A comparative study on the effectiveness of standing balance training in a temperature-controlled pool versus land for children with cerebral palsy

Abstract

Aquatic therapy in a temperature-controlled pool is an integral part of rehabilitation for children with cerebral palsy (CP) because of the unique properties of water. The aim of this study was to assess the effectiveness of standing balance training in a temperature-controlled pool versus land for children with CP after a type of single event multilevel surgery called Single Event Multilevel Lever Arm Restoration Anti Spasticity Surgery (SEMLARASS). A prospective clinical trial was conducted in a single rehabilitation centre on 80 children with CP. The participants who fulfilled the eligibility criteria were randomly allocated into 2 groups: experimental group A (n = 40; 18 boys, 22 girls) with mean age of 9.45 years and control group B (n = 40; 20 boys, 20 girls) with mean age of 8.75 years. Participants in both the groups underwent a programmed set of static and dynamic standing balance training with group A in a temperature-controlled pool and group B in land for 1 hour per day for 6 days per week for 6 weeks. The therapy was performed by trained physiotherapists in land and in water. The primary tools used for measuring outcomes were Paediatric Balance Scale (PBS) and Timed Up and Go test (TUG). The data was collected at the end of 6 weeks and follow-up data was collected after 1 month and 3 months. Significant differences were seen on all the outcomes in both the groups at the end of 6 weeks’ program in group A, PBS (P < 0.001) and TUG (P < 0.001), compared to group B. The observed progress was also maintained in the follow-ups after 1 month and 3 months. This study demonstrated that the pre-programmed balance training in a temperature-controlled pool can be included in the post SEMLARASS rehabilitation program.