Eficácia da fisioterapia aquática no equilíbrio de crianças com paralisia cerebral

Abstract

INTRODUCTION: Children with cerebral palsy (CP) have balance disorders, involuntary movements and atypical gait. Aquatic Physical Therapy is an alternative approach that has been widely used in the treatment of children with CP. AIM: To determine the efficacy of an Aquatic Physical Therapy protocol based on tasks oriented training to improve balance in children with CP. METHODS: This study is a clinical study with series of cases, type ABA, with multiple evaluations, where A1 are pre-treatment evaluations (baseline), B - treatment evaluations and A2 evaluations after one month of treatment. This work was approved by the University Ethical committee with CAAE: 43225914.7.0000.5546, n: 1.114.628. The sample was composed of children with CP. Inclusion criteria: Age between 5 and 18 years; Classification in GMFCS I, II, III and able to perform the commands. Exclusion criteria: Children with severe cognitive impairment, infectious skin disease, severe scoliosis, severe cardiovascular problems, epilepsy, and using urinary or a colostomy catheter. The intervention consisted of activities performed in the pool, once a week, lasting 50 minutes, totaling 10 sessions. The instruments used for evaluation were the Pediatric Berg Balance Scale (BERG), the Functional Reach Test and the Timed Up & Go Test (TUG). RESULTS: Three children, all classified as spastic hemiplegia, GMFCS I and MACS I, participated in this study. Two of three children showed a significant improvement in all balance assessments. Child 3 already started the intervention with very good balance scores and because of the ceiling effect at the used measures, there was no significant improvement for him. CONCLUSION: The aquatic physiotherapy protocol based on oriented tasks was shown to be effective in improving balance in children with CP.