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Aquatic Therapy for Hemiplegia

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May 2015

Aquatic Therapy

Water may improve strength and mobility associated with hemiplegic cerebral palsy in some people (Ondrack &Thorpe 2007). A review of available evidence for use of aquatic therapy for children with cerebral palsy by Kelly & Darrah (2005) concluded that further evidence was needed to determine the effectiveness of aquatic exercise for children with cerebral palsy.

CIMT Aquatic TherapyDespite the limited evidence for the effectiveness of aquatic therapy for children with hemiplegia, therapists can use the properties of water as a tool to address the goals of these children. For some children, the aquatic environment may be more motivating or interesting than therapy on land.

A few suggested ways to use the pool to address the goals of children in CIMT programs are summarized below:

Example of Therapeutic Goal

Ways to Achieve Goal Through Aquatic Therapy

Example Activity

Improved ability to reach across midline to doff sock on unaffected side

Use buoyancy of water to support affected upper extremity while reaching

Use affected upper extremity to reach across the water surface for floating toys

Improved shoulder extension strength to pull to stand at a surface

  • Use water to resist shoulder extension
  • Use water buoyancy to support movement of sit to stand
  • Pushing a beach ball underwater
  • Sit to stand with upper extremity support on side of pool

Decrease involved upper extremity tone to tolerate passive range of motion

Use warmth of water to relax muscle tone

Submerge involved upper extremity for swim strokes prior to stretching


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