Effect of a 10-Week Aquatic Exercise Training Program on Gross Motor Function in Children With Spastic Cerebral Palsy

Bolarinwa Isaac Akinola, Caleb Ademola Gbiri, Daniel Oluwafemi Odebiyi, Bolarinwa Isaac Akinola, Caleb Ademola Gbiri, Daniel Oluwafemi Odebiyi

Abstract

Introduction. Cerebral palsy (CP) is caused by an injury to the developing brain, and abnormal gross motor function is a hallmark of CP. Properly structured exercises on land have been reported to be effective in improving functional performance in children with CP while only few have been documented on aquatic therapy. Objective. To investigate the effect of a 10-week aquatic exercise training program on gross motor function in children with spastic CP. Methods. Thirty participants aged 1 to 12 years were randomized into the experimental and control groups. Both groups received manual passive stretching and functional training exercises, depending on their level of motor impairment, either in water (temperature 28°C to 32°C) or on land. Each exercise training session lasted for about 1 hour 40 minutes, twice per week for 10 weeks in both groups. Measurement of gross motor function was done using Gross Motor Function Measure (GMFM-88) at baseline and after 4 weeks, 8 weeks, and 10 weeks of intervention. Both groups were compared for differences in change in gross motor function using Mann-Whitney U test. The level of significance was set at P < .05. Results. Only the experimental group showed significant improvement (P < .05) in all dimensions of gross motor function except for walking, running, and jumping (P = .112). Statistically significant difference (P < .05) was found between both groups for all dimensions of gross motor function after 10 weeks of intervention. Conclusion. Aquatic exercise training program is effective in the functional rehabilitation of children with spastic CP.

Keywords: aquatic exercise; cerebral palsy; gross motor function; spastic.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comparison of mean rank change pattern in overall gross motor function between both groups across the duration of intervention.

References

    1. Aisen ML, Kerkovich D, Mast J, et al. Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol. 2011;10:844-852.
    1. Chahine NHA, Wehbe TW, Hilal RA, Zoghbi VV, Melki AE, Habib EB. Treatment of cerebral palsy with stem cells: a report of 17 cases. Int J Stem Cells. 2016;9:90-95.
    1. Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: new perspectives from a Canadian registry. Semin Pediatr Neurol. 2013;20:60-64.
    1. El-Tallawy HN, Farghaly WM, Shehata GA, Metwally NA, Rageh TA, Abo-Elfetoh N. Epidemiology of cerebral palsy in El-Kharga District-New Valley (Egypt). Brain Dev. 2011;33:406-411.
    1. Lagunju IA, Okafor OO. An analysis of disorders seen at the Paediatric Neurology Clinic, University College Hospital, Ibadan, Nigeria. West Afr J Med. 2009;28:38-42.
    1. Adekoje TO, Ibeabuchi MN, Lesi FE. Anthropometry of children with cerebral palsy at the Lagos University Teaching Hospital. J Clin Sci. 2016;13:96-104.
    1. Dimitrijević L, Aleksandrović M, Madić D, Okiĉić T, Radovanović D, Daly D. The effect of aquatic intervention on the gross motor function and aquatic skills in children with cerebral palsy. J Hum Kinet. 2012;32:167-174.
    1. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol. 2007;109:8-14.
    1. Koop SE. Musculoskeletal growth and development. In: Gage JR, Schwarts MH, Koop SE, Novacheck TF. eds. The Identification and Treatment of Gait Problems in Cerebral Palsy. 2nd ed. London, England: MacKeith Press; 2009.
    1. Levitt S. The clinical picture for therapy and management. In: Treatment of Cerebral Palsy and Motor Delay. 4th ed. Hoboken, NJ: Blackwell; 2004:1-13.
    1. Mesterman R, Leitner Y, Yifat R, et al. Cerebral palsy—long-term medical, functional, educational, and psychosocial outcomes. J Child Neurol. 2010;25:36-42.
    1. Kerr C, McDowell BC, Parkes J, Stevenson M, Cosgrove AP. Age-related changes in energy efficiency of gait, activity, and participation in children with cerebral palsy. Dev Med Child Neurol. 2011;53:61-67.
    1. Lockette KF, Keyes AM. Conditioning With Physical Disabilities. Champaign, IL: Human Kinetics; 1994.
    1. Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okicić T, Madić D. Effects of aquatic programs in children and adolescents with cerebral palsy: systematic review. Sport Sci. 2012;5:49-56.
    1. Franki I, Desloovere K, De Cat J, et al. The evidence-base for basic physical therapy techniques targeting lower limb function in children with cerebral palsy: a systematic review using the International Classification of Functioning, Disability and Health as a conceptual framework. J Rehabil Med. 2012;44:385-395.
    1. Fragala MA, Goodgold S, Dumas HM. Effects of lower extremity passive stretching: pilot study of children and youth with severe limitations in self-mobility. Pediatr Phys Ther. 2003;15:167-175.
    1. Pin T, Dyke P, Chan M. The effectiveness of passive stretching in children with spastic cerebral palsy. Dev Med Child Neurol. 2006;48:855-862.
    1. Hadden KL, von Baeyer CL. Pain in children with cerebral palsy: common triggers and expressive behaviours. Pain. 2002;99:281-288.
    1. Getz M, Hutzler Y, Vermeer A. Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature. Clin Rehabil. 2006;20:927-936.
    1. Fragala-Pinkham M, Haley SM, O’Neil ME. Group aquatic aerobic exercise for children with disabilities. Dev Med Child Neurol. 2008;50:822-827.
    1. Declerck M. Effect of Aquatic Intervention on the Gross Motor Function and Quality of Life of Children with Cerebral Palsy [thesis]. Edinburgh, Scotland: University of Edinburgh; 2010.
    1. Blohm D. Effectiveness of aquatic interventions for children with cerebral palsy: systematic review of current literature. J Aquatic Phys Ther. 2011;19:19-29.
    1. Cole A, Becker B. Comprehensive Aquatic Therapy. 2nd ed. Philadelphia, PA: Elsevier; 2004.
    1. Kelly M, Darah J. Aquatic exercise for children with cerebral palsy. Dev Med Child Neurol. 2005;47:838-842.
    1. Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross Motor Function Measure (GMFM-66 and GMFM-88) User’s Manual. London, England: MacKeith Press; 2002.
    1. Salem Y, Godwin EM. Effects of task-oriented training on mobility function in children with cerebral palsy. Neurorehabilitation. 2009;24:307-313.
    1. El-Maksoud GMA, Sharaf MA, Rezk-Allah SS. Efficacy of cold therapy on spasticity and hand function in children with cerebral palsy. J Adv Res. 2011;2:319-325.
    1. Chrysagis DN, Douka A, Nikopoulos M, Apostolopoulou F, Koutsouki D. Effects of an aquatic program on gross motor function of children with spastic cerebral palsy. Biol Exerc. 2009;5:13-25.
    1. Park ES, Park CI, Lee HJ, Cho YS. The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy. J Korean Med Sci. 2001;16:347-350.
    1. Declerck M. Swimming and the Physical, Social and Emotional Well-Being of Youth With Cerebral Palsy [thesis]. Edinburgh, Scotland: University of Edinburgh; 2014.
    1. Nottidge VA, Okogbo ME. Cerebral palsy in Ibadan, Nigeria. Dev Med Child Neurol. 1991;33:241-245.
    1. Iloeje SO, Ejike-Orji I. Compliance by cerebral palsy (CP) patients attending a child neurology service in a developing country: a preliminary study. West Afr J Med. 1993;12:1-5.

Source: PubMed

3
Subscribe