January 2017: Congenital Disorders



The therapeutic pool is a very forgiving medium. It is possible to work with individuals with significant restrictions and limitations. In today's world, pediatric therapists are asked to perform minor miracles with few resources; they may be asked to do in 10 visits what they once could do in 20. In such times, the therapy pool becomes important. Why? Aquatic therapy offers an amazingly versatile - and often expedient - environment to challenge many deficits simultaneously. 

Properly planned water activities can provide children with congenital disorders like cerebral palsy (CP) and muscular dystrophy (MD) with many opportunities to challenge tactile, proprioceptive, vestibular and other systems in a single session. Water activities can provide children with the opportunity to improve their understanding of their own bodies. It helps that pool-time seems less like therapy and more like fun for the children. The pediatric therapist who chooses water, chooses well. 

Below is an incomplete list of some of the most recent publications which examine aquatic therapy for children with congenital disorders like CP or MD or Down’s Syndrome. It can serve as a birds-eye showing the progress related to this technique.

Recent Publications: Systematic reviews and meta-analysis 

Adams, S., Hutton, S., Janszen, A., Rawson, R., Sisk, C., Stenger, S., … Adams, S., Hutton, S., Janszen, A., Rawson, R., Sisk, C., Stenger, S., & Ennis, B. (2016). Effects of an Individualized Aquatic Therapy Program on Respiratory Muscle Function in Adolescents with Muscular Dystrophy. Archives of Physical Medicine and Rehabilitation, 97(10), e130–e131. http://doi.org/10.1016/j.apmr.2016.08.407

Appel, J. (2016). Commentary on “Benefits and Enjoyment of a Swimming Intervention for Youth With Cerebral Palsy: An RCT Study”. Pediatric Physical Therapy, 28(2), 170. http://journals.lww.com/pedpt/Citation/2016/28020/Commentary_on__Benefits_and_Enjoyment_of_a.6.aspx

Arifuddin, E. (2015). Penatalaksanaan Hydrotherapy Pada Anak Cerebral Palsy Spastic Quadriplegy Dengan Gangguan Kemampuan Fungsional Berdiri Dan Berjalandi Yayasan Sayap. Retrieved from http://eprints.ums.ac.id/36645/

Badawy, W. W. M., Ibrahem, M. M. B., Ph, D., Ibrahem, M. M. B., & Ph, D. (2016). Comparing the Effects of Aquatic and Land-Based Exercises on Balance and Walking in Spastic Diplegic Cerebral Palsy Children. Medical Journal of Cairo, 84(1), 1–8. Retrieved from http://medicaljournalofcairouniversity.net/home2/images/pdf/2016/march/57.pdf

Ballaz, L., Plamondon, S., & Lemay, M. (2011). Group aquatic training improves gait efficiency in adolescents with cerebral palsy. Disability and Rehabilitation, 33(17–18), 1616–1624. article. http://doi.org/10.3109/09638288.2010.541544

Blohm, D. (2012). Effectiveness of aquatic therapy in children and adolescents with cerebral palsy (ICP): The potential for positive effects is large [German]. Zeitschrift Fur Physiotherapeuten, 64(8), 6–15. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=jlh&AN=108096512&site=ehost-live

Byoungook, K., & Hyojeong, L. (2015). Effects of Aquatic Rehabilitation Program on Gross Motor Function and Balance in Children with Cerebral Palsy. Journal of The Korean Society of Integrative Medicine, 3(3), 35–42. http://doi.org/10.15268/ksim.2015.3.3.035

Carter, H., & Spence, A. (2014). Cardiovascular responses to water immersion in humans: impact on cerebral perfusion. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. Retrieved from http://ajpregu.physiology.org/content/306/9/R636.abstract

Chan, P. E., Crosland, K. A., & Fogel, V. A. (2016). Reducing Phobic Behavior Near Water and Increasing Water Approach Skills. Behavioral Interventions, Epub ahead of print. http://doi.org/10.1002/bin.1443

Chavez, M. M. C. (2016). Hippotherapy versus Aquatic Therapy use in Early Intervention Physical Therapy in Children with Down Syndrome. University of New Mexico School of Medicine. Retrieved from https://repository.unm.edu/handle/1928/32398

ChiaLing Chen. (2015). Effects of Pediatric Aquatic Therapy in Children With Spastic Cerebral Palsy. Chang Gung Memorial Hospital. Retrieved from https://clinicaltrials.gov/ct2/show/record/NCT01049581

Connor, J. O. (2012). Effects of Aquatic Exercise on Balance in Children with Cerebral Palsy, (May). California State University, Northridge. http://citeseerx.ist.psu.edu/viewdoc/download?doi=

Declerck, M., Feys, H., & Daly, D. (2013). Benefits of Swimming for Children with Cerebral Palsy: A Pilot Study. Serbian Journal of Sports Sciences, 7(2), 57–69. article. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=sph&AN=90844790&lang=es&site=ehost-live&scope=site

Declerck, M., Verheul, M., Daly, D., Sanders, R., & Declerck, M., Verheul, M., Daly, D., & Sanders, R. (2016). Benefits and Enjoyment of a Swimming Intervention for Youth With Cerebral Palsy: An RCT Study. Pediatric Physical Therapy, 28(2), 162–169. http://doi.org/10.1097/PEP.0000000000000235

Declerck, M. (2014). Swimming and the physical, social and emotional well-being of youth with cerebral palsy. Retrieved from http://www.era.lib.ed.ac.uk/handle/1842/9459

Declerck, M., Feys, H., & Daly, D. (2013). Benefits of Swimming for Children With Cerebral Palsy: a Pilot Study. Serbian Journal of Sports Sciences, 7(2), 57–69. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=sph&AN=90844790&site=ehost-live

Dibiasio, P., Primus, K. B., Drogos, J., Husted, C., Stephens, H., Thorpe, D., … Hospital, D. R. (2015). Case Report An Aquatic Exercise Program for an Adolescent With Limb Girdle Muscular Dystrophy. The Journal of Aquatic Physical Therapy, 23(1), 3–14.

Dimitrijevic, L., Bjelakovic, B., Lazovic, M., Stankovic, I., Colovic, H., Kocic, M., … Zlatanović, D. (2012). Aquatic exercise in the treatment of children with cerebral palsy. Srpski Arhiv Za Celokupno Lekarstvo, 140(11–12), 746–750. http://doi.org/10.2298/SARH1212746D

Dimitrijević, L., Aleksandrović, M., Madić, D., Okičić, T., Radovanović, D., & Daly, D. (2012). The Effect of Aquatic Intervention on the Gross Motor Function and Aquatic Skills in Children with Cerebral Palsy. Journal of Human Kinetics, 32(May), 167–174. article. http://doi.org/10.2478/v10078-012-0033-5

Education, P., Naučni, O., Bojan Jorgić, R., Dimitrijević, L., Aleksandrović, M., Okičić, T., … Radovanović, D. (2012). The Swimming Program Effects on the Gross Motor Function, Mental Adjustment to the Aquatic Environment, and Swimming Skills in Children with Cerebral Palsy: A Pilot Study. Clinic of Physical Medicine and Rehabilitation, 11(1), 51–66. http://doi.org/10.5937/specedreh1201051J

Emmi-Sofia Kangas. (2016). The use of performance enhancing swimwear during aqua therapy for cerebral palsy - a case study. Satakunnan ammattikorkeakoulu, Satakunta University of Applied Sciences.

Erickson, E. (2016). Benefits of OT and Aquatic Therapy. Retrieved May 16, 2016, from http://scholarworks.gvsu.edu/cgi/viewcontent.cgi?filename=0&article=1466&context=honorsprojects&type=additional

Fragala-Pinkham, M. A., Smith, H. J., Lombard, K. A., Barlow, C., O’Neil, M. E., & O’Neil, M. E. (2014). Aquatic aerobic exercise for children with cerebral palsy: a pilot intervention study. Physiotherapy Theory & Practice, 30(2), 69–78. http://doi.org/10.3109/09593985.2013.825825

Franzen, K., & Tryniszewski, P. (2013). Effectiveness of Aquatic Therapy for Children with Neurodevelopmental Disorders: Systematic Review of Current Literature. The Sage Colleges.

Getz, M., Hutzler, Y., Vermeer, A., Yarom, Y., & Unnithan, V. (2012). The Effect of Aquatic and Land-Based Training on the Metabolic Cost of Walking and Motor Performance in Children with Cerebral Palsy: A Pilot Study. ISRN Rehabilitation, 2012, 1–8. article. http://doi.org/10.5402/2012/657979

Gorter, J. W., & Currie, S. J. (2011). Aquatic Exercise Programs for Children and Adolescents with Cerebral Palsy: What Do We Know and Where Do We Go? International Journal of Pediatrics, 2011(2), 1–7. http://doi.org/10.1155/2011/712165

Hamed, S., Osama, S., & Azab, A. (2016). Effect of Aquatic Program Therapy on Dynamic Balance in Down’s Syndrome Children. Journal of Medical Science and Clinical Research, 4(3), 9938–9942. Retrieved from http://jmscr.igmpublication.org/v4-i3/59 jmscr.pdf

Henriques, M., Henriques, R., & Mirco, T. (2013). Exercício aquático na reabilitação de crianças e adolescentes com paralisia cerebral Aquatic exercise in rehabilitation of children and adolescents with cerebral palsy. Revista Da Sociedade Portuguesa de Medicina Física E de Reabilitação, 23(2), 43–52.

Hernandez, A. A. (2016). The Benefits of Aquatic Therapy on Individuals with Cerebral Palsy. University Presentation Showcase Event. Eastern Kentucky University. Retrieved from http://encompass.eku.edu/swps/2016/undergraduate/54/

Hill, M., McAuliffe, K., Watkins, P., Wheeler, A., Raynes, E., M., H., … Raynes, E. (2015). The Underwater Treadmill as a Physical Therapy Intervention for Children with Cerebral Palsy. The Federation of American Societies for Experimental Biology Journal (FASEB), 29(1), 983.10. http://doi.org/10.1096/fj.1530-6860

Israel, V. (2015). Aquatic assessment of motor skills in muscular dystrophy: a case study. Physiotherapy. Retrieved from https://scholar.google.com/scholar?start=100&q=%22aquatic+therapy%22+OR+%22aquatic+exercises%22&hl=en&as_sdt=0,10&as_ylo=2014#4

Johannes, B., Bernius, P., Lindemann, J., Camargo, O. K. de, & Oerter, R. (2016). Feasibility Study Using In-Water EEG Measurement during Dolphin Assisted Therapy. International Journal of Clinical Psychiatry. Scientific & Academic Publishing.

Jorgić, B., Dimitrijević, L., Lambeck, J., Aleksandrović, M., Okičić, T., & Madić, D. (2012). Effects of aquatic programs in children and adolescents with cerebral palsy: Systematic review. Sport Science, 5(2), 49–56.

Jorgic, B. (2014). The Effects of a Program of Swimming and Aquatic Exercise on Flexibility in Children with Cerebral Palsy. Facta Universitatis. Retrieved from http://casopisi.junis.ni.ac.rs/index.php/FUPhysEdSport/article/view/289

Ka, B., Declerck, M., Daly, D. J., Karklina, B., Declerck, M., Daly, D. J., … Daly, D. J. (2013). Quantification of Aquatic Interventions in Children With Disabilities: A Systematic Literature Review. International Journal of Aquatic Research & Education, 7(4), 344–379. Retrieved from http://www.humankinetics.com/acucustom/sitename/Documents/DocumentItem/07Declerck_344-379.pdf

Labianca, L., Calderaro, C., Rota, P., Vulpiani, M. C., Turturro, F., Montanaro, A., … Ferretti, A. (2013). Evaluation by gross motor function measure of a pilot aquatic exercise program for children with cerebral palsy. Journal of Orthopaedics and Traumatology, 14(1), S84–S85. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71249575\nhttp://dx.doi.org/10.1007/s10195-013-0264-9\nhttp://rd8hp6du2b.search.serialssolutions.com?sid=EMBASE&issn=15909921&id=doi:10.1007/s10195-013-0264-9&atitle=Evaluation+by

Lai, C., Liu, W., Yang, T., & Chen, C. (2015). Pediatric Aquatic Therapy on Motor Function and Enjoyment in Children Diagnosed With Cerebral Palsy of Various Motor Severities. Journal of Child Neurology, 30(2), 200–208. Retrieved from http://jcn.sagepub.com/content/early/2014/05/29/0883073814535491.abstract

Lai, C.-J., Liu, W.-Y., Yang, T.-F., Chen, C.-L., Wu, C.-Y., & Chan, R.-C. (2015). Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. Journal of Child Neurology, 30(2), 200–8. http://doi.org/10.1177/0883073814535491

Lambeck, J. (2015). Clinical Spotlight : A reaction to the Clinical Spotlight on Pediatric Aquatic Therapy. International Organization of Physical Therapists in Pediatrcs, pp. 16–20.

Lamont, L. S., Panagiotis, P., Armitano, C., & Clapham, E. (2014). Development of a wet suit for children with down syndrome. International Journal of Aquatic Research and Education, 8(1), 98–103. http://doi.org/10.1123/ijare.2013-0021

Maniu, D. A., Maniu, E. A., & Benga, I. (2013). Effects of an aquatic therapy program on vital capacity, quality of life and physical activity index in children with cerebral palsy. Human & Veterinary Medicine, 5(3), 117–124. Retrieved from http://0-search.ebscohost.com.fama.us.es/login.aspx?direct=true&db=asx&AN=93995046&lang=es&site=eds-live

Maniu, D., Maniu, E. A., & Benga, I. (2013). Influencing the Gross Motor Function, Spasticity and Range of Motion in Children with Cerebral Palsy by an Aquatic Therapy Intervention Program. Studia Universitatis Babes-Bolyai, Educatio Artis Gymnasticae. Retrieved from http://0-search.ebscohost.com.fama.us.es/login.aspx?direct=true&db=edb&AN=94083050&lang=es&site=eds-live

Meneghetti, C. H. Z., Carraro, L., Leonello, L. a, Batistella, a C. T., & Ferracini Junior, L. C. (2012). Aquatic physiotherapy influence in function and balance in stroke. Revista Neurociencias, 20(3), 410–414. Retrieved from http://www.revistaneurociencias.com.br/edicoes/2012/RN2003/relato de caso 20 03/736 rc.pdf\nhttp://sfx.scholarsportal.info/uhn?sid=OVID:embase&id=pmid:&id=doi:&issn=0104-3579&isbn=&volume=20&issue=3&spage=410&pages=410-414&date=2012&title=Revista+Neurocie 

Meyer, E., Vanheuverzwijn, A., Remacle, M., & Lambeck, J. (2016). Comparison of the passive range of motion of the upper (UE) and lower extremities (LE) after a session of classical hydrotherapy versus «Halliwick» in children with cerebral palsy (CP): Randomized Clinical Trial (RCT). In AQUA Leuven. Retrieved from http://www.halliwicktherapy.org/pdf/leuven/6. Meyer et al (2015) Halliwick vs classical AT in CP - RCT.pdf

Moualed, D., Masterson, L., Kumar, S., & Donnelly, N. (2016). Water precautions for prevention of infection in children with ventilation tubes (grommets). The Cochrane Database of Systematic Reviews, 1. http://doi.org/10.1002/14651858.CD010375.pub2

Nelson, L., Early, D., & Iannaccone, S. (2013). P.7.14 Effects of a regular aquatic therapy program on one individual with Duchenne Muscular Dystrophy (DMD): A case study. Neuromuscular Disorders, 23(9–10), 777–778. http://doi.org/10.1016/j.nmd.2013.06.495

Olama, K., Kassem, H., & Aboelazm, S. (2015). Impact of Aquatic Exercise Program on Muscle Tone in Spastic Hemiplegic Children with Cerebral Palsy. Clinical Medicine, 1(4), 138–144. Retrieved from http://www.aiscience.org/journal/cmj

Pugh, C., Sprung, V., & Ono, K. (2014). The Impact of Water Immersion during Exercise on Cerebral Blood Flow. Retrieved from http://www.h2o-physio.co.uk/files/Pugh_et_al_2014__water_immersion_and_CBF.pdf

Pugh, C. J. A., Sprung, V. S., Ono, K., Spence, A. L., Thijssen, D. H. J., Carter, H. H., & Green, D. J. (2015). The effect of water immersion during exercise on cerebral blood flow. Medicine and Science in Sports and Exercise, 47(2), 299–306. http://doi.org/10.1249/MSS.0000000000000422

Quick, E. (2015). Aquatic Therapy Strength Training Benefits for the Leg Strength of Children with Cerebral Palsy. Retrieved from http://gru.openrepository.com/gru/handle/10675.2/579478

Roostaei, M., Baharlouei, H., Azadi, H., & Fragala-Pinkham, M. A. (2016). Effects of Aquatic Intervention on Gross Motor Skills in Children with Cerebral Palsy: A Systematic Review. Physical & Occupational Therapy In Pediatrics, 1-20.

Ryu, K., Ali, A., Kwon, M., Lee, C., Kim, Y., Lee, G., … Jingu Kim. (2016). Effects of assisted aquatic movement and horseback riding therapies on emotion and brain activation in patients with cerebral palsy. Journal of Physical Therapy Science, 28(12), 3283–3287. Retrieved from https://www.jstage.jst.go.jp/article/jpts/28/12/28_jpts-2016-570/_article/-char/ja/

Sanders, M. E., & Torres, L. E. (2010). Aquatic exercise for muscular dystrophy: The story of Laura Sos, Castell??n, Spain. ACSM’s Health and Fitness Journal, 14(6), 35–41. http://doi.org/10.1249/FIT.0b013e3181f8a332

Stan, A. E. (2016). Applictions of Bad Ragaz Method in Aquatic Programs of Rehabilitation. Marathon, 8(1), 110–117.

Vo, S., Becnel, S., Salem, P., Liu, P., Vo, A., Becnel, M., … Liu, H. (2016). Effectiveness of Aquatic Therapy Interventions in the Management of Children with Cerebral Palsy: A Systematic Review. Research Appreciation Day. University of North Texas. Retrieved from http://digitalcommons.hsc.unt.edu/rad/RAD16/Other/3

Yokoyama, H., Naghavi, N., Hirasawa, Y., Takeda, R., Ota, A., … Okazaki, K. (2016). Forced respiration during the deeper water immersion causes the greater inspiratory muscle fatigue in healthy young men. Journal of Physical Therapy Science, 28(2), 412–418. http://doi.org/10.1589/jpts.28.412