
*Protects against injury  
</li><li>Decreases post exercise discomfort
*Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
</li></ul>
*Decreases post exercise discomfort
<h2> Safety Considerations and Outcome Measures  </h2>
 
<p>Absolute Contra-indications&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015</span>  
== Safety Considerations and Outcome Measures  ==
</p>
 
<ul><li>Acute vomiting / diarrhoea  
Absolute Contra-indications&nbsp;<ref>Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015</ref>  
</li><li>Medical instability  
 
</li><li>Chlorine / Bromine allergy  
*Acute vomiting / diarrhoea  
</li><li>Resting angina  
*Medical instability  
</li><li>Shortness of breath at rest  
*Chlorine / Bromine allergy  
</li><li>Uncontrolled cardiac failure  
*Resting angina  
</li><li>High BMI limiting exit from pool
*Shortness of breath at rest  
</li></ul>
*Uncontrolled cardiac failure  
<p><br />  
*High BMI limiting exit from pool
</p><p>Relative Contra-indications  
 
</p>
<br>  
<ul><li>Acute illness  
 
</li><li>Irradiated skin  
Relative Contra-indications  
</li><li>Known aneurysm  
 
</li><li>Open infected wounds  
*Acute illness  
</li><li>Poorly controlled epilepsy  
*Irradiated skin  
</li><li>Unstable diabetes  
*Known aneurysm  
</li><li>Exercise dependent O2 demand increases
*Open infected wounds  
</li></ul>
*Poorly controlled epilepsy  
<p><br />  
*Unstable diabetes  
</p><p>Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.</span>.  
*Exercise dependent O2 demand increases
</p><p><br />  
 
</p><p>Common motor function meaures utilised in Aquatic Therapy research:&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.</span>  
<br>  
</p>
 
<ul><li>Gross Motor Function Measure (GMFM)&nbsp;  
Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)&nbsp;<ref>World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.</ref>.  
</li><li>Paediatric Evaluation of Disability Inventory - functional skills  
 
</li><li>Dynamometer - muscle strength  
<br>  
</li><li>Energy Expenditure Index (EEI) - energy efficiency  
 
</li><li>3/5/6 minute walk tests  
Common motor function meaures utilised in Aquatic Therapy research:&nbsp;<ref>Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.</ref>  
</li><li>Timed up and Go (TUG)  
 
</li><li>Vital Capacity  
*Gross Motor Function Measure (GMFM)&nbsp;  
</li><li>Goniometry - range of movement  
*Paediatric Evaluation of Disability Inventory - functional skills  
</li><li>Ashworth Scale - spasticity
*Dynamometer - muscle strength  
</li></ul>
*Energy Expenditure Index (EEI) - energy efficiency  
<p><br />  
*3/5/6 minute walk tests  
</p><p>Swimming based measures:  
*Timed up and Go (TUG)  
</p>
*Vital Capacity  
<ul><li>Aquatics Independence Measure  
*Goniometry - range of movement  
</li><li>Water Orientation Test-Alyn 2 (WOTA)
*Ashworth Scale - spasticity
</li></ul>
 
<p><br />  
<br>  
</p><p>Social function measures:  
 
</p>
Swimming based measures:  
<ul><li>PEDI - social function domain  
 
</li><li>Pictoral scale of perceived competence  
*Aquatics Independence Measure  
</li><li>Canadian Occupational Performance Measure
*Water Orientation Test-Alyn 2 (WOTA)
</li></ul>
 
<h2> Key Evidence  </h2>
<br>  
<p>Administered correctly, aquatic therapy can:  
 
</p>
Social function measures:  
<ul><li>Improve muscle tone  
 
</li><li>Increase core strength  
*PEDI - social function domain  
</li><li>Enhance circulation  
*Pictoral scale of perceived competence  
</li><li>Improve cardiovascular functioning  
*Canadian Occupational Performance Measure
</li><li>Improve flexibility  
 
</li><li>Increase endurance  
== Key Evidence  ==
</li><li>Extend range of motion  
 
</li><li>Reduce muscle spasticity  
Administered correctly, aquatic therapy can:  
</li><li>Elevate metabolism  
 
</li><li>Reduce sleep disturbances  
*Improve muscle tone  
</li><li>Relieve joint stress  
*Increase core strength  
</li><li>Improve muscle tone  
*Enhance circulation  
</li><li>Increase stability  
*Improve cardiovascular functioning  
</li><li>Decrease pain and discomfort
*Improve flexibility  
</li></ul>
*Increase endurance  
<h2> Resources  </h2>
*Extend range of motion  
<p><br /><span class="fck_mw_template">{{#ev:youtube|lvIufSb9dYk}}</span>
*Reduce muscle spasticity  
</p>
*Elevate metabolism  
<h2> Case Studies  </h2>
*Reduce sleep disturbances  
<p>add links to case studies here (case studies should be added on new pages using the <a href="Template:Case Study">case study template</a>)<br />
*Relieve joint stress  
</p>
*Improve muscle tone  
<h2> Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)  </h2>
*Increase stability  
<div class="researchbox">
*Decrease pain and discomfort
<p><br />
 
</p>
== Resources  ==
</div>
 
<h2> References  </h2>
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<p><span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /><br />  
 
</p><p>&nbsp;<br />
== References  ==
</p>
 
<references /><br>  
 
&nbsp;<br>
[[Category:Cerebral Palsy]]
[[Category:Paediatrics]]
[[Category:Paediatrics - Interventions]]

Latest revision as of 16:36, 26 September 2023

Original Editors - Eoin McNamee

Top Contributors - Eoin McNamee, Sweta Christian, Candace Goh, 127.0.0.1, Naomi O'Reilly, WikiSysop, Kim Jackson, Amanda Ager, Chelsea Mclene and Ines Musabyemariya

Description[edit | edit source]

'Hydrotherapy' also known as 'Aquatic Therapy' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydrostatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change[1]. The buoyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training[2]. 

Benefits[edit | edit source]

Hydrotherapy is indicated in children with cererbal palsy. The main benefits of aquatic therapy are: 

  • Water provides resistance in all planes and directions
  • Encourages a wider range of movement and opposition
  • Alleviates stress and tension
  • Reduces pain and tension in muscles and joints
  • Protects against injury
  • Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water
  • Decreases post exercise discomfort

Safety Considerations and Outcome Measures[edit | edit source]

Absolute Contra-indications [3]

  • Acute vomiting / diarrhoea
  • Medical instability
  • Chlorine / Bromine allergy
  • Resting angina
  • Shortness of breath at rest
  • Uncontrolled cardiac failure
  • High BMI limiting exit from pool


Relative Contra-indications

  • Acute illness
  • Irradiated skin
  • Known aneurysm
  • Open infected wounds
  • Poorly controlled epilepsy
  • Unstable diabetes
  • Exercise dependent O2 demand increases


Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) [4].


Common motor function meaures utilised in Aquatic Therapy research: [5]

  • Gross Motor Function Measure (GMFM) 
  • Paediatric Evaluation of Disability Inventory - functional skills
  • Dynamometer - muscle strength
  • Energy Expenditure Index (EEI) - energy efficiency
  • 3/5/6 minute walk tests
  • Timed up and Go (TUG)
  • Vital Capacity
  • Goniometry - range of movement
  • Ashworth Scale - spasticity


Swimming based measures:

  • Aquatics Independence Measure
  • Water Orientation Test-Alyn 2 (WOTA)


Social function measures:

  • PEDI - social function domain
  • Pictoral scale of perceived competence
  • Canadian Occupational Performance Measure

Key Evidence[edit | edit source]

Administered correctly, aquatic therapy can:

  • Improve muscle tone
  • Increase core strength
  • Enhance circulation
  • Improve cardiovascular functioning
  • Improve flexibility
  • Increase endurance
  • Extend range of motion
  • Reduce muscle spasticity
  • Elevate metabolism
  • Reduce sleep disturbances
  • Relieve joint stress
  • Improve muscle tone
  • Increase stability
  • Decrease pain and discomfort

Resources[edit | edit source]


<img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="0" _fck_mw_template="true">

References[edit | edit source]

  1. ↑ Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&R; 2009,1;9:859-72
  2. ↑ Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.
  3. ↑ Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015
  4. ↑ World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.
  5. ↑ Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.


 

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