The Effect of Aquatic and Land-Based Training on the Metabolic Cost of Walking and Motor Performance in Children with Cerebral Palsy: A Pilot Study

Abstract

Aim . To evaluate the effects of aquatic (AQ) compared to a land-based (LB) intervention programs on metabolic cost of walking (MCW), gross motor function and locomotor performance in children with cerebral palsy (CP). Methods . Eleven children with spastic diplegic CP completed this study, six in the AQ (5.2 ± 1.45 yrs) and five in the LB group (4.1 ± 1.33 yrs). MCW derived from Oxygen uptake (VO 2 ) measured with a Cosmed K4 device and walking speed at steady state. Additional measures included the 10-m test, Gross Motor Function Measure (GMFM), and Pediatric Evaluation Developmental Inventory (PEDI). Non-parametric statistics were used to analyze change in each group. Results . The AQ group significantly decreased MCW ( Z = − 2.2 ; P < .05 ) and increased steady state walking speed ( Z = − 2.2 ; P < .05 ). Both groups significantly increased 10-m walking speed ( Z = − 2.2 ; P < .03 , and Z = − 2.02 ; P < .05 , resp.). The LB group exhibited moderate to large effect sizes in 10-m self-selected and fast walking speeds (Cohen's d = 1.07 and 0.73, resp.). Conclusion . Our findings suggest that Both AQ and LB programs were effective in improving 10-m speed, while the AQ training also improved the MCW of walking at steady state in children with spastic diplegic CP.