水中运动治疗对脑性瘫痪儿童青少年运动功能和活动效果的系统评价与Meta分析

doi:10.3969/j.issn.1006-9771.2021.01.012

Abstract

Abstract: Objective To evaluate the intervention effects of aquatic therapeutic exercise on functioning and quality of life for children and youth with cerebral palsy within framework of World Health Organization Family International Classifications using systematic review. Methods Literatures were retrieved and reviewed from the databases of Cochrane Library, PEDro, PubMed, EMBASE, Web of Knowledge, Web of Science, OVID, EBSCO, CMCI, CNKI, Wangfang and VIP until May, 2020. The randomized controlled trials (RCTs) about aquatic therapeutic exercise for children and youth with cerebral palsy for functioning were systematically reviewed. The data were analyzed with RevMan 5.3. Results Nine RCTs were selected, including 162 children and youth. The score of Gross Motor Function Measure improved significantly after aquatic exercise (WMD = 6.31, 95 %CI 2.57 to 10.06, P < 0.001), as well as daily activities and quality of life. Conclusion Aquatic therapeutic exercise can help improve the gross motor function of children and youth with cerebral palsy, and has positive effects on function of activity and quality of life.

Key words: cerebral palsy, aquatic therapeutic exercise, motor function, activities, quality of life, meta-analysis

CLC Number:

R742.3

CUI Yao, XIAO Dun-wu, DING Lin, QIU Fu-bing, CONG Fang, QIU Zhuo-ying. Effects of Aquatic Therapeutic Exercise on Motor Function and Activities for Children and Youth with Cerebral Palsy: A Systematic Review and Meta-Analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(1): 79-92.

References

1 中华医学会物理医学与康复学分会康复治疗学组,中国医师协会康复医师分会水疗康复专业委员会,中国康复医学会循证康复医学工作委员会. 脑性瘫痪儿童水中运动治疗临床实践指南[J]. 中国康复理论与实践, 2021, 27(1): 1-14. Group of Rehabilitation Therapy, Branch of Physical Medicine and Rehabilitation, Chinese Medical Association; Special Committee of Aquatic Rehabilitation, Branch of Rehabilitation, Chinese Medical Doctor Association;Working Committee of Evidence-based Rehabilitation Medicine, Chinese Association of Rehabilitation Medicine. Clinical Practice Guideline on Aquatic Therapeutic Exercise for Children with Cerebral Palsy [J]. Chin J Rehabil Theory Pract, 2021, 27(1): 1-14.
2 World Health Organization. International Classification of Diseases (ICD) [EB/OL]. [2020-09-02]. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/76906748.
3 邱卓英,李伦,陈迪,等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 26(2): 125-135. Qiu Z Y, Li L, Chen D, et al. Research on rehabilitation guidelines using World Health Organization Family International Classifications: framework and approaches [J]. Chin J Rehabil Theory Pract, 2020, 26(2): 125-135.
4 Green M M, Gaebler-Spira D. Cerebral palsy [J]. J Pediatr Rehabil Med, 2019, 12(2): 113-114.
5 Wimalasundera N, Stevenson V L. Cerebral palsy [J]. Pract Neurol, 2016, 16(3): 184-194.
6 Gorter J W, Currie S J. Aquatic exercise programs for children and adolescents with cerebral palsy: what do we know and where do we go? [J]. Int J Pediatr, 2011, 2011(2011): 712165.
7 罗文文. 功能性水疗对痉挛型脑瘫儿童肌力及运动功能的影响分析[J]. 中国疗养医学, 2018, 27(8): 909-911. Luo W W. Analysis of the effect of functional hydrotherapy on muscle strength and motor function of children with spastic cerebral palsy [J]. Chin J Convalescent Med, 2018, 27(8): 909-911.
8 Dimitrijevic L, Aleksandrovic M, Madic D, et al. The effect of aquatic intervention on the gross motor function and aquatic skills in children with cerebral palsy [J]. J Hum Kinet, 2012, 32(5): 167-174.
9 Novak I. Evidence-based diagnosis, health care, and rehabilitation for children with cerebral palsy [J]. J Child Neurol, 2014, 29(8): 1141-1156.
10 World Health Organization. International Classification of Health Interventions Beta-2 Version (ICHI Beta-2) [EB/OL]. [2020-09-02]. https://mitel.dimi.uniud.it/ichi/#http://id.who.int/ichi/entity/619012253.
11 崔尧,丛芳. 水疗[M]// 丛芳. 物理因子治疗技术. 北京:人民卫生出版社, 2019: 191-241. Cui Y, Cong F. Hydrotherapy [M]// Cong F. Physical Agents Therapy Technology. Beijing: People's Medical Publishing House, 2019: 191-241.
12 宋凡旭,李晓捷,程春凤,等. 水疗对痉挛型双瘫脑性瘫痪患儿粗大运动功能及下肢肌力肌张力的影响[J]. 中国中西医结合儿科学, 2015, 7(4): 331-333. Song F X, Li X J, Cheng C F, et al. Effect of hydrotherapy on gross motor function and muscle strength of lower limbs in children with spastic diplegic cerebral palsy [J]. Chin Pediatr Integr Tradit West Med, 2015, 7(4): 331-333.
13 Ryu K, Ali A, Kwon M, et al. Effects of assisted aquatic movement and horseback riding therapies on emotion and brain activation in patients with cerebral palsy [J]. J Physther Sci, 2016, 28(12): 3283-3287.
14 Badawy W M, Ibrahem M B. Comparing the effects of aquatic and land-based exercises on balance and walking in spastic diplegic cerebral palsy children [J]. Med J Cairo Univ, 2016, 84(1): 1-8.
15 Adar S, Dundar U, Demirdal U S, et al. The effect of aquatic exercise on spasticity, quality of life, and motor function in cerebral palsy [J]. Turk J Phys Med Rehabil, 2017, 63(3): 239-248.
16 Oliveira L C, Trócoli T O, Kanashiro M S, et al. Electromyographic analysis of rectusfemoris activity during seated to standing position and walking in water and on dry land in healthy children and children with cerebral palsy [J]. J Electromyogr Kinesiol, 2014, 24(6): 855-859.
17 Becker B E. Aquatic therapy in contemporaryneurorehabilitation: an update [J]. PM R, 2020, 12(6): 12435.
18 Kārkliņa B, Declerck M, Daly D J. Quantification of aquatic interventions in children with disabilities: a systematic literature review [J]. Int J Aquat Res Educ, 2013, 7(4): 344-379.
19 Depiazzi J, Smith N, Gibson N, et al. Aquatic high intensity interval training to improve aerobic capacity is feasible in adolescents with cerebral palsy: pilot randomised controlled trial [J]. Clin Rehabil, 2020, 2020: 269215520956499.
20 Margiotta D P E, Schitter A M, Fleckenstein J, et al. Applications, indications, and effects of passive hydrotherapy WATSU (WaterShiatsu): a systematic review and meta-analysis [J]. PLoS One, 2020, 15(3): e0229705.
21 邱卓英,李沁燚,陈迪,等. ICF-CY理论架构、方法、分类体系及其应用 [J]. 中国康复理论与实践, 2014, 20(1): 1-5. Qiu Z Y, Li Q Y, Chen D, et al. ICF-CY: framework, approach, classification and implementation [J]. Chin J Rehabil Theory Pract, 2014, 20(1): 1-5.
22 王国祥,梁兵,陶蓉,等. 基于ICF-CY的脑性瘫痪儿童运动功能评定及水疗方案[J]. 中国康复理论与实践, 2017, 23(2): 146-150. Wang G X, Liang B, Tao R, et al. Motor function evaluation and hydrotherapy scheme for children with cerebral palsy: based on ICF-CY [J]. Chin J Rehabil Theory Pract, 2017, 23(2): 146-150.
23 郝文哲,吴卫红,丛芳,等. 水疗对痉挛型双瘫儿童肺功能的影响 [J]. 中国康复理论与实践, 2010, 16(7): 622-625. Hao W Z, Wu W H, Cong F, et al. Effects of hydrotherapy on pulmonary function of children with spastic diplegia [J]. Chin J Rehabil Theory Pract, 2010, 16(7): 622-625.
24 Ballington S J, Naidoo R. The carry-over effect of an aquatic-based intervention in children with cerebral palsy [J]. Afr J Disabil, 2018, 7(1): 361.
25 Lai C J, Liu W Y, Yang T F, et al. Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities [J]. J Child Neurol, 2015, 30(2): 200-208.
26 Getz M, Hutzler Y, Vermeer A, et al. 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 [J]. ISRN Rehabil, 2012, 2012(3): 1-8.
27 Retarekar R, Fragala-Pinkham M A, Townsend E L. Effects of aquatic aerobic exercise for a child with cerebral palsy: single-subject design [J]. Pediatr Phys Ther, 2009, 21(4): 336-344.
28 Ballaz L, Plamondon S, Lemay M. Group aquatic training improves gait efficiency in adolescents with cerebral palsy [J]. Disabil Rehabil, 2011, 33(17-18): 1616-1624.
29 Fragala-Pinkham M A, Smith H J, Lombard K A, et al. Aquatic aerobic exercise for children with cerebral palsy: a pilot intervention study [J]. Physiother Theory Pract, 2014, 30(2): 69-78.
30 盛威威,李欣,邱卓英,等. 残疾儿童康复需求与康复服务发展研究[J]. 中国康复理论与实践, 2020, 26(5): 502-507. Sheng W W, Li X, Qiu Z Y, et al. Unmet needs and service of rehabilitation for children with disabilities [J]. Chin J Rehabil Theory Pract, 2020, 26(5): 502-507.
31 Anttila H, Autti-Ramo I, Suoranta J, et al. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review [J]. BMC Pediatr, 2008, 8(14): 1-10.
32 Franki I, Desloovere K, de Cat J, et al. The evidence-base for conceptual approaches and additional therapies targeting lower limb function in children with cerebral palsy: a systematic review using the ICF as a framework [J]. J Rehabil Med, 2012, 44(5): 396-405.
33 Getz M, Hutzler Y, Vermeer A. Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature [J]. Clin Rehabil, 2006, 20(11): 927-936.
34 Roostaei M, Baharlouei H, Azadi H, et al. Effects of aquatic intervention on gross motor skills in children with cerebral palsy: a systematic review [J]. Phys Occup Ther Pediatr, 2017, 37(5): 496-515.
35 Jorgić B, Dimitrijević L, Lambeck J, et al. Effects of aquatic programs in children and adolescents with cerebral palsy: systematic review [J]. Sport Sci, 2012, 5(2): 49-56.
36 Shaunak M, Kelly V B. Cerebral palsy in under 25s: assessment and management (NICE Guideline NG62) [J]. Arch Dis Child Educ Prac Ed, 2018, 103(4): 189-193.
37 Colvin C, Greve K, Lehn C, et al. Evidence-based Clinical Care Guideline for Physical Therapy Management of Single Event Multi-Level Surgeries (SEMLS) for Children, Adolescents, and Young Adults with Cerebral Palsy or Other Similar Neuromotor Conditions [EB/OL]. (2019-12-15). http://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/recommendations/default/.
38 Muñoz-Blanco E, Merino-Andrés J, Aguilar-Soto B, et al. Influence of aquatic therapy in children and youth with cerebral palsy: a qualitative case study in a special education school [J]. Int J Environ Res Public Health, 2020, 17(10): 3690.
39 Stirrups R. Cerebral palsy: managing expectations and optimising outcomes [J]. Lancet Child Adolesc Health, 2020, 4(3): 179-180.
40 崔尧,丛芳,金龙. Halliwick理念及其在水疗康复中的应用[J]. 中国康复理论与实践, 2013, 19(3): 239-245. Cui Y, Cong F, Jin L. Halliwick concept and its application in aquatic rehabilitation [J]. Chin J Rehabil Theory Pract, 2013, 19(3): 239-245.
41 罗杰,冷卫东. 系统评价/Meta分析理论与实践[M]. 北京:军事医学科学出版, 2013. Luo J, Leng W D. Theory and Practice of Systematic Review/Meta-Analysis [M]. Beijing: Military Medical Science Press, 2013.
42 Institute for Musculoskeletal Health, School of Public Health at the University of Sydney, Neuroscience Research Australia (NeuRA). Physiotherapy Evidence Database [EB/OL]. [2020-05-22]. https://www.pedro.org.au/.
43 The Cochrane Collaboration. Review Manager (RevMan) [CP]. The Nordic Cochrane Centre, 2014.
44 李初阳,梁琪,侯晓晖,等. 游泳对学龄期脑瘫儿童的康复作用[J]. 中国康复理论与实践, 2010, 16(7): 626-628. Li C Y, Liang Q, Hou X H, et al. Role of swimming in rehabilitation to school-age children with cerebral palsy [J]. Chin J Rehabil Theory Pract, 2010, 16(7): 626-628.
45 侯晓晖,李裕和,王春阳,等. Halliwick技术对学龄期脑瘫儿童平衡和粗大运动功能的影响[J]. 中国运动医学杂志, 2013, 32(10): 875-880. Hou X H, Li Y H, Wang C Y, et al. Effect of Halliwick technique on the gross motor function of preschool children with cerebral patsy [J]. Chin J Sports Med, 2013, 32(10): 875-880.
46 谷艳霞,王遐. 水疗对迟缓型脑瘫患儿运动功能康复的影响[J]. 中国实用神经疾病杂志, 2014, 17(9): 107-108. Gu Y X, Wang X. Effect of hydrotherapy on motor function rehabilitation of children with delayed cerebral palsy [J]. Chin J Pract Nerv Dis, 2014, 17(9): 107-108.
47 张瑞. 水疗配合感觉统合训练在脑性瘫痪儿童康复治疗中的应用观察 [J]. 中国疗养医学, 2018, 27(10): 1016-1019. Zhang R. Observation on the application of hydrotherapy combined with sensory integration training in rehabilitation treatment of children with cerebral palsy [J]. Chin J Convalescent Med, 2018, 27(10): 1016-1019.
48 Akinola B I, Gbiri C A, Odebiyi D O. Effect of a 10-week aquatic exercise training program on gross motor function in children with spastic cerebral palsy [J]. Glob Pediatr Health, 2019, 6(3): 2333794x19857378.
49 Chrysagis N, Douka A, Nikopoulos M, et al. Effects of an aquatic program on gross motor function of children with spastic cerebral palsy [J]. J Biol Exerc, 2009, 5(1): 13-25.
50 Declerck M, Verheul M, Daly D, et al. Benefits and enjoyment of a swimming intervention for youth with cerebral palsy: an RCT study [J]. Pediatr Phys Ther, 2016, 28(2): 162-169.
51 Olama K A, Kassem H I, Aboelazm S N. Impact of aquatic exercise program on muscle tone in spastic hemiplegic children with cerebral palsy [J]. Clin Med J, 2015, 1(4): 138-144.
52 崔尧,丛芳,李建军,等. Alyn水中适应性测试量表2的汉化及在脊髓损伤患者中的信度与效度 [J]. 中国康复理论与实践, 2018, 24(11): 1302-1308. Cui Y, Cong F, Li J J, et al. Water orientation test of Alyn 2 (chinese) and its reliability and validity in patients with spinal cord injury [J]. Chin J Rehabil Theory Pract, 2018, 24(11): 1302-1308.
53 金龙,丛芳,崔尧,等. Alyn水中适应性测试量表1的汉化及信度与效度研究[J]. 中国康复理论与实践, 2015, 21(5): 539-543. Jin L, Cong F, Cui Y, et al. Reliability and validity of chinese version of Water Orientation Test of Alyn 1 [J]. Chin J Rehabil Theory Pract, 2015, 21(5): 539-543.
54 Amini A, Salehi M, Bazgir B, et al. The effect of aquatic exercise therapy on gross motor function of students with spastic cerebral palsy [J]. Asian Exer Sport Sci J, 2020, 4(2): 21-28.
55 Kujala U M, Vaara J P, Kainulainen H, et al. Associations of aerobic fitness and maximal muscular strength with metabolites in young men [J]. JAMA Netw Open, 2019, 2(8): e198265.
56 丛芳,崔尧. 水中运动治疗的发展现状与展望[J]. 华西医学, 2020, 35(5): 527-533. Cong F, Cui Y. Development status and prospect of aquatic therapeutic exercise [J]. West Chin Med J, 2020, 35(5): 527-533.
57 2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report [M]. Washington, D. C.: U.S. Department of Health and Human Services, 2018.
58 Verschuren O, Peterson M D, Balemans A C, et al. Exercise and physical activity recommendations for people with cerebral palsy [J]. Dev Med Child Neurol, 2016, 58(8): 798-808.
59 Lowe L M, Bass-Carrigan D, Yates C C. Commentary on "Current Physical Therapy Practice in Norway for Children With Cerebral Palsy" [J]. Pediatr Phys Ther, 2021, 33(1): 46.
60 梁兵,丁相平,邱卓英,等. 残疾儿童的社区康复:理论、架构和方法[J]. 中国康复理论与实践, 2014, 20(9): 817-819. Liang B, Ding X P, Qiu Z Y, et al. Habilitation/rehabilitation of children with disabilities at community setting: framework and approach [J]. Chin J Rehabil Theory Pract, 2014, 20(9): 817-819.
61 姜静远,邱卓英,王国祥,等. 世界卫生组织国际健康分类家族在康复中系统应用的方案与路线图[J]. 中国康复理论与实践, 2020, 26(11): 1241-1255. Jiang J Y, Qiu Z Y, Wang G X, et al. Systematic implementation of World Health Organization Family International Classifications in rehabilitation: protocol and roadmap [J]. Chin J Rehabil Theory Pract, 2020, 26(11): 1241-1255.

[1]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[2]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[3]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[4]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[5]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[6]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[7]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[8]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[9]	LI Fang, HUO Su, DU Jubao, LIU Xiuzhen, LI Xiaoshuang, SONG Weiqun. Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 777-781.
[10]	CUI Yao, CONG Fang, HUANG Fubiao, ZENG Ming, YAN Ruxiu. Brain and muscle activation under mirror neuron-based training strategies: a near-infrared spectroscopy and surface electromyography study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 782-790.
[11]	LIU Hui, YIN Hang, JIA Shaohui, QIU Fubing. Structure, contents and psychometric properties of measurement of motor function and motor ability applicable to children and adolescents with disabilities: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 630-638.
[12]	WANG Yiji, ZHOU Hongjun, HE Zejia, LIU Genlin, ZHENG Ying, HAO Chunxia, WEI Bo, KANG Haiqiong, ZHANG Ying, LU Xiaolei, YUAN Yuan, MENG Qianru. Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 639-645.
[13]	XU Miaomiao, LI Nan, YING Ying, YANG Kaixiang, YANG Jingrui, LI Jie, QIU Yanqun. Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 686-690.
[14]	ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min. Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 691-696.
[15]	ZHANG Qian, SUN Xinting. Effect of video-based mirror therapy on lower limb motor function of stroke patients at recovery stage [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 703-707.

Effects of Aquatic Therapeutic Exercise on Motor Function and Activities for Children and Youth with Cerebral Palsy: A Systematic Review and Meta-Analysis

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0