Aquatic Therapy for Cerebral Palsy

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Disqualifiers: Compromised airway, uncontrolled seizures

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 22

Duration: 10 weeks

36 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The purpose of this study is to explore the feasibility, fidelity and acceptability of an aquatic therapy assessment and intervention for children ages 3-9 with neuromotor deficits such as cerebral palsy. The intervention takes place in a warm water therapy pool, twice a week for ten weeks and targets swim safety skills, upper extremity function and self care participation and performance.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is aquatic therapy safe for humans?

Aquatic therapy is generally considered safe, but there are concerns about safety protocols in some facilities, such as the lack of rescue equipment and emergency communication systems. It's important for practitioners to be trained in safety standards to prevent accidents. ^{1 2 3 4 5}

How is aquatic therapy different from other treatments for cerebral palsy?

Aquatic therapy is unique because it uses water to reduce the force of gravity, making it easier for children with cerebral palsy to move and exercise, which can improve motor function and enjoyment compared to land-based therapies. ^{1 5 6 7 8}

What data supports the effectiveness of the treatment Aquatic Therapy for Cerebral Palsy?

Research shows that aquatic therapy can improve motor skills and enjoyment in children with cerebral palsy. Children participating in aquatic therapy had better motor function and enjoyed physical activities more than those who did not participate. ^{1 2 5 9 10}

Are You a Good Fit for This Trial?

This trial is for children aged 3-9 with neuromotor issues like cerebral palsy or brain hypoxia, who have trouble using their arms and doing self-care tasks. Their parents or guardians must be over 18. Kids can't join if they have breathing problems or seizures that aren't under control.

Inclusion Criteria

My child has a diagnosis affecting their brain and muscle function.

My child has difficulty using their arms or hands.

My child struggles with daily self-care activities.

Exclusion Criteria

I have trouble breathing due to a blocked airway.

I have seizures that are not controlled by medication.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intake Evaluation

Initial evaluation session to assess baseline skills and set individualized goals

1 session

1 visit (in-person)

Treatment

Aquatic therapy sessions focusing on swim safety skills, upper extremity function, and self-care participation

10 weeks

20 visits (in-person)

Post Evaluation

Evaluation session to assess changes in skills and performance after intervention

1 session

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Aquatic therapy

Trial Overview The study tests aquatic therapy in a warm pool, focusing on swim safety, improving arm use, and helping kids do everyday activities by themselves. It involves going to the pool twice a week for ten weeks.

How Is the Trial Designed?

Group I: Intervention: aquatic occupational therapy (AquOTic-NM) Experimental Treatment 1 Intervention

aquatic occupational therapy 30 minutes, self care training 15 minutes

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

Franklin County Board of Developmental Disabilities

Collaborator

Trials

2

Recruited

100+

Published Research Related to This Trial

A case series involving four pediatric patients with conditions like cerebral palsy and juvenile idiopathic arthritis showed significant improvements in functional mobility, walking endurance, range of motion, muscle strength, and pain reduction after participating in an aquatic physical therapy program.

The study suggests that aquatic physical therapy, when combined with traditional land-based therapy, can effectively enhance physical abilities in children with disabilities, particularly those needing low-impact activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An aquatic physical therapy program at a pediatric rehabilitation hospital: a case series. Fragala-Pinkham, MA., Dumas, HM., Barlow, CA., et al.[2022]

The study identified a wide range of intervention categories for aquatic therapy, including 41 Body Functions, 8 Body Structures, 36 Activities and Participation, and 6 Environmental Factors, which can be targeted by physical therapists working with disabled children.

Using the Delphi technique, the research gathered consensus on these categories, emphasizing the diverse approaches available to enhance the functioning and participation of children with disabilities in aquatic settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey. Güeita-Rodríguez, J., García-Muro, F., Cano-Díez, B., et al.[2019]

Aquatic interventions for children with cerebral palsy (CP) show potential for improving gross motor skills, particularly when conducted 2-3 times per week over 6-16 weeks, although the evidence is limited and mixed across studies.

Most studies reported minimal adverse effects, indicating that aquatic exercise is a safe option for children with CP, but further research is needed to clarify the optimal frequency and duration of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Aquatic Intervention on Gross Motor Skills in Children with Cerebral Palsy: A Systematic Review. Roostaei, M., Baharlouei, H., Azadi, H., et al.[2018]

Pediatric aquatic therapy significantly improved motor function in children with spastic cerebral palsy, as evidenced by higher scores on the Gross Motor Function Measure compared to a control group, indicating its efficacy as a therapeutic intervention.

Children participating in aquatic therapy also reported greater enjoyment of physical activity, suggesting that this therapy not only aids in motor skills but also enhances overall quality of life for these children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. Lai, CJ., Liu, WY., Yang, TF., et al.[2022]

A 12-week aquatic exercise program for 19 children with spastic cerebral palsy significantly improved gross motor function, with scores increasing from 80.2% to 86.2% (p < 0.05).

The program also effectively reduced muscle spasticity, as indicated by a decrease in the Modified Ashworth Scale score from 3.21 to 1.95 (p < 0.001), and enhanced cardiorespiratory endurance, shown by a significant decrease in heart rate and an increase in maximal oxygen consumption (p < 0.001).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Aquatic exercise in the treatment of children with cerebral palsy]. Dimitrijević, L., Bjelaković, B., Lazović, M., et al.[2019]

Many aquatic therapy practitioners lack knowledge about safety regulations and emergency protocols, which poses risks as they often work alone in pools without proper rescue equipment or lifeguards.

As the field of aquatic therapy grows, it is crucial to educate practitioners on safety standards and environmental assessments to prevent accidents, and organizations like ATRI are available to provide support and training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety first. Wykle, MO.[2005]

Aquatic exercise is becoming a popular intervention for children with cerebral palsy (CP) due to its benefits, such as reduced joint loading and impact, which can help improve balance and postural control.

The review highlights the importance of tailored aquatic exercise programming for children with CP, suggesting that water-based activities can be more appealing and effective compared to traditional land-based exercises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aquatic exercise for children with cerebral palsy. Kelly, M., Darrah, J.[2022]

Aquatic physical therapy utilizes the unique properties of water to facilitate early rehabilitation, making it an effective environment for recovery from injuries.

Successful aquatic rehabilitation programs require clinicians to have specialized knowledge and experience to create and supervise individualized treatment plans for common athletic injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aquatic therapy in the rehabilitation of athletic injuries. Prins, J., Cutner, D.[2019]

Aquatic therapy significantly improved balance in post-stroke patients compared to land-based exercises, with a standardized mean difference of 0.72 based on the Berg Balance Scale, indicating a strong positive effect.

Additionally, aquatic therapy showed small but positive effects on walking speed and mobility, suggesting it may be a beneficial rehabilitation method for improving lower limb function in stroke patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis. Ghayour Najafabadi, M., Shariat, A., Dommerholt, J., et al.[2022]

Aquatic therapy (AT) is recognized by physical therapists and kinesiologists in Canada as a beneficial approach for enhancing balance, mobility, and overall health in individuals with spinal cord injuries or disorders, offering multi-system benefits such as improved function and confidence.

Despite facing barriers like pool accessibility and client comorbidities, therapists successfully integrate AT into their practice, highlighting its versatility and effectiveness in rehabilitation for clients with SCI/D.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of aquatic therapy among rehabilitation professionals for individuals with spinal cord injury or disorder. Marinho-Buzelli, AR., Zaluski, AJ., Mansfield, A., et al.[2020]

Citations

1. United States pubmed.ncbi.nlm.nih.gov

An aquatic physical therapy program at a pediatric rehabilitation hospital: a case series. [2022]

2. Brazil pubmed.ncbi.nlm.nih.gov

Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Effects of Aquatic Intervention on Gross Motor Skills in Children with Cerebral Palsy: A Systematic Review. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. [2022]

5. Serbia pubmed.ncbi.nlm.nih.gov

[Aquatic exercise in the treatment of children with cerebral palsy]. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Safety first. [2005]

7. England pubmed.ncbi.nlm.nih.gov

Aquatic exercise for children with cerebral palsy. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Aquatic therapy in the rehabilitation of athletic injuries. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis. [2022]

10. England pubmed.ncbi.nlm.nih.gov

The use of aquatic therapy among rehabilitation professionals for individuals with spinal cord injury or disorder. [2020]