Advantage of Water Specific Therapy-Halliwick versus Conventional Aqua Therap on the Active Trunk Recovery in Children with Cerebral Palsy (CP).

Transcription

1 Advantage of Water Specific Therapy-Halliwick versus Conventional Aqua Therap on the Active Trunk Recovery in Children with Cerebral Palsy (CP). MEYER E 1, TOMASZEWSKI M 2, LAMBECK J Licencié en Kinésitherapie et Réadaptation, Centre Arnaud Fraiteur, Bruxelles, Belgium 2. Master en Kinésithérapie et Réadaptation, ULB, Bruxelles, Belgium 3. Physiotherapist, Association IATF, Valens, Switzerland

2 I. INTRODUCTION 1) After IZMIR In children with CP, HALLIWICK aquatic therapy shows significant results on the global decrease of spasticity lasting in time. 2) After LEUVEN The classical method increases the range of motion mainly in the distal joints, whereas Halliwick increased the range of motion mainly in the proximal joints with more specific effects than the classical method

3 I. INTRODUCTION 3) Now QUERETARO The aim of this study is to assess the effects of aquatic therapy on the active trunk extension in children with CP. Comparison between the conventional method (CM), and Water Specific Therapy-Halliwick (WSTH).

4 II. MATERIAL AND METHOD II.1. Population * 13 quadriplegic spastic CP children ( 5 ; 8 ) GMFCS II to IV * All registered at the Centre Arnaud Fraiteur * Aged between 7 and 13 years * 6 move in a electrical chair ; 4 are in a manual chair * All hold sitting alone * All have a sufficient comprehension to understand simple orders

5 II. MATERIAL AND METHOD II.2. Aquatic therapy * Swimming pool with - a water between an ambient temperature of 27 * WSTH consists of various rotation exercises (sagittal/transverse/longitudinal) given at a child without head control and flotation equipment * Classical therapy aims to control the child's head giving various sensations, on the back, without specifically rotations * The sessions are «standardized» * 20 minutes for one session

6 II. MATERIAL AND METHOD II.3. Assessment in range of motion R * Mesure with a inclinometer Baseline AcuAngle C7 * At 3 points of their spine (C7-Th8-Th12) C 7T h 8 TH8 TH12

7 II. MATERIAL AND METHOD

8 II. MATERIAL AND METHOD II.4. Trial * Each child receives a WSTH and a classical session (random) * One or two weeks between each session * Assessment of range of motion [1] --- > before therapy [2] --- > immediatly after therapy, [3] --- > +/- 1 hour after dressing

9 II. MATERIAL AND METHOD II.5. Statistics * We used the ANOVA variance statistical test with one factor (time) and repetitive measures.

10 III. RESULTS C7 36 Halliwick Classique 32 Amplitude niveau C7 ( ) Halliwick : S 12 Classique : NS t1 t2 t3 t1 t2 t3

11 III. RESULTS TH8 32 Halliwick Classique Amplitude niveau Th8 ( ) Halliwick : S 12 Classique : NS t1 t2 t3 t1 t2 t3

12 III. RESULTS TH12 18 Halliwick Classique Amplitude niveau Th12 ( ) Halliwick : VHS 6 Classique : NS t1 t2 t3 t1 t2 t3

13 IV. DISCUSSION WSTH showed significant increases in range of motion at C7 and Th8 (P = 0,01; P = 0,05) a highly significant change at Th12 (P < 0,001) - data show that the effects are - immediat for C7 ( + stabilization) (*) - after 1 hour for TH8 and TH12 (**) Conventional method showed no significant result (*)

14 IV. DISCUSSION (*) - With WSTH, the children must maintain actively his head --- > C7 - With WSTH, there are specific active rotation exercices --- > TH8-TH12 - With CM, children do spontaneous mouvements + passive head control --- > in the pathological pattern --- > no possibility to develop new competences - In agreement with our present results, Meyer et al, 2013, with the same protocol and population, has also shown that WSTH decrease the spasticity; and, in 2015, improves range of motion in the lower. and upper limb

15 IV. DISCUSSION (**) - Why do the effects on TH8-TH12 happen 1 hour after WSHT? --- > No objective interpretation --- > External factors (t )? --- > Because bad posture pattern acquired by the child requires some time before he could properly have the active trunk extension?

16 IV. CONCLUSION This study has highlighted the short-term benefits of the Water Specific Therapy-Halliwick on the active range of motion of trunk extension of the whole spine in this sample of children with CP. However, no conclusion can be settled regarding the long-term effects.

17 IV. CONCLUSION

18 IV. CONCLUSION

19 (Halliwick session) (Spastic CP) THANKS FOR YOUR ATTENTION