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The effect of aquatic therapy on postural balance and muscle strength in stroke survivors – a randomized controlled pilot trial 


Journal: Clinical Rehabilitation, 2008; Volume 22


Authors: Noh DK, Lim J-Y, Shin H-I, Paik N-J


The authors studied 25 men (n=11) and women (n=14), average age 64 yrs., with unilateral limb weakness secondary to stroke at least 6 months prior and able to walk independently. They measured the outcomes of dynamic balance (Berg Balance Scale), static standing balance (force plate), gait ability (Modified Motor Assessment Scale) and muscle strength (isokinetic knee flexion and extension bilaterally).  Thirteen participants were age and balance function –matched to 12 participants; participants were from 6 months to 5 years post stroke. The aquatic intervention was 8 weeks, 3x/week for 1 hour in a 1.15m depth at 34°C. Ai Chi and Halliwick methods were incorporated by trained physiotherapists (2) in a structured group class that included a warm up and cool-down. To progress balance control, the therapists gradually decreased support. The control group completed an 8 week group gym program, 3x/wk. for 1 hour, which was supervised by a physiotherapist and addressed strengthening and gait ability.


Results showed a stronger effect size for the aquatic therapy group Berg Balance Scale and forward and backward balance control compared to the land-based group. Gait ability and strength improved for both groups equally.


Take Home Message: The more intensive therapeutic and specific balance-challenging exercises of Ai Chi and Halliwick in water positively affect balance outcomes in individuals 6 months or more post stroke. 

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