Halliwick Concept on Motor Functions in Spastic CP

October 6 University

Status: Completed

Conditions: Spastic Cerebral Palsy; Spastic Hemiplegic Cerebral Palsy

Treatments: Procedure: Conventional physical therapy; Other: Aquatic Halliwick method

Study type: Interventional

Funder types: Other

Identifiers

NCT05094921

Halliwick07

Details and patient eligibility

About

This randomized controlled trial will investigate the effect of hydrotherapy (halliwick concept) on motor functions in children with spastic cerebral palsy (CP). Minimum of 30 Spastic CP children will be recruited for this study. Children will be randomly assigned into control group who will receive conventional selected exercise treatment or study group who will receive the same conventional program in addition to underwater exercise program. Motor function will be evaluated at baseline and after 3 months of treatment. No potential harms are expected during this study.

Enrollment: 36 patients

Sex: All

Ages: 5 to 9 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children from both sexes diagnosed with spastic CP according to a pediatrician
• The degree of spasticity will be determined as grade two or less according to modified Ashworth scale
• Their age will range from five to nine years
• Intelligence quotient score > 35 (no worse than moderate intellectual disability) as assessed via Wechsler test scales
• No severe psychosocial or behavioral problems, such high aggression or risk of self-harm.

Exclusion criteria

• Initiation of oral antispastic medication
• botulinum toxin injections or surgery performed less than 90 days before enrollment
• severe visual or auditory impairment
• uncontrollable epilepsy (defined as the occurrence of seizures despite the use of at least one antiepileptic drug)
• open wounds
• children with a psychiatric disorder
• cognitive disorders evaluated by the pediatric evaluation of disability inventory
• uncontrolled epilepsy
• active infection
• severe cardiopulmonary disorders.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Group A (Halliwick method group)

Experimental group

Description:

Under water exercise program according to halliwick concept which will be applied as three sessions per week for three successive months. Underwater exercises will be performed under the supervision of a certified aquatic therapist. This practitioner will instruct the child in proper techniques for performing exercises while ensuring child's safety by using flotation devices, body boards or float belts when necessary. Also the pool where the children will perform underwater exercises will be equipped with ramps, chair lifts, stairs, and handrails to facilitate a child's ability to access the pool.

Treatment:

Other: Aquatic Halliwick method

Group B (conventional physical therapy group)

Active Comparator group

Description:

Conventional selected exercise program for 60 minutes , three sessions per week for three successive months aiming to improve the motor functions of the children in form of: (1) Neuro-developmental technique, (2) Back and abdominal exercises, (3) improving postural responses, (4) Flexibility exercises, (5) Strengthening exercise (particularly knee extensors, hip abductors and the ankle dorsi-flexors muscles) and (6) Improving standing, weight transfer and shift and finally facilitation of normal walking pattern .

Treatment:

Procedure: Conventional physical therapy