The partial immersion aquatic approach using adjustable weight bearing to improve posture and sitting balance adaptation for children with severe cerebral palsy

Abstract

The innovative "Partial Immersion" Aquatic Therapy Approach was developed to enhance balance and posture during sitting adaptation for children with severe cerebral palsy who exhibit deficiency in those skills on land. Stable balance during sitting posture is one of the preconditions for hands function in activities of daily living. Aquatic skills learned during aquatic therapy were then transferred to a land environment. Therapy included the use of a treatment chair that enabled adjustable weight bearing in a series of 30 mm steps. A mixed-methods design employing a multiple case study approach (n=5) including quantitative and qualitative methods investigated the effectiveness of the proposed treatment. Cases were tested at pre-and post-treatment times (base-lines 1 and 2) and at a 12-month follow-up point. All participants improved posture and balance adaptations during free sitting on land. Water intervention treatments achieved the highest improved output result as measured per minute of treatment time. Combined water-land treatments achieved less efficient results and the land-only intervention achieved the lowest output results in relation to minute of treatment time. The findings extend our knowledge in relation to theories of natural selection, motor control, motor learning and dynamical systems.