Effect of aquatic motor therapy combined with routine rehabilitation therapy on motor function among children with spastic cerebral palsy

ZHONG Chen&gt;; HU Shanshan&gt;; ZHANG Hengshuo&gt;; ZHANG Cui&gt;; YAO Chuanlei&gt;; SONG Qipeng&gt;

doi:10.11852/zgetbjzz2022-0596

PDF(582 KB)

Chinese Journal of Child Health Care ›› 2023, Vol. 31 ›› Issue (5) : 486-490. DOI: 10.11852/zgetbjzz2022-0596

Effect of aquatic motor therapy combined with routine rehabilitation therapy on motor function among children with spastic cerebral palsy

ZHONG Chen¹, HU Shanshan², ZHANG Hengshuo³, ZHANG Cui⁴, YAO Chuanlei⁵, SONG Qipeng⁶

Author information +

History +

Abstract

Objective To study the influence of aquatic motor therapy (AT) combined with conventional rehabilitation therapy (CRT) on the motor function of preschool children with spastic cerebral palsy, in order to provide theoretical basis for improving the motor function of preschool children with spastic cerebral palsy. Methods A total of 25 preschoolers with spastic cerebral palsy who were admitted to Qilu Children's Hospital of Shandong University from January 2020 to August 2020 were enrolled in this study and were randomly divided into AT+CRT group (n=12) and CRT group(n=13).Children in CRT group were given CRT for 12 weeks, while children in AT+CRT received AT additionally, with the frequency of 5 times/week.The range of lower extremity joint motion, calf muscle tone, plantar contact area and gross motor function were compared before and after intervention. Results After intervention, triceps muscle tension, joint motion of lower extremity and plantar contact area in both AT+CRT group and CRT group were all significantly better than those before intervention (AT+CRT group: t=2.803, 7.197, 3.550, 3.730, 3.541; CRT group:t=2.941, 6.921, 4.335, 3.199, 4.554, P<0.05).After intervention, the scores in the D area of the Gross Motor Function Rating Scale (GMFM-88) in both AT+CRT and CRT groups were significantly higher than those before intervention (t=4.979, 3.750, P<0.05), and the improvement in the AT+CRT group was greater than that in the CRT group (t=0.757, P<0.05).After intervention, the score of GMFM-88E in the AT+CRT group was significantly higher than that before intervention (t=5.244, P<0.05), while there was no significant difference in the CRT group (P>0.05).The improvement amplitude in the AT+CRT group was greater than that in the CRT group, with statistical significance (t=2.305, P<0.05). Conclusion Both AT+CRT and CRT can effectively improve the range of motion, calf muscle tone and plantar contact area of lower extremity in children with spastic cerebral palsy, but AT+CRT can improve the gross motion function better than CRT.

Key words

aquatic motor therapy / conventional rehabilitation therapy / cerebral palsy / muscle tone / rehabilitation

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

ZHONG Chen>, HU Shanshan>, ZHANG Hengshuo>, ZHANG Cui>, YAO Chuanlei>, SONG Qipeng>. Effect of aquatic motor therapy combined with routine rehabilitation therapy on motor function among children with spastic cerebral palsy[J]. Chinese Journal of Child Health Care. 2023, 31(5): 486-490 https://doi.org/10.11852/zgetbjzz2022-0596

References

[1] Chen D,Bao C,Geng YX,et al.Effect of "Tonifying Kidney and Invigorating Brain" acupuncture in children with spastic cerebral palsy analyzed by multi-modality MRI combined with dynamic electroencephalogram[J].Medicine,2020,99(30):e21082.
[2] 林爱金,陈昕,施少云,等.水疗治疗痉挛型脑瘫患儿疗效的Meta分析[J].中华物理医学与康复杂志,2021,43(1):69-73.
Lin AJ,Chen X,Shi SY,et al.Meta-analysis of therapeutic effect of hydrotherapy on children with spastic cerebral palsy[J].Chin J Phys Med Rehabil, 2021,43(1):69-73.(in Chinese)
[3] 孟静,徐怡.基于Bobath理念的综合康复治疗在改善痉挛型脑性瘫痪患儿运动功能中的应用[J].中国临床研究,2020,33(3):387-390.
Meng J,Xu Y.Application of comprehensive rehabilitation therapy based on Bobath concept in improving motor function of children with spastic cerebral palsy[J].Clin J Clin Res,2020,33(3):387-390.(in Chinese)
[4] Clutterbuck G,Auld M,Johnston L.Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: A systematic review[J].Disabil Rehabil,2019,41(10):1131-1151.
[5] Gorter JW,Currie SJ.Aquatic exercise programs for children and adolescents with cerebral palsy: What do we know and where do we go[J].Int J Pediatr, 2011,2011:712165.
[6] Clerici I,Maestri R,Bonetti F,et al.Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of freezing of gait in parkinson disease: A randomized controlled trial[J].Phys Ther,2019,99(5):591-600.
[7] 丛芳,崔尧.脑性瘫痪儿童水中运动治疗临床实践指南[J].中国康复理论与实践,2021,27(1):1-14.
Cong F,Cui Y.Clinical practice guidelines for water exercise therapy in children with cerebral palsy[J].Chin J Rehabil Theory Pract,2021,27(1):1-14.(in Chinese)
[8] Retarekar R,Fragala-Pinkham MA,Townsend EL.Effects of aquatic aerobic exercise for a child with cerebral palsy: Single-subject design[J].Pediatr Phys Ther,2009,21(4):336-344.
[9] Getz M,Hutzler Y,Vermeer A.Effects of aquatic interventions in children with neuromotor impairments: A systematic review of the literature[J].Clin Rehabil, 2006,20(11):927-936.
[10] Li XJ,Tang JL,Ma BX,et al.Cerbral palsy of the definition,diagnostic criteria and clinical classification[J].Chinese Practical Pediatric Clinical Journal,2014,(19):1520-1520.
[11] 张莉莉,刘一苇,叶常州,等.悬吊运动训练结合家庭姿势管理对痉挛型脑瘫儿童粗大运动功能、平衡功能和日常生活活动能力的影响[J].中华物理医学与康复杂志,2021,43(10):927-929.
Zhang LL,Liu YW,Ye CZ,et al.Effects of suspension exercise training combined with family postural management on gross motor function, balance function and activities of daily living in children with spastic cerebral palsy[J].Chin J Phys Med Rehabil,2021,43(10):927-929.(in Chinese)
[12] Teixeira-Machado L,DeSantana JM.Effect of dance on lower-limb range of motion in young people with cerebral palsy: A blinded randomized controlled clinical trial[J].Adolesc Health Med Ther,2019,27(10):21-28.
[13] Kokaridas D,Lambeck J.The halliwick concept: Toward a collaborative aquatic approach[J].Inquiry Sport & Phys Edu,2015,13(2):65-76.
[14] 任雪松,蔡志军,张小安,等.全身振动训练联合肉毒毒素注射对痉挛型双瘫脑瘫儿童尖足及粗大运动功能的影响[J].中华物理医学与康复杂志,2019,41(9):688-692.
Ren XS,Cai ZJ,Zhang XA,et al.Effects of whole body vibration training combined with botulinum toxin injection on tiptoe and gross motor function in children with spastic diplegia cerebral palsy[J].Chin J Phys Med Rehabil,2019,41(9):688-692.(in Chinese)
[15] Lucena-Antón D,Rosety-Rodríguez I,Moral-Munoz JA.Effects of a hippotherapy intervention on muscle spasticity in children with cerebral palsy: A randomized controlled trial[J].Complement Ther Clin Pract,2018,31:188-192.
[16] 徐怡,赵晓科,陈梦莹,等.虚拟现实技术缓解痉挛型脑性瘫痪患儿治疗性疼痛的效果[J].中国康复理论与实践,2019,25(12):1458-1462.
Xu Y,Zhao XK,Chen MY,et al.Effect of virtual reality technology on relieving therapeutic pain in children with spastic cerebral palsy[J].Chin J Rehabil Theory Pract,2019,25(12):1458-1462.(in Chinese)
[17] Hallett M.Neurophysiology of dystonia: The role of inhibition[J].Neurobiol Dis, 2011,42(2):177-184.
[18] Esquenazi A,Talatu M.Gait analysis: Technology and clinical applications[J].Phys Med Reh,2000,1(1):242-262.
[19] 李杜娟,周云.脑瘫患儿继发髋关节脱位的防治研究进展[J].中华物理医学与康复杂志,2020,43(1):91-94.
Li DJ, Zhou Y.Research progress of prevention and treatment of secondary hip dislocation in children with cerebral palsy[J].Chin JPhys Med Rehabil,2020,43(1):91-94.(in Chinese)
[20] Adar S,Dündar Ü,Demirdal ÜS,et al.The effect of aquatic exercise on spasticity quality of life and motor function in cerebral palsy[J].Turk J Phys Med Rehabil,2017,63(3):239-248.
[21] Becker BE.Aquatic therapy: scientific foundations and clinical rehabilitation applications[J].PMR,2009,1(9):859-872.
[22] Lai CJ,Liu WY,Yang TF,et al.Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities[J].J Child Neurol,2015,30(2):200-208.
[23] Etoom M,Khraiwesh Y,Lena F,et al.Effectiveness of physiotherapy interventions on spasticity in people with multiple sclerosis: A systematic review and Meta-analysis[J].Am J Phys Med Rehabil,2018,97(11):793-807.
[24] Akinola BI,Gbiri CA,Odebiyi DO.Effect of a 10-Week aquatic exercise training program on Gross Motor Function in children with spastic cerebral palsy[J].Glob Pediatr Health,2019,6(1):2333794X19857378.
[25] 敬竹子,张鑫,马晓东,等.水中运动疗法在膝关节周围骨折中的应用[J].四川医学,2020,41(4):351-353.
Jing ZZ,Zhang X,Ma XD,et al.Application of water exercise therapy in the treatment of periknee fracture[J].Sichuan Med,2020,41(4):351-353.(in Chinese)
[26] 赵燕挺,陈伟,苑杰华,等.水疗法治疗脑瘫患儿的康复效果[J].中华物理医学与康复杂志,2021,43(6):538-540.
Zhao YT,Chen W,Yuan JH,et al.Therapeutic effect of hydrotherapy on children with cerebral palsy[J].Chin J Phys Med Rehabil,2021,43(6):538-540.(in Chinese)
[27] 李永杰,扈盛.水中运动训练对脑卒中患者下肢肢体功能和日常生活能力影响的Meta分析[J].中国康复医学杂志,2019,34(10):1209-1215.
Li YJ,Hu S.A Meta-analysis of the effects of water exercise training on lower limb function and daily living ability of stroke patients[J].Chin J Rehabil Med,2019,34(10):1209-1215.(in Chinese)
[28] DimitrijevićL,Aleksandrović M,Madić D,et al.The effect of aquatic intervention on the gross motor function and aquatic skills in children with cerebral palsy[J].J Hum Kinet,2012,32:167-174.
[29] Bojan J,Marko A,Lidija D,et al.The effects of a program of swimming and aquatic exercise on flexibility in children with cerebral palsy[J].Astrophys J,2014,561(1):7-10.
[30] 冯重睿,郭永亮,郑炳铃,等.痉挛型脑性瘫痪马蹄足跟腱延长术后系统康复训练患儿三维步态分析表现[J].中国康复医学杂志,2020,35(10):1243-1246.
Feng ZR,Guo YL,Zheng BL,et al.Three-dimensional gait analysis of children with spastic cerebral palsy after systematic rehabilitation training of equinofoot Achilles tendon extension[J].Chin J Rehabil Med,2020,35(10):1243-1246.(in Chinese)
[31] Zhou J,Butler EE,Rose J.Neurologic Correlates of Gait Abnormalities in Cerebral palsy: Implications for Treatment[J].Front Hum Neurosci.2017,17(11):103-104.
[32] 向俊璐,周文智,田萍,等.基于肌内神经分布的针刺方法治疗痉挛型脑瘫尖足的疗效观察[J].中华物理医学与康复杂志,2019,41(8):613-615.
Xiang JL,Zhou WZ,Tian P,et al.Therapeutic effect of acupuncture based on intramuscular nerve distribution in the treatment of spastic cerebral palsy apical foot[J].Chin J Phys Med Rehabil,2019,41(8):613-615.(in Chinese)
[33] Gough M,Shortland AP.Could muscle deformity in children with spastic cerebral palsy be related to an impairment of muscle growth and altered adaptation[J].Dev Med Child Neurol,2012,54(6):495-499.
[34] Roostaei M,Baharlouei H,Azadi H,et al.Effects of Aquatic Intervention on gross motor skills in children with cerebral palsy: A systematic review[J].Phys Occup Ther Pediatr,2017,37(5):496-515.
[35] Declerck M,Daly D,Feys H.Benefits of swimming for children with cerebral palsy: A pilot study[J].Serb J Sports Sci,2013,7(2):57-69.
[36] 丛芳,崔尧.水中运动治疗的发展现状与展望[J].华西医学,2020,35(5):527-533.
Cong F,Cui Y.Current situation and prospect of water exercise therapy[J].West China Med J,2020,35(5):527-533.(in Chinese)