Halliwick Concept on Motor Functions in Spastic CP

Effect of Hydrotherapy (Halliwick Concept)on Motor Function in Spastic Cerebral Palsy: A Randomized Controlled Trial

This randomized controlled trial will investigate the effect of hydrotherapy (halliwick concept) on motor functions in children with spastic cerebral palsy (CP). Minimum of 30 Spastic CP children will be recruited for this study. Children will be randomly assigned into control group who will receive conventional selected exercise treatment or study group who will receive the same conventional program in addition to underwater exercise program. Motor function will be evaluated at baseline and after 3 months of treatment. No potential harms are expected during this study.

Inclusion Criteria:

• Children from both sexes diagnosed with spastic CP according to a pediatrician
• The degree of spasticity will be determined as grade two or less according to modified Ashworth scale
• Their age will range from five to nine years
• Intelligence quotient score > 35 (no worse than moderate intellectual disability) as assessed via Wechsler test scales
• No severe psychosocial or behavioral problems, such high aggression or risk of self-harm.

Exclusion Criteria:

• Initiation of oral antispastic medication
• botulinum toxin injections or surgery performed less than 90 days before enrollment
• severe visual or auditory impairment
• uncontrollable epilepsy (defined as the occurrence of seizures despite the use of at least one antiepileptic drug)
• open wounds
• children with a psychiatric disorder
• cognitive disorders evaluated by the pediatric evaluation of disability inventory
• uncontrolled epilepsy
• active infection
• severe cardiopulmonary disorders.