Comparative study between aquatic therapy and land-based exercises in hemiplegic patients after stroke: a randomized controlled trial.

OBJECTIVE: This study aimed to assess the effects of aquatic therapy in individuals with hemiplegia compared to those of a conventional land-based exercise program. DESIGN: This was a blinded, randomized controlled study of chronic stroke patients with hemiplegia. The participants were randomized in to aquatic therapy (experimental) or conventional therapy (control) groups. The aquatic therapy group conducted the exercise program in a swimming pool, and the conventional therapy group performed to an exercise on the land environment three times per week for six weeks. Both interventions focused on posture, balance, and weight-bearing exercises. Outcomes included the Berg Balance Scale, Brunnstrom scale, Motricity Index, muscle strength tests, Modified Ashworth Scale, Postural Assessment Scale for Stroke, Trunk Control Test and Functional Independence Measure. Also, postural sway was evaluated by using the variables of center of pressure displacements in the mediolateral and anteroposterior directions. RESULTS: The findings of the present study show that the experimental group (26 patients) exhibited significant improvements in spasticity compared to the control group (25 patients) (p = 0.01). The conventional therapy group also achieved significant improvements (p < 0.05) in anteroposterior deviation, mediolateral velocity, and total velocity of center of pressure in a sitting position with eyes closed. CONCLUSION: Land-based exercises were more beneficial in the spasticity of chronic stroke patients.

The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy.

Purpose: To evaluate the efficacy of Equine Assisted Therapy in children with Cerebral Palsy, in terms of gross motor function, performance, and spasticity as well as whether this improvement can be maintained for 2 months after the end of the intervention. Methods: Children with Cerebral Palsy participated in this prospective cohort study. The study lasted for 28 weeks, of which the equine assisted therapy lasted 12 weeks taking place once a week for 30 min. Repeated measures within the subject design were used for the evaluation of each child's physical performance and mental capacity consisting of six measurements: Gross Motor Function Measure-88 (GMFM-88), Gross Motor Performance Measure (GMPM), Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS) and Wechsler Intelligence Scale for Children (WISC III). Results: Statistically significant improvements were achieved for 31 children in Gross Motor Function Measure and all its subcategories (p < 0.005), also in total Gross Motor Performance Measure and all subcategories (p < 0.005). These Gross Motor Function Measure results remained consistent for 2 months after the last session of the intervention. Regarding spasticity, although an improving trend was seen, this was not found to be statistically significant. Conclusion and implications: Equine Assisted Therapy improves motor ability (qualitatively and quantitatively) in children with Cerebral Palsy, with clinical significance in gross motor function.