Sequential water-based balance training after stroke (2020)

Home / Knowledge / Temperoni (2020) A Water-Based Sequential Preparatory Approach vs. Conventional Aquatic Training in Stroke Patients: A Randomized Controlled Trial With a 1-Month Follow-Up

In short: In this randomized controlled trial, people with chronic stroke followed four weeks of aquatic balance training: either a sequential preparatory approach (SPA) or conventional aquatic training. Both groups improved; the SPA group improved more on balance and stroke-specific quality of life.

About this study

Temperoni and colleagues randomly assigned 33 outpatients with hemiplegia after chronic stroke to water-based SPA balance training or traditional water balance training. Both groups trained 45 minutes twice a week for four weeks in a rehabilitation pool. Patients were assessed before training, after four weeks and four weeks after the end of training with the Berg Balance Scale, the modified Barthel Index, the Tinetti balance and gait scale, the Stroke Specific Quality of Life Scale and the modified Ashworth scale. Data of 28 patients after training and 24 at follow-up were analyzed.

Main findings

Both groups improved significantly on all clinical scales over time.
After training, the SPA group scored significantly higher on the Berg Balance Scale (p = 0.01) and on stroke-specific quality of life at follow-up (p < 0.05).
The SPA group showed a significantly greater percentage of improvement on the Berg Balance Scale (p = 0.02) and quality of life (p = 0.03).
Both groups improved significantly on the modified Ashworth scale for spasticity.

The authors conclude

The authors conclude that a sequential, preparatory water-based approach can be more effective than conventional aquatic therapy for improving motor function and quality of life in chronic stroke survivors in the short and medium term.

Limitations

The sample was small and mixed (ischemic and hemorrhagic stroke, both hemispheres), there was no instrumental gait analysis, water depth was not adapted to height and there was no land-based comparison group.

Source

Temperoni G, Curcio A, Iosa M, Mangiarotti MA, Morelli D, De Angelis S, Vergano S, Tramontano M. A Water-Based Sequential Preparatory Approach vs. Conventional Aquatic Training in Stroke Patients: A Randomized Controlled Trial With a 1-Month Follow-Up. Frontiers in Neurology. 2020;11:466. doi: 10.3389/fneur.2020.00466. Published under a Creative Commons Attribution (CC BY) licence.