Influence of aquatic physiotherapy on gross motor function of individuals with cerebral palsy: a systematic review

Abstract

Cerebral palsy (CP) is a group of non-progressive developmental disorders resulting from a lesion in the immature brain, causing functional limitations. Movement disorders can be accompanied by sensory, perceptual, cognitive, communication, and behavioral changes. For the rehabilitation of these individuals, aquatic physical therapy is widely used. Thus, the objective of this review is to investigate the quality of studies and the influence of aquatic physical therapy in individuals with CP. Searches were performed in the following databases PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), MedLine, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro) and Biblioteca Virtual em Saúde, based on the acronym “Pico”. Inclusion criteria were aquatic physical therapy intervention in children and/or adolescents with CP, controlled and uncontrolled clinical studies, randomized and non-randomized clinical studies, double-blind or not. Studies with mixed populations and other diagnoses, adults, studies of the systematic review type with or without meta-analysis, case reports, case series, and with any type of outcome other than motor function were excluded. The methodological evaluation was performed using the PEDro scale. Forty-three studies were identified in the searches. Of these, 37 were excluded after reading the title, abstract, and methods, with the reason being, mostly, wrong outcomes or wrong population, resulting in six eligible studies. In conclusion, evidence on aquatic physical therapy for individuals with CP is limited. Yet, this therapy is feasible and adverse effects are minimal. More research is needed to determine the effectiveness of aquatic physical therapy in this population at different levels of the Gross Motor Function Classification System (Sistema de Classificação da Função Motora Grossa [GMFCS]).