Getz (2012) 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

Introduction: The Challenge of Cerebral Palsy (CP) in Children

Cerebral Palsy (CP) represents a group of permanent movement and posture disorders, severely affecting the activity levels due to disturbances in the developing brain of infants or fetuses. Children with CP exhibit a range of functional restrictions including exaggerated muscle tone, reduced range of motion, and diminished muscular strength, which collectively compromise their walking ability. Notably, these children experience an increased metabolic cost of walking (MCW), necessitating up to three times the energy compared to their peers without disabilities.

Study Aim: Comparing Aquatic and Land-Based Interventions

This pilot study aimed to evaluate the impact of aquatic (AQ) versus land-based (LB) training programs on the MCW, gross motor function, and locomotor performance in children with CP. Eleven children with spastic diplegic CP participated, divided into AQ (n=6) and LB (n=5) groups. The study measured oxygen uptake (VO2) to derive MCW, alongside assessments including the 10-m walk test, Gross Motor Function Measure (GMFM), and Pediatric Evaluation Developmental Inventory (PEDI).

Methodology: Tailored Training Programs

The AQ group underwent a tailored 30-minute aquatic session twice weekly, focusing on improving water adjustment skills and functional abilities, while the LB group received land-based exercises aimed at enhancing fundamental motor skills and treadmill walking.

Results: Significant Improvements in AQ Group

Post-intervention analysis revealed a significant decrease in MCW and an increase in steady-state walking speed exclusively in the AQ group, indicating enhanced energy efficiency in walking. Both AQ and LB groups showed significant improvements in the 10-m walking speed, although the AQ training additionally improved the MCW of walking at steady state.

Conclusion: The Advantage of Aquatic Training

The findings suggest that while both AQ and LB interventions can enhance walking speed, aquatic training uniquely improves the metabolic efficiency of walking in children with spastic diplegic CP. This underscores the potential of aquatic training as an effective rehabilitation strategy, complementing traditional land-based therapies.

Keywords: Cerebral Palsy, Aquatic Training, Land-Based Training, Metabolic Cost of Walking, Motor Performance, Rehabilitation, Children.