Halliwick
The Halliwick Concept focuses on biophysical principles of motor control in water, in particular developing sense of balance (equilibrioception) and core stability. The Halliwick Ten-Point-Programme implements the concept in a progressive programme of mental adjustment, disengagement, and development of motor control, with an emphasis on rotational control, and applies the programme to teach physically disabled people balance control, swimming, and independence. Halliwick Aquatic Therapy (also known as Water Specific Therapy, WST), implements the concept in patient-specific aquatic therapy for application in rehabilitation of injury and disability. The Halliwick Concept. The Halliwick Concept was originally developed by  fluid mechanics engineer James McMillan in the late 1940s and 1950s, at the Halliwick School for Girls with Disabilities in London, to teach physically disabled people independence in water. Based on fluid mechanics, McMillan developed teaching and therapeutic approaches to enhance sense of balance (equilibrioception) and core stability. According to the Halliwick Concept, physical properties of water form the basis for therapeutic intervention: The first part of the concept, the Halliwick Ten-Point-Programme, incorporates these biophysical principles and focuses on mental adjustment, disengagement, and development of motor control, with an emphasis on rotational control, and is applied to teach  participation in water activities, moving independently in water, and swimming. McMillan emphasized participation and independence: the willingness to lose balance and knowing how to stand up again. The second part of the concept, Halliwick Aquatic Therapy (also known as Water Specific Therapy, WST), applies the fundamental biophysical principles and the underlying principles of the Ten-Point-Programme for planning and implementing patient-specific aquatic therapy. Technique. The Halliwick Ten-Point-Programme. The first part of the Halliwick Concept implements the Halliwick Ten-Point-Programme to develop balance control, swimming skills, and independence: Halliwick Aquatic Therapy. The second part of the  Halliwick Concept, known as Halliwick Aquatic Therapy (also called Water Specific Therapy, WST) is an aquatic therapy approach developed in Bad Ragaz, Switzerland since 1974. Halliwick Aquatic Therapy is a system-oriented aquatic motor (re)learning approach, which includes elements of the Ten-Point-Programme. It uses a holistic task-directed approach within the context of the International Classification of Functioning, Disability and Health (ICF), in particular postural control, normalizing muscle stiffness, and facilitation of movement to attain functional goals on land. It also follows training guidelines of physiology and its clinical reasoning in various patient populations. Most Halliwick therapy is  active (dynamic) to facilitate movement and sensory input. Halliwick also has a passive (static) component, in which, for example involving selective activation of muscles and stabilization of specific joints by the therapist. Halliwick Aquatic Therapy is a problem-solving approach, in that specific possibilities and constraints of the client are analyzed in order to plan a systematic intervention to help the client gain functional increases. Applications. The Halliwick Ten-Point-Programme has been applied for teaching swimming to people with disability, as well as more broadly as a general approach to teaching swimming and working with disability. Halliwick Aquatic Therapy  has mainly used in neurorehabilitation and pediatrics. It has resemblances to Bobath and Conductive education. In neurological and paediatric rehabilitation, clients can experience early mobility. The mechanical advantages of water support the abilities of the trunk in a mobilising and stabilising way. In this sense Halliwick is a constraint-induced movement therapy without the disadvantage of gravity compensation. Many activities easily can be repeated and varied and clients can learn balance- and stumble- strategies, which have carry-over effects to dry land. This application in fall prevention is extended by using obstacle courses or Ai Chi. Halliwick also enables a  graded activity programme: with low mechanical impact and increasing physiological demand, chronic low back pain patients and others can increase their functional capacity in a mostly joyful way.