Authors (including presenting author) :
Lam CPY(1), Chau RMW(1), Leung KKL(1), Cheung EYY(1), Lau DMF(1)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital
Introduction :
Balance impairment is commonly observed in patients with neurological conditions, leading to reduced mobility and increased risk of falls. Hydrotherapy was shown to be effective in mobility enhancement in patients with chronic neurological disorders. However, there is paucity of literature on functional balance control and self-efficacy improvement.
Objectives :
This study aims to investigate the effectiveness of an adjunct hydrotherapy program in enhancing postural stability and balance confidence in chronic neurological patients.
Methodology :
Sixty-six participants(Experimental group n=47; Control group n=19) with chronic neurological disorders(onset>6months), who could walk without manual assistance, were recruited from the out-patient physiotherapy unit of Kowloon Hospital. Participants in the control group received 60-minute conventional physiotherapy three times a week for six weeks, while the experimental group received additional 30-minute hydrotherapy twice a week for six weeks. The hydrotherapy program consisted of limbs control exercise, perturbation exercise and gait training to challenge the balance control systems. Assessments were conducted at baseline, upon program completion(week 6) and 6 weeks after program completion(week 12). Outcome measures included sensory and motor function assessment with Sensory Organization Test(SOT) and Limits of Stability(LOS) test using computerized dynamic posturography; and self-efficacy in balance ability using Activities-specific Balance Confidence(ABC) scale. Two-way repeated measures ANOVA was used to analyze the treatment effect.
Result & Outcome :
Both groups demonstrated significant improvement in the somatosensory and visual ratio of the SOT and ABC scale, with greater increase in the experimental group. Improvement in the vestibular ratio of the SOT and endpoint excursion of the LOS test were only observed in the experimental group. All improvements were maintained at the 12-week follow-up. The results suggested that an adjunct hydrotherapy program can provide additional improvement to sensory, reflexive motor and voluntary motor function in balance control. With improved postural stability, patients with neurological disorders may be more willing and confident to displace their bodies towards the limits of stability in performing mobility tasks in everyday life. To conclude, novel water-based balance training program is safe, enjoyable and effective for advanced functional balance rehabilitation.
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