Effect of a structured aqua-plyometric exercise program on postural control and functional ability in children with hemiparetic cerebral palsy: A two-arm randomized controlled trial

BACKGROUND: Individuals with hemiparetic cerebral palsy (h-CP) encounter postural control issues that largely interfere with activity and participation. So, there might be a need for improved, clearly effective rehabilitation protocols that target postural control dysfunction, which may, then, reduce activity limitations and participation restrictions. OBJECTIVE: This trial was undertaken to examine the effect of a structured, 12-week aqua-plyometric (Aqua-PLYO) exercise program on postural control and functional ability in children with h-CP. METHODS: Fifty-six children with h-CP took part in a two-arm, randomized single-blind controlled trial. They were randomly assigned to either receive the standard physical therapy (Control group; n'='28) or the Aqua-PLYO training program (Aqua-PLYO group; n'='28), three times/week over 12 consecutive weeks. The dynamic limit of stability [i.e., movement directional control (M-DC), reaction time (ReT), movement velocity (M-Vel), endpoint excursion (EP-Exc), and maximum excursion (M-Exc)] and functional ability [i.e., 30-second sit-to-stand test (30sec-STS), timed up and down stairs test (TUDS), and the dynamic gait index (DGI)] were assessed pre- and post-treatment. RESULTS: From the pre- to post-treatment occasion, the Aqua-PLYO group achieved greater improvement for the M-DC (P'='0.013), ReT (P'='0.004), M-Vel (P'='0.03), EP-Exc (P'='0.002), and M-Exc (P'='0.006), compared to controls. Besides, the Aqua-PLYO group showed more conducive changes in functional ability [as evidenced by the 30sec-STS (P'='0.005), TUDS (P'='0.002), and DGI (P'='0.004) scores]. CONCLUSION: Aqua-PLYO training is likely an effective training paradigm for enhancing postural control and functional ability in children with h-CP. Further studies are, however, recommended to substantiate the current evidence.