Effects of aquatic physical therapy on balance in post-cerebrovascular accident patients: an integrative review

Authors

DOI:

https://doi.org/10.33233/fb.v23i4.5168

Keywords:

stroke, hydrotherapy, physical therapy modalities, postural balance, quality of life

Abstract

Introduction: Stroke can be characterized as ischemic or hemorrhagic, and in individuals with this condition there is a decrease in their functional independence, which reproduces a decrease in quality of life. Aquatic physical therapy is an approach that stands out in the rehabilitation of these patients, mainly due to the increase in treatment due to the environment. Subjects: Patients with stroke. Objective: To update the literature on the effects of aquatic therapy on the balance of post-stroke patients, verifying the most used evaluation methods. Methods: The literature search was performed in 6 Pubmed, Web of Science, Scopus, Medline, PEDro and Cochrane databases, using the association of descriptors, keywords and Boolean operators “Stroke” AND “Hydrotherapy” OR “Hydrokinesiotherapy” OR “Aquatic Physiotherapy” AND “Balance”, stipulating inclusion and exclusion criteria. Results: Of the 259 studies identified, 14 were selected for analysis and qualitative synthesis. Overall, the results showed significant differences in the balance of individuals with cerebral vascular accident after aquatic therapy. Conclusion: When compared to conventional neurofunctional physical therapy techniques, aquatic physiotherapy has superior efficacy. The most used evaluative means are the Berg Balance Scale and Timed Up and Go, as they are tools that are quick and easy to apply, in addition to being highly effective, demonstrating the relevance of the study in aspects of functional recovery in the midst of dysfunctions arising from neurological impairments.

Author Biographies

Antonia Cristina Silva dos Santos , UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Bárbara Bernabé Pratti, UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Deisiane Pereira de Lima , UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Larissa Torquato de Carvalho, UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Taynara Esperança Silva Santos, UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Elivelton Sousa Montelo , UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Jardeson, UFDPAR

Curso de Fisioterapia, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, Brasil

Jaqueline Fernandes do Nascimento, UNIG

Universidade Iguaçu (UNIG), RJ, Brasil

Tassiane Maria Alves Pereira, UFDPAR

Laboratório de Mapeamento Cerebral e Funcionalidade (LAMCEF/UFDPAR), Universidade Federal do Delta do Parnaíba, PI, Brasil

Jéssica Inara de Brito Siqueira, UFDPAR

Laboratório de Mapeamento Cerebral e Funcionalidade (LAMCEF/UFDPAR),Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, PI, Brasil

Lucas da Silva Nascimento, UFDPAR

Laboratório de Mapeamento Cerebral e Funcionalidade (LAMCEF/UFDPAR),Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, PI, Brasil

Ariel Soares Teles, IFMA

Professor associado do Instituto Federal do Maranhão (IFMA), São Luís, MA, Brasil

Marco Orsini, UNIG

Professor associado e coordenador do Mestrado de Neurologia da Universidade Severino Sombra, RJ, professor da UNIG, Rio de Janeiro, RJ, Brasil

Janaína de Moraes Silva , UEPI

Laboratório de Mapeamento Cerebral e Funcionalidade, LAMCEF/UFDPAR, Pós-Doutorado em Ciências Biomédicas, UFDPAR, Parnaiba, PI, Brasil

Nélio Silva Souza, UNIFESO

Professor assistente na Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, RJ, Brasil

Ariela Thaís Albuquerque da Silva, UFDPAR

Laboratório de Mapeamento Cerebral e Funcionalidade (LAMCEF/UFDPAR), Universidade Federal do Delta do Parnaíba, PI, Brasil

Silmar Teixeira, UFDPAR

Professor Associado da UFDPAR, Laboratório de Neuroinovação Tecnológica & Mapeamento Cerebral (NitLab) UFDPAR, Parnaíba, PI, Brasil

Victor Hugo do Vale Bastos, UFDPAR

Departamento de Fisioterapia, Laboratório de Mapeamento Cerebral e Funcionalidade - LAMCEF, Universidade Federal do Delta do Parnaíba (UFDPAR), Parnaíba, PI, Brasil

References

Zafar F, Tariq W, Shoaib R, Shah A, Siddique M, Zaki A, et al. Frequency of ischemic stroke subtypes based on toast classification at a tertiary care center in Pakistan. Asian J Neurosurg 2018;13(4):984-9. doi: 10.4103/ajns.AJNS_365_16

Hankey GJ. Stroke. Lancet 2017;389(10069):641-54. doi: 10.1016/S0140-6736(16)30962-X

Lundy-Ekman L. Neuroscience: Fundamentals for rehabilitation. London: WB Saunders; 1998. doi: 10.1016/S0964-3397(98)80696-4

Koch G, Bonnì S, Casula EP, Iosa M, Paolucci S, Pellicciari MC, et al. Effect of cerebellar stimulation on gait and balance recovery in patients with hemiparetic stroke: a randomized clinical trial. JAMA Neurol 2019;76(2):170. doi: 10.1001/jamaneurol.2018.3639

Chae CS, Jun JH, Im S, Jang Y, Park G. Effectiveness of hydrotherapy on balance and paretic knee strength in patients with stroke: a systematic review and meta-analysis of randomized controlled trials. Am J Phys Med Rehabil 2020;99(5):409-19. doi: 10.1097/PHM.0000000000001357

Donkor ES. Stroke in the 21st century: a snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat 2018;2018:1-10. doi: 10.1155/2018/3238165

Francisco GE, McGuire JR. Poststroke spasticity management. Stroke 2012;43(11):3132-6. doi: 10.1161/STROKEAHA.111.639831

Verbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Heniks E, Rietberg M, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PloS One 2014;9(2):e87987. doi: 10.1371/journal.pone.0087987

Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM R 2009;1(9):859. doi: 10.1016/j.pmrj.2009.05.017

Martin J. The Halliwick Method. Physiotherapy 1981;67(10):288. PMID: 6460262.

Boyle AM. The Bad Ragaz ring method. Physiotherapy 1981;67(9):265.PMID: 7291338

Mehrholz J, Kugler J, Pohl M, Mehrholz J. Water‐based exercises for improving activities of daily living after stroke. Cochrane Database Syst Rev 2011;2011(1):CD008186. doi: 10.1002/14651858.CD008186.pub2

Iliescu AM, McIntyre A, Wiener J, Iruthayarajah J, Lee A, Caughlin S, et al. Evaluating the effectiveness of aquatic therapy on mobility, balance, and level of functional independence in stroke rehabilitation: a systematic review and meta-analysis. Clin Rehabil 2020;34(1):56-68. doi: 10.1177/0269215519880955

Makiyama TY, Battistella LR, Litvoc J, Martins LC. Estudo sobre a qualidade de vida de pacientes hemiplégicos por acidente vascular cerebral e de seus cuidadores. Acta Fisiátr 2004;11(3):106-9. doi: 10.5935/0104-7795.20040004

Salinet AS. Hidroterapia e reabilitação cardiorrespiratoria após acidente vascular cerebral. Rev Neurocienc 2012;20(2):183-4. doi: 10.34024/rnc.2012.v20.8270

Meneghetti CHZ, Carraro L, Leonello LA, Batistella ACT, Ferracini Júnior LC. A influência da fisioterapia aquática na função e equilíbrio no acidente vascular cerebral. Rev Neurocienc 2012;20(3):410-4. doi: 10.34024/rnc.2012.v20.8268

Pérez-de la Cruz S. Comparison of aquatic therapy vs. dry land therapy to improve mobility of chronic stroke patients. Int J Environ Res Public Health 2020;17(13):4728. doi: 10.3390/ijerph17134728

Temperoni G, Curcio A, Iosa M, Mangiarotti MA, Morelli D, De Angelis S, et al. A water-based sequential preparatory approach vs. conventional aquatic training in stroke patients: a randomized controlled trial with a 1-month follow-up. Front Neurol 2020;11:466. doi: 10.3389/fneur.2020.00466

Ku P, Chen S, Yang Y, Lai T, Wang R. The effects of Ai Chi for balance in individuals with chronic stroke: a randomized controlled trial. Sci Rep 2020;10(1):1201. doi: 10.1038/s41598-020-58098-0

Park H, Lee H, Lee S, Lee W. Land-based and aquatic trunk exercise program improve trunk control, balance and activities of daily living ability in stroke: a randomized clinical trial. Eur J Phys Rehabil Med 2019;55(6):687. doi: 10.23736/S1973-9087.18.05369-8

Franciulli PM, Bigongiari A, Grilletti JVF, Mazuchi FAS, Amadio AC, Mochizuki L. The effect of aquatic and treadmill exercise in individuals with chronic stroke. Fisioter Pesqui 2019;26(4):353-9. doi: 10.1590/1809-2950/17027326042019

Babaeipour H, Sahebozamani M, Mohammadipour F, Vakilian A. The effect of training at different depths on the balance of chronic ischemic stroke patients. IJAEP 2018;7(3):68-78. doi: 10.30472/ijaep.v7i3.295

Eyvaz N, Dundar U, Yesil H. Effects of water-based and land-based exercises on walking and balance functions of patients with hemiplegia. Neuro Rehabilitation 2018;43(2):237‐46. doi: 10.3233/NRE-182422

Zhu Z, Cui L, Yin M, Yu Y, Zhou X, Wang H, et al. Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial. Clin Rehabil 2016;30(6):587-93. doi: 10.1177/0269215515593392

Kim K, Lee DK, Kim EK. Effect of aquatic dual-task training on balance and gait in stroke patients. J Phys Ther Sci 2016;28(7):2044-7. doi: 10.1589/jpts.28.2044

Chan K, Phadke CP, Stremler D, Suter L, Pauley T, Ismail F, et al. The effect of water-based exercises on balance in persons post-stroke: a randomized controlled trial. Top Stroke Rehabil 2017;24(4):228-35. doi: 10.1080/10749357.2016.1251742

Downs S. The Berg Balance Scale. J Physiother 2014;2015;61(1):46. doi: 10.1016/j.jphys.2014.10.002

Pérez-de la Cruz S. Comparison between three therapeutic options for the treatment of balance and gait in stroke: a randomized controlled trial. Int J Environ Res Public Health 2021;18(2):426. doi: 10.3390/ijerph18020426

Cha H, Shin Y, Kim M. Effects of the Bad Ragaz Ring Method on muscle activation of the lower limbs and balance ability in chronic stroke: A randomized controlled trial. Hong Kong Physiother J 2017;37:39-45. doi: 10.1016/j.hkpj.2017.02.001

Chan PP, Si Tou JI, Tse MM, Ng SS. Reliability and validity of the Timed Up and Go Test with a motor task in people with chronic stroke. Arch Phys Med Rehabil 2017;98(11):2213-20. doi: 10.1016/j.apmr.2017.03.008

Saleh MSM, Rehab NI, Aly SMA. Effect of aquatic versus land motor dual task training on balance and gait of patients with chronic stroke: A randomized controlled trial. Neuro Rehabilitation 2019;44(4):485-92. doi: 10.3233/NRE-182636.

Lim C. Effect of underwater treadmill gait training with water-jet resistance on balance and gait ability in patients with chronic stroke: a randomized controlled pilot trial. Front Neurol 2020;10:1246. doi: 10.3389/fneur.2019.01246

Noh DK, Lim J, Shin H, Paik N. The effect of aquatic therapy on postural balance and muscle strength in stroke survivors - a randomized controlled pilot trial. Clin Rehabil 2008;22(10-11):966-76. doi: 10.1177/0269215508091434

Montagna JC, Santos BC, Battistuzzo CR, Loureiro AP. Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors. Int J Clin Exp Med 2014 [Internet];7(4):1182-7. [cited 2022 aug 5]. Available from: https://pubmed.ncbi.nlm.nih.gov/24955206/

Berger L, Klein C, Commandeur M. Évaluation des effets immédiats et à moyen terme de la mobilisation en eau chaude thermale sur l’équilibre statique et dynamique de sujets âgés. Annales de Réadaptation et de Médecine Physique 2008;51(2):84-9. doi: 10.1016/j.annrmp.2007.10.007

Veldema J, Jansen P. Aquatic therapy in stroke rehabilitation: systematic review and meta‐analysis. Acta Neurol Scand 2021;143(3):221-41. doi: 10.1111/ane.13371

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Published

2022-08-13