Effect of Aquatic Therapy Program on Balance in Children With Spastic Diplegic Cerebral Palsy

1. Evaluate the effect of a structured aquatic therapy programme on static balance in children with spastic diplegic cerebral palsy.
2. Assess the effect of the same programme on dynamic balance in this patient population.
3. Compare balance outcomes between children receiving aquatic therapy and those receiving conventional land-based physiotherapy.

Study Overview

• Status: Not yet recruiting
• Conditions: Cerebral Palsy (CP)
• Intervention / Treatment: Other: aquatic therapy; Other: land exercise program

Detailed Description

Cerebral palsy (CP) is the most common cause of permanent motor disability in childhood, with spastic diplegia being the most prevalent subtype, characterized by bilateral lower limb spasticity, impaired postural control, and significantly compromised balance - deficits that restrict functional mobility and participation in daily activities. These balance impairments arise from disrupted selective motor control, abnormal muscle tone, reduced proprioceptive integration, and impaired neuromuscular coordination, and represent a central therapeutic target in paediatric rehabilitation. Aquatic therapy exploits the physical properties of water - buoyancy, hydrostatic pressure, warmth, and viscosity - to reduce spasticity, facilitate movement, and promote motor learning in a safe environment, with meta-analytic evidence confirming significant improvements in gross motor function compared to land-based approaches. However, studies specifically targeting balance as a primary outcome in children with spastic diplegic CP remain limited, representing a clinically important gap that this study seeks to address.

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: ibrahim A abu ella, Phd; Phone Number: +201008442281; Email: ibrahimneuron@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Confirmed diagnosis of spastic diplegic cerebral palsy by a paediatric neurologist or developmental paediatrician
2. Age between 5 and 12 years
3. Classified at GMFCS levels I-III
4. Bilateral lower limb spasticity with a Modified Ashworth Scale (MAS) score of ≥ 1

Exclusion Criteria:

1. Athetoid, ataxic, or mixed-type cerebral palsy
2. GMFCS levels IV or V (non-ambulatory children)
3. Uncontrolled seizure disorder or epilepsy not managed by medication
4. Open wounds, skin infections, or active dermatological conditions contraindicating water immersion
5. Fear of water (aquaphobia) or inability to tolerate the aquatic environment

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: Study group; study group will receive aquatic exercise therapy	Other: aquatic therapy; Aquatic therapy is a specialized rehabilitation approach that utilizes the physical properties of water, including buoyancy, hydrostatic pressure, and resistance, to facilitate movement and improve functional performance in children with diplegic cerebral palsy. The aquatic environment reduces weight-bearing demands, allowing safer practice of balance, gait, strength, and motor control activities while minimizing joint stress. Regular aquatic therapy may enhance muscle strength, postural stability, mobility, and overall participation in daily activities.
Active Comparator: control group; land exercise program	Other: land exercise program; The control group participated in a conventional land-based exercise program consisting of stretching, strengthening, balance, and functional mobility exercises. The program focused on improving lower-extremity muscle strength, postural control, gait performance, and overall functional abilities through activities performed on a stable surface. Exercises were progressed according to each participant's abilities while maintaining consistency in treatment duration and frequency across the study groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
static balance	Static and dynamic balance will be assessed using the Biodex Balance System. Stability indices will be recorded to evaluate postural control and balance performance	baseline

Collaborators and Investigators

• Sponsor: Delta University for Science and Technology

Study record dates

Study Major Dates

• Study Start (Estimated): June 25, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 15, 2026

Study Registration Dates

• First Submitted: June 20, 2026
• First Submitted That Met QC Criteria: June 20, 2026
• First Posted (Actual): June 25, 2026

Study Record Updates

• Last Update Posted (Actual): June 25, 2026
• Last Update Submitted That Met QC Criteria: June 20, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Aquatic therapy; cerebral palsy; Diaplegia
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Cerebral Palsy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Hydrotherapy; Aquatic Therapy
• Other Study ID Numbers: trial CP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: confidentiality of the research

Drug and device information, study documents

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