Menchero Sánchez-Cifuentes (2025) Influence of Aquatic Physiotherapy on Mobility in People with Spinal Cord Injury: A Randomized Controlled Trial
Summary
Incomplete spinal cord injury (SCI) often results in impaired balance, reduced walking ability and loss of functional independence. In this randomized controlled doctoral study, Raquel Menchero Sánchez-Cifuentes (2025) investigated whether adding a structured aquatic physiotherapy programme to conventional rehabilitation could improve mobility outcomes in people with incomplete SCI during the acute and subacute rehabilitation phase.
Fifty participants with incomplete spinal cord injury (<6 months after injury) were randomly assigned to either standard rehabilitation alone or standard rehabilitation combined with 18 aquatic therapy sessions over six weeks. Balance, gait performance and health-related quality of life were evaluated using validated clinical outcome measures, including the Berg Balance Scale (BBS), Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), WISCI-II and quality-of-life questionnaires.
The aquatic therapy group demonstrated significantly greater improvements in balance than the control group. Participants receiving aquatic rehabilitation were nearly four times more likely to achieve clinically meaningful improvements on the Berg Balance Scale, while posturography also showed improved stability on unstable surfaces. Although no significant additional improvements were found in walking speed, walking endurance or health-related quality of life, over 90% of participants in the aquatic therapy group achieved independent walking by the end of the intervention.
The authors conclude that aquatic physiotherapy is a safe, effective and adaptable rehabilitation intervention for people with incomplete spinal cord injury, particularly for improving balance during the early stages of recovery. The buoyancy, reduced joint loading and supportive aquatic environment enable intensive task-specific balance training while minimizing the risk of falls. Further research is recommended to determine the optimal treatment duration and timing within SCI rehabilitation.
