The Benefits of Group Aquatic Therapy for Young Children With Down syndrome

Abstract

Background and Purpose: To describe the implementation of an aquatic-based exercise program for young children with Down syndrome (DS). The aquatic setting is particularly motivating for children with DS. Swimming can be a safe and effective way to promote lifetime physical activity for individuals with DS. Caregivers often feel unprepared to assist their children in swimming activities, limiting participation in community programs. Case Series: Twenty children with DS participated in an aquatic-based program to facilitate transition to a community swim programs. Intervention: The Trisomy 21 Aquatic Group, an 8-week group-based exercise program, was developed that included aquatic skills, water acclimation, fitness activities, and caregiver instruction. A pre- and postparticipation evaluation included the establishment of goals and standardized assessments including the Gross Motor Function Measure (GMFM), a parent questionnaire, and the Water Orientation Test Alyn (WOTA-1). The aquatic-based exercise program was piloted with 20 children between the ages of 1 and 5 years and included caregiver participation. Interventions consisted of respiratory control, water orientation, swim skills, balance and strengthening activities, and functional skills. Instruction promoted caregiver confidence and carryover in the community with consistent routines, repetition, and scaffolding of skills. Outcomes: Both WOTA and GMFM were analyzed using pre- and postgroup paired t tests. Statistically significant changes from pre- to postgroup tests were noted. The mean GMFM improved from 154 to 179.45 or 24.65 points (P < .00001 ± 18.93) and the mean WOTA improved from 25.53 to 37.33 or 12.2 points (P < .00001 ± 8.13). The parent questionnaire revealed significant changes in the child's ability to follow simple directions and take turns (Z = 2.157, P = .030) and blow bubbles (Z = 2.50, P = .0124) and an increase in the number of signs (mean change of 6.8 signs). Parents reported having confidence supporting their children in the water, improvements in strength, improved respiratory control, and readiness for swim lessons. Discussion: A standardized aquatics program for individuals with DS is presented. This is a step toward the establishment of effective treatment strategies regarding aquatic therapy for those with DS.