Comparing the Effects of Aquatic and Land-Based Exercises on Balance and Walking in Spastic Diplegic Cerebral Palsy Children

Background: Children with spastic diplegic Cerebral Palsy (CP) often show motor impairment due to a number of deficits; including poor muscle control, weakness, spasticity and reduced range of motion in the extremities. All these factors affect the ability of children with CP to maintain balance and walk which are the primary rehabilitation concerns of parents and clinicians.Aim of the Study: The present study was designed to compare between aquatic and land-based exercises on balance control and gait kinematics in children with spastic diplegia.Material and Methods: Thirty children with spastic diplegic (CP) of both sexes (19 boys and 11 girls) with gross motor function classification system level (II-III) and age ranged between 6-9 years were included in this study. Children were randomly assigned into two equal groups; Aquatic intervention (AQ) group and land-based exercise (LB) group. Balance parameters (overall, mediolateral and anteroposterior stability indices) were evaluated using biodex balance systemTM. Also gait kinematics parameters (step length, walking speed and time spent on each foot) were measured using biodex gait trainer IITM. Evaluation for each child in both groups was done before and after 12 successive weeks of treatment.Results: There was a statistically significant improvement in the measured parameters in both groups when comparing their pre and post treatment mean values. However, significant difference was recorded between the two groups after treatment in favor of the aquatic intervention group.Conclusion: The obtained results suggest that the aquatic therapy is beneficial to improve balance control and walking performance in spastic diplegic (CP) children.