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The effect of aquatic therapy on postural balance and muscle strength in stroke survivors--a randomized controlled
Dong Koog Noh1, Jae-Young Lim, Hyung-Ik Shin
1Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
Objective:
To evaluate the effect of an aquatic therapy programme designed to increase balance in stroke survivors.
Design:
A randomized, controlled pilot trial.
Setting:
Rehabilitation department of a university hospital.
Subjects:
Ambulatory chronic stroke patients (n = 25):13 in an aquatic therapy group and 12 in a conventional therapy group.
Interventions:
The aquatic therapy group participated in a programme consisting of Ai Chi and Halliwick methods, which focused on balance and weight-bearing exercises. The conventional therapy group performed gym exercises. In both groups, the interventions occurred for 1 hour, three times per week, for eight weeks.
Main Measures:
The primary outcome measures were Berg Balance Scale score and weight-bearing ability, as measured by vertical ground reaction force during four standing tasks (rising from a chair and weight-shifting forward, backward and laterally). Secondary measures were muscle strength and gait.
Results:
Compared with the conventional therapy group, the aquatic therapy group attained significant improvements in Berg Balance Scale scores, forward and backward weight-bearing abilities of the affected limbs, and knee flexor strength (P < 0.05), with effect sizes of 1.03, 1.14, 0.72 and 1.13 standard deviation units and powers of 75, 81, 70 and 26%, respectively. There were no significant changes in the other measures between the two groups.
Conclusions:
Postural balance and knee flexor strength were improved after aquatic therapy based on the Halliwick and Ai Chi methods in stroke survivors. Because of limited power and a small population base, further studies with larger sample sizes are required.