Effects of aquatic physiotherapy versus conventional physical therapy on the risk of fall in the elderly: a randomized clinical tria / Efeitos da fisioterapia aquática versus fisioterapia convencional no risco de queda em idosos: ensaio clínico

Objective: To identify whether physiotherapy treatment in water is more effective than the treatment in land environment, aiming at improving the process of physical limitation or functional inability (gait speed, balance, motor abilities) caused by lack of balance in elderly with risk of fall. Methods: Randomized clinical trial, experimental study. The sample was composed of 35 senior individuals of both sexes, with average age of 65. Nineteen people composed the control Group /Conventional Physiotherapy, while the rest composed the experimental Group/Aquatic Physical therapy. Both groups were submitted to twenty sessions of physical therapy, twice a week, for 50 minutes in individual treatment. Aerobic activities were conducted for both groups separately. Exercises using water specific therapy, such as Halliwick rotation control and Bad Ragaz ring method, were used in the aquatic group and in the conventional group, physiotherapeutic techniques were applied, approaching the concepts of proprioceptive neuromuscular facilitation (PNF) and decubitus change training. The following tests were used to measure the risk of fall/balance: Timed Up and Go Test, Sit-to-Stand in 30 seconds and Functional Reach. Results: Both physiotherapeutic interventions, aquatic and conventional, showed to be greatly efficient however aquatic physiotherapy showed certain advantages compared to conventional physical therapy, promoting more beneficial effects in the gait speed, balance, motor abilities and, mainly, in the reduction of the risk of fall. (AU)

Objetivo: Identificar se a Fisioterapia aquática é mais eficaz que a fisioterapia convencional, visando a melhora do processo de limitação física ou incapacidade funcional (Velocidade da marcha, equilíbrio, habilidades motoras) causada por desequilíbrio em pacientes idosos com risco de queda. Métodos: Ensaio clínico randomizado, estudo experimental. A amostra foi composta por 35 idosos de ambos os sexos, com uma média de idade de 65 anos. Dezenove pessoas compuseram o Grupo Controle/Fisioterapia Convencional, enquanto o restante constituiu o Grupo Experimental / Fisioterapia Aquática. Ambos os grupos foram submetidos a vinte sessões de fisioterapia, duas vezes por semana, durante 50 minutos em tratamento individual. As atividades aeróbicas foram realizadas para ambos os grupos separadamente. Exercícios utilizando terapia específica da água, como o controle de rotação de Halliwick e o método do anel de Bad Ragaz, foram utilizados no grupo aquático e, no grupo convencional, foram aplicadas técnicas fisioterapêuticas, abordando os conceitos de facilitação proprioceptiva e treinamento de mudança de decúbito. Os seguintes testes foram usados para medir o risco de queda/equilíbrio: Timed Up and Go Teste, Teste de sentar e levantar em 30 segundos e Teste de Alcance Funcional. Resultados: Ambas as intervenções fisioterapêuticas, aquáticas e convencionais se mostraram bastante eficientes, entretanto a fisioterapia aquática apresentou certas vantagens em relação à fisioterapia convencional, promovendo efeitos mais benéficos na velocidade da marcha, equilíbrio, habilidades motoras e, principalmente, na redução do risco de queda. (AU)

Water Orientation Test of Alyn 2 (Chinese) and Its Reliability and Validity in Patients with Spinal Cord Injury / 中国康复理论与实践

@#Objective To translate the Water Orientation Test of Alyn 2 (WOTA2) into Chinese, and to study its reliability and validity for patients with spinal cord injury. Methods After authorizing, the English version WOTA2 scale and its training package were translated into Chinese. From January to September, 2018, 137 patients with spinal cord injury were evaluated with the Chinese version WOTA2 by two evaluators independently, and evaluated again three days later by one of the evaluators. The Cronbach's α, Spearman-Brown coefficient, intra-group correlation coefficient (ICC) and Kappa coefficient were calculated to evaluate the reliability. Content Validity Index (CVI) of items (I-CVI) and scale (S-CVI) were used to evaluate the content validity, and factors analysis was used to evaluate the structure validity. Results The Cronbach's α was 0.947 in all items of the scale, 0.890 in mental adjustment items and 0.954 in aquatic skills items. Pearson correlation coefficient of the half scales separated by odd and even items was 0.948, and the Spearman-Brown coefficient was 0.973. The ICC of test-retest was 0.965 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The ICC of inter-testers was 0.964 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The Kappa coefficient was 0.528 to 0.927 in test-retest and 0.528 to 0.927 in inter-testers. The I-CVI was 0.8 to 1.0 and S-CVI was 0.63. Factors analysis extracted four factors, which met the theory, and contributed 67% of cumulative variance. Conclusion The Chinese version WOTA2 is good in reliability and validity for patients with spinal cord injury, and can be used in the clinical practice of aquatic therapeutic exercise in China.

Role of Swimming in Rehabilitation to School-age Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To observe the effects of swimming on school-age children with cerebral palsy. MethodsHalliwick swimming method was used in swimming group (n=16), while the control group (n=15) received routine training. Before and after training, they were assessed with the Gross Motor Function Measure (GMFM-88) and the Berg Balance Scale. ResultsMost of the swimming group mastered swimming skills. The total scores of GMFM-88 and the Berg Balance Scale scores improved significantly in the swimming group (P<0.05), but not significantly in the control group (P>0.05) after training. ConclusionHalliwick technique is an effective way to learn swimming for school-age children with cerebral palsy. There is certain effect of swimming on motor function, especially on the balance functions.