Effectiveness of Bobath/Halliwick on Children With Cerebral Palsy

Study Overview
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Brief Summary
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Investigation of the effectiveness of water based therapy on children with Cerebral Palsy (CP)

Detailed Description
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The purpose of this randomized controlled trial was: To examine the effectiveness of the Halliwick concept intervention in water approach for people with motor deficiency and, more specifically, for children with diagnosed cerebral palsy. In a second phase, to compare the contribution of water intervention to the child's motor development against just Bobath physiotherapeutic intervention, in terms of the milestones of gross motor skills of the children over time. The aim of the research is to determine the contribution of the Halliwick Concept- Hydrotherapeutic Intervention approach in the psychomotor development in children with cerebral palsy and to explore its contribution to a comprehensive therapeutic approach for these children. It is a fact that, in recent years, parallel therapeutic approaches have gained ground, which, in combination with the physiotherapeutic treatment, contributes to the enhancement of therapeutic effects in early and follow-up intervention for children with cerebral palsy. The study resulted from the fact that there is not such a large-scale study in Greece. Also, there are few published studies in the world, trying to evaluate the therapeutic benefit of the Halliwick Concept as an hydro-therapeutic approach.

Official Title
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The Effectiveness of the Bobath Neurodevelopmental Treatment and Halliwick Concept Hydrotherapy in the Treatment of Children With Cerebral Palsy.

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Halliwick Concept


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with Cerebral Palsy Not have some type of surgery or botulinum toxin infusion in the last year. The children with cognitive limitations were selected, in order to be able to execute elementary commands. Attending treatment program by the same therapist, either on water, or on land. Exclusion Criteria: Children with autism Children who had some scheduled surgery or botulinum toxin injection. Children with severe vision problems Children who could not follow the verbal instructions or reproduce a test reproduction. Children who were absent from the treatment program either in the water or on land for over a week

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 3 groups, 80 children with CP group: Intervention in water- halliwick, 40 children group: On land therapy- bobath, 40 children group: No intervention
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Halliwick Assessment Group<br>8 children with GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM (GMFCS) I, 13 children with GMFCS II, 7 GMFCS III children, 8 GMFCS IV children and 4 children with GMFCS V. Intervention in water environment (Halliwick Concept), 1 times/week- 1 intervention on land/week, 9 months duration. | Other: Halliwick Concept<br>* Halliwick Concept: Water intervention Bobath Concept: Neurodevelopmental Treatment<br>* Other names: Bobath Concept;|
| Experimental: Bobath Assessment Group<br>7 children with GMFCS I, 12 children with GMFCS II, 8 children with GMFCS III, 6 children with GMFCS IV and 2 children with GMFCS V. Intervention on land ( Bobath), 2 times/week, 9 months duration. | Other: Halliwick Concept<br>* Halliwick Concept: Water intervention Bobath Concept: Neurodevelopmental Treatment<br>* Other names: Bobath Concept;|
| No Intervention: No intervention group<br>1 children with GMFCS I, 1 child with GMFCS III, 1 child with GMFCS IV and 2 GMFCS V children. No intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| GMFM | GROSS MOTOR FUNCTION MEASURE (Scale for gross mobility) (scoring 0%-100%) | 9 months | 
| PEDI | PEDIATRIC EVALUATION OF DISABILITY INVENTORY (Scale for assess the daily life activities) (scoring 0%-100%) | 9 months | 
| PBS | PAEDIATRIC BALANCE SCALE (BERG BALANNCE SCALE MODIFIED) (Scale for assess the balance) (score 0-56) | 9 months | 
| TUG | TIMED UP AND GO (Scale to asses speed) (the minimoum time the better) | 9 months | 
| WOTA 1 | WATER ORIENTATION TEST ALYN 1 (Aquatic Scale to asses adaptation in water environment) (Aquatic Score 0- 52) | 9 MONTHS | 
| WOTA 2 | WATER ORIENTATION TEST ALYN 12 (Aquatic Scale to asses adaptation in water environment) ( Score 0-81) | 9 months | 
| SWIM | SWIM WITH INDEPENDENT MEASURE (Aquatic Scale to asses adaptation in water environment) (Score 0-71) | 9 months | 
| HAAR | HUMPHRIES' ASSESSMENT OF AQUATIC READINESS (Aquatic Scale to asses adaptation in water environment)(Score 0-34) | 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aquatic therapy, pediatrics, cerebral palsy, Bobath, Halliwick