《Chinese Journal of Rehabilitation Theory and Practice》 ›› 2023, Vol. 29 ›› Issue (11): 1286-1295.doi: 10.3969/j.issn.1006-9771.2023.00.002

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Health and functional benefits of aquatic exercise rehabilitation for children with disabilities: a systematic review of systematic reviews based on ICD-11 and ICF

LIAO Ting1, CONG Fang2,3, HUANG Kunlun4()   

  1. 1. Aquatic Therapy Aand Fitness Center, Wuhan Sports University, Wuhan, Hubei 430079, China
    2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
    3. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
    4. Physical Education Institute of Shenzhen University, Shenzhen, Guangdong 518060, China
  • Received:2023-10-04 Revised:2023-10-09 Published:2023-11-25 Online:2023-11-30
  • Contact: HUANG Kunlun, E-mail: huangkunlun@szu.edu.cn
  • Supported by:
    Humanities and Social Science Research Project of the Ministry of Education(1926);Hubei Education Science and Technology Research Key Project(D20204103);Excellent Young and Middle-aged Scientific and Technological Innovation Teams in Hubei Universities(T202203)


Objective To conduct a systematic review of systematic reviews on benefits of health and functioning for children with disabilities in aquatic exercise rehabilitation, in reference to the PRISMA guidelines, based on ICD-11 and ICF.

Methods Systematic reviews about aquatic exercise rehabilitation for children with disabilities were searched in PubMed, Web of Science, Embase and CNKI from January, 2014 to August, 2023. A systematic review was conducted.

Results Seven English reviews were included from Iran, Brazil, Spain, Australia, USA and Poland, involving 69 randomised controlled trials with a total of 1 825 participants. They were mainly from the journals in the fields of pediatric physics and occupational therapy, physical therapy and rehabilitation, and children with disabilities, and the publication date was mainly from 2014 to 2023. The main types of diseases were intellectual and developmental disability (Down's syndrome, mild or high-functioning autism spectrum disorder, Asperger's syndrome), cerebral palsy (spastic cerebral palsy, spastic quadriplegia), developmental mental coordination disorder, attention deficit hyperactivity disorder, etc. The main impariment of functioning were consciousness function (b110), sleep function (b134), attention function (b140), memory function (b144), psychomotor function (b147), high-level cognitive function (b164), mobility (d4), interpersonal interactions and relationships (d7), community life (d910), recreation and leisure (d920). In the field of physical activity, the main barriers included insufficient participation in physical activity, less participation in aquatic exercise, low overall level of development, physical development as well as motor development and motor ability. The aquatic exercise rehabilitation program mainly included swimming exercises; water resistance and breathing training; water walking, running, jumping; shallow standing exercises; water aerobic activities, strength training and endurance exercises; as well as water games and spa programs. The intervention intensity of aquatic sports rehabilitation was low to moderate, and the frequency was 15 to 100 minutes a time, one to six times a week, lasting six to 40 weeks. The health and functional benefits of aquatic sports rehabilitation for children with disabilities were mainly reflected in improving cardiopulmonary function, enhancing respiratory muscle strength, improving core muscle strength, improving balance and coordination function, improving aerobic endurance, enhancing flexibility, and improving walking speed; reducing body mass, optimizing body mass index, reducing body fat percentage, waist circumference and waist-to-height ratio; improving cognitive and intellectual function, and improving sleep quality. For children with autism spectrum disorder, it could also promote communication activities, reduce repetitive stereotyped behaviors, improve swimming skills and abilities, and increase aquatic physical activity behaviors.

Conclusion Aquatic exercise rehabilitation can improve the body functions of children with disabilities, promote activity and participation, and enhance their overall health, quality of life and well-being.

Key words: disabilities, children, aquatic exercise, rehabilitation, hydrotherapy, health, functional benefit, systematic review

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