The effect of hydrotherapy according to Halliwick concept on children with cerebral palsy and the evaluation of their balance: a randomised clinical trial

Abstract

<p><strong>Background:</strong> Hydrotherapy according to Halliwick concept is a physiotherapeutic intervention technique for disabled patients and for children with neurodevelopmental disorders. Assessing the balance in children with cerebral palsy (CP) is an extremely complex process and more difficult to evaluate the results of some therapeutic interventions in these patients. The purpose of this study is to investigate the effect of Halliwick based Hydrotherapy on the support base in children with CP. Several studies have proven the beneficial effects of hydrotherapy in the respiratory system of children, but few are studies that report the effect on the balance of children with CP.</p><p><strong>Methods:</strong> The study involved 16 children diagnosed with CP. The 10 children were following a Halliwick Concept hydrotherapy program and the 6 children classical physiotherapy program for 3 months. Their balance was assessed with the Berg, GMFM, and footprint plate. The assessment was performed at the start of the program (pre-test) and after 3 months (post-test).</p><p><strong>Results</strong>: Τhere is a statistically significant change between the 1<sup>st</sup> and 2<sup>nd</sup> measurement with the BERG and GMFM tools and better for the water intervention group. The change in the support base between the 1st and 2nd measurement was better in the water intervention group but not statistically significant.</p><p><strong>Conclusions:</strong> The results of the study showed that hydrotherapy according to Halliwick has positive effects on gross mobility and the balance of children with CP. It also appears to have a positive effect on changing the support base compared to classical physiotherapy.</p>

Aquatic Interventions to Improve Motor and Social Functioning in Children with ASD: A Systematic Review

“…Their 8-week aquatic interventions showed significantly improved locomotor and object control skills in both the Halliwick and the swim technique group, compared to the controls doing sports as usual. This is consistent with studies that have reported improvements in balance and motor skills after an aquatic intervention in children and adults with neurological disorders (Carroll et al, 2020;Chandolias et al, 2022;Fatorehchy, 2019;Montagna et al, 2014;Terrens et al, 2020;Veldema & Jansen, 2021). These findings are valuable as they suggest a positive transfer of learned water-related motor skills to land-related balance and locomotion which, in turn, can contribute to reducing the risk of motor impairments in children with ASD (Mickle et al, 2011;Stins & Emck, 2018).…”

The effects of Halliwick aquatic exercises on gross motor function of children aged from 3 to 5 years with spastic cerebral palsy

“…This finding is in agreement with our study regardless of age. A beneficial effect of the Hallwick aquatic method on sitting, walking, running & jumping activities compared to conventional exercises might be attributed to the fact that children engaged in aquatic activities using the Halliwick Concept learn on their own and, they always work at one to one with a personal instructor who knows when and how to progress [22]. Besides, the Halliwick concept teaches independence allowing the child to move and swim without the help of others, which contributes to improving self-esteem and self-awareness [29].…”

“…Besides, the Halliwick concept teaches independence allowing the child to move and swim without the help of others, which contributes to improving self-esteem and self-awareness [29]. Children may see the activity on water as a recreational or sporting activity, increasing adherence to the program [22].…”

“…According to the Halliwick idea, patients first learn how to balance in a stable posture before learning how to balance while traveling through the water in an unstable position [18,19]. The idea has been shown to improve motor function in children with CP, although the evidence supporting this claim is poor and primarily based on observational studies [20,21,22,23]. In recent years, parallel therapeutic approaches are gaining ground, which in combination with physiotherapy treatment contribute to the increase of therapeutic results in early and post-intervention for children with cerebral palsy.…”