Aquatic high intensity interval training to improve aerobic capacity is feasible in adolescents with cerebral palsy: pilot randomised controlled trial

Abstract

Objective: To investigate feasibility of aquatic high intensity interval training for adolescents with cerebral palsy, who can ambulate independently but may choose a mobility aid in some circumstances. Design: Pilot randomised controlled trial. Method: Following baseline assessments, participants were randomised to usual care or ten weeks of twice weekly aquatic high intensity interval training. Each class comprised 10 one-minute exercise intervals separated by one-minute rest. High intensity exercise was defined as the attainment of ⩾80% of peak heart rate measured by telemetry. Setting: Tertiary paediatric hospital. Main Measures: Primary outcomes related to the feasibility of the protocol to progress to a definitive trial. Consumer feedback was obtained. Results: Of 119 potential participants, 46 appeared eligible and 17 consented, resulting in a recruitment fraction of 37% (95% CI 23–52). Twelve completed baseline assessments and were randomised (5 males; 14 years 7 months SD 2 years 0 months). In the intervention group, of the 1190 exercise stations (across all participants and sessions), heart rate data were available for 1180 stations and high intensity exercise was achieved during 1111 stations (93%, 95% CI 92–95). All randomised participants completed the study and reported that the intervention was fun and provided friendship opportunities. There were no major adverse events or exacerbation of pain. Conclusions: Aquatic high intensity interval training in ambulant adolescents with cerebral palsy is feasible, while maintaining adherence and fidelity. Uncertainty remains on the efficacy of the intervention, highlighting the need for a large definitive trial.

The effect of hydrotherapy on the functioning and quality of life of children and young adults with cerebral palsy

“…Properties of water, such as buoyancy, facilitate the exercise without pain, as in relation to the exercise programs on land, the friction of the joints and the risk of falls are reduced. The results showed a significant improvement in gross mobility and more specifically the quality and distance of gait and static standing position [6][7][8][9][10]14] . There was also an improvement in the cardiorespiratory system in endurance, balance, fluidity of movement and range of motion [9] .…”

“…There was also an improvement in the cardiorespiratory system in endurance, balance, fluidity of movement and range of motion [9] . Management of spasticity showed improvement, but to a lesser extent, as did muscle strength [6][7][8][9][10][11] . The improvement of the psychological condition of these children as well as their social skills, with special emphasis on their willingness to participate in activities, in family, therapeutic and school context was also noted [11] .…”

“…The researchers concluded that children with CP who attend a hydrotherapy program for 14 weeks, with two sessions per week, and follow moderate to vigorous exercise and functional activities, will notice an improvement in their gross motor skills and gait endurance. In another study, Depiazzi et al [10] conducted a randomized controlled trial to study the effect of a high-intensity interval training (HIIT) aquatic program on adolescents with CP who move independently but may, at times, choose an aid. The study involved 12 participants, who were randomized into two equal groups, one following a conventional exercise program and the other a HIIT program in the water.…”

Exercícios aeróbicos aquáticos em indivíduos com Paralisia Cerebral: Revisão Sistemática

“…Indivíduos com PC podem apresentar dificuldades para a execução dos exercícios máximos e submáximos, por conta de sobrecargas articulares, alterações posturais, amplitudes de movimentos limitadas e quadros álgicos 12,13 . Portanto, uma das alternativas para a realização dos exercícios aeróbicos é a realização no ambiente aquático 14 .…”

“…O ambiente aquático promove benefícios através dos princípios físicos e termodinâmicos da água 14 . O indivíduo em imersão sofre alterações fisiológicas, como, aumento do débito cardíaco, diminuição da resistência vascular periférica, diminuição da frequência cardíaca e consequente facilitação do retorno venoso, por conta da pressão hidrostática e temperatura aquecida da água 15 .…”