Effects Aquatic Exercises on Balance and Hand Function in Multiple Sclerosis

Effects Aquatic Exercises on Balance and Hand Function in Multiple Sclerosis: Halliwick Versus Aquatic Plyometric Exercises

This study aims to compare and contrast the effects of two different aquatic exercises on postural control and hand functions in people with multiple sclerosis.

Study Overview

• Status: Completed
• Conditions: Multiple Sclerosis, Relapsing-Remitting
• Intervention / Treatment: Other: Halliwick; Other: Aquatic Plyometric Exercises

Detailed Description

Impaired limits of stability causes falls in people with Multiple sclerosis (pwMS) whereas a well-controlled posture provides improved upper limb functions which are limited in almost 75% of pwMS due to weakness, spasticity or tremor. It is an already known fact that hand dexterity is an indicator of fall risk due to neuromuscular causes and/or abnormalities in the corpus callosum in pwMS.

Aquatic therapy (AT) provides a safe and effective environment for many therapeutic purposes. It is important to understand the effects of each type, intensity, and duration of the aquatic interventions to accomplish most suitable aquatic exercise program.

Halliwick method, neuromotor treatment approach which uses fluid and mechanical properties of water, is based on postural control by mobilizing and controlling body parts through the Ten Point Program.

During Aquatic Plyometric Exercises, proximal part of the body needs to be stabilized to generate a sudden and powerful contraction at the distal part and stabilization of the proximal joints is necessary for maintaining distal movements in a coordinated way.

It is important to understand the effects of each type, intensity, and duration of the aquatic interventions to accomplish most suitable aquatic exercise program. This study aims to compare and contrast the effects of two different aquatic exercises on postural control and hand function.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Izmir, Turkey, 35330
    • Dokuz Eylul University School of Physical Therapy and Rehabilitation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• EDSS>6
• volunteered

Exclusion Criteria:

• Clinical relapse within three months
• incontinence
• persistent infection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Halliwick; Exercises were performed in a private pool owned by the local MS society twice in a week for 8 weeks. Pool depth was 120 cm 30-31°C Mental adjustment, sagittal rotation, transverse rotation, and combined rotation controls, balances in stillness steps of the Halliwick concept were included.	Other: Halliwick; The exercise program was progressed by increasing the speed and the range of motion of the movements. Patients were asked not to accelerate the exercise and to focus on their alignment. Mental adjustment, sagittal rotation, transverse rotation, and combined rotation controls, balances in stillness steps of the Halliwick concept were included.
Experimental: Aquatic Plyometric Exercise; Exercises were performed in a private pool owned by the local MS society twice in a week for 8 weeks. Pool depth was 120 cm 30-31°C. The three phases of each exercise; eccentric (or loading) phase, the amortization phase, and the concentric (or unloading) phase included.	Other: Aquatic Plyometric Exercises; The APE programme was progressed by increasing speed and the range of motion of the movements. Patients were carefully informed not to deform the exercise just to emulate the speed. The three phases of each exercise; eccentric (or loading) phase, the amortization phase, and the concentric (or unloading) phase explained thoroughly at the beginning of every exercise.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in limits of stability	measured with Biodex Balance System (BBS; SD 12.1"Display 115 VAC). Patients were asked to stand on the rigid surface with barefoot and eyes open during measuring limits of stability. During each test trial, patients must shift their weight to move the cursor from the center target to a blinking target and back as quickly and with as little deviation as possible. The same process is repeated for each of the nine targets. Targets on the screen blink in random order. The tests repeated three times with 30 second resting time between trials. Patients' performance is evaluated from a total score of 100 where the higher score represents better trunk control.	Baseline and 8 weeks
Change in Nine hole peg Test	The patient is seated at a table with a plastic NHPT placed at the patient's middle and asked to place pegs in a random order as quick as possible by using dominant hand first total time was recorded in seconds. Three consecutive trials with the dominant hand are immediately followed by three consecutive trials with the non-dominant hand.	Baseline and 8 weeks

Collaborators and Investigators

• Sponsor: Dokuz Eylul University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2016
• Primary Completion (Actual): July 1, 2016
• Study Completion (Actual): September 1, 2016

Study Registration Dates

• First Submitted: September 18, 2018
• First Submitted That Met QC Criteria: September 19, 2018
• First Posted (Actual): September 20, 2018

Study Record Updates

• Last Update Posted (Actual): September 20, 2018
• Last Update Submitted That Met QC Criteria: September 19, 2018
• Last Verified: September 1, 2018

More Information

Terms related to this study

• Keywords: aquatic therapy; Limits of stability; Halliwick; aquatic plyometric exercises
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Immune System Diseases; Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Autoimmune Diseases; Multiple Sclerosis; Sclerosis; Multiple Sclerosis, Relapsing-Remitting
• Other Study ID Numbers: msdexerity

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No