To summarize the evidence on the efficacy of aquatic therapy on motor and social skill as well as executive function compared to land-based exercises in children with neurodevelopmental disorders.
The following six databases were searched: Cochrane Central Register of Controlled Trials, Pubmed, Embase, Scopus, Google scholar (advance), and Web of Science from 1990 to June 2022.
The search included only clinical trials. Two reviewers independently assessed the full text and conducted manuscript selection, data extraction, and quality assessment.
Using standardized forms, data were extracted and all points of disagreement were discussed between authors.
Data synthesis was applied to summarize information from the included trials. The quantitative analysis incorporated fixed-effect models. Of the 150 studies identified in the initial search, 16 trials (248 children) met the eligibility criteria. Aquatic therapy improved factors related to the Humphries’ Assessment of Aquatic Readiness (HAAR) checklist such as mental adjustment (standardized mean difference [SMD], 0.69; 95% confidence interval [CI], 0.20-1.19; I = 10%) compared with land-based exercises (control), water environment (SMD, 0.99; 95% CI,0.43 – 1.54; I = 83%), Rotation (SMD, 0.63; 95% CI,0.14-1.12; I = 0%), balance and control (SMD, 2.09; 95% CI,1.47-2.72; I = 36%) and independent movement (e.g., walking, moving upper body, standing, transferring) in water (SMD, 0.87; 95% CI,0.37-1.38; I = 0%) compared with the control group in the 4 trails. The HAAR tool is based on the Halliwik method and aims to assess the appropriateness for an individual with disability to engage in aquatic therapy. The study protocol was also registered with PROSPERO number (CRD42022341898).
Aquatic therapy demonstrated a more robust positive effect on factors related to the HAAR checklist than land-based exercises. Further research is needed to further elucidate the clinical utility of aquatic therapy for children with neurodevelopmental disorder at long-term follow up.
Copyright © 2023. Published by Elsevier Inc.
