The Effectiveness of Aquatic Therapy on Motor and Social Skill as Well as Executive Function in Children With Neurodevelopmental Disorder: A Systematic Review and Meta-analysis

Ardalan Shariat; Mahboubeh Ghayour Najafabadi; Isis Kelly Dos Santos; Albert Thomas Anastasio; Homa Rafiei Milajerdi; Gholamreza Hassanzadeh; Elahe Nouri

doi:10.1016/j.apmr.2023.08.025

The Effectiveness of Aquatic Therapy on Motor and Social Skill as Well as Executive Function in Children With Neurodevelopmental Disorder: A Systematic Review and Meta-analysis

Arch Phys Med Rehabil. 2024 May;105(5):1000-1007. doi: 10.1016/j.apmr.2023.08.025. Epub 2023 Sep 9.

Authors

Ardalan Shariat¹, Mahboubeh Ghayour Najafabadi², Isis Kelly Dos Santos³, Albert Thomas Anastasio⁴, Homa Rafiei Milajerdi⁵, Gholamreza Hassanzadeh⁶, Elahe Nouri⁷

Affiliations

¹ Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran. Electronic address: ghayournaj@gmail.com.
³ Department of Physical Education, Faculty of Physical Education, State University of Rio Grande do Norte, Mossoro, Brazil.
⁴ Department of Orthopaedic Surgery, Duke University, Durham, NC.
⁵ Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
⁶ Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.

PMID: 37690741
DOI: 10.1016/j.apmr.2023.08.025

Abstract

Objective: To summarize the evidence on the efficacy of aquatic therapy on motor and social skill as well as executive function compared with land-based exercises in children with neurodevelopmental disorders.

Data sources: The following 6 databases were searched: Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, Google scholar (advance), and Web of Science from 1990 to June 2022.

Study selection: The search included only clinical trials. Two reviewers independently assessed the full text and conducted manuscript selection, data extraction, and quality assessment.

Data extraction: Using standardized forms, data were extracted and all points of disagreement were discussed between authors.

Data synthesis: 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; I²=10%) compared with land-based exercises (control), water environment (SMD, 0.99; 95% CI, 0.43-1.54; I²=83%), Rotation (SMD, 0.63; 95% CI, 0.14-1.12; I²=0%), balance and control (SMD, 2.09; 95% CI, 1.47-2.72; I²=36%) and independent movement (eg, walking, moving upper body, standing, transferring) in water (SMD, 0.87; 95% CI, 0.37-1.38; I²=0%) compared with the control group in the 4 trails. The HAAR tool is based on the Halliwick 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.

Conclusion: 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.

Keywords: Aquatic exercise therapy; Child mental disorder; Motor skills, Neurodevelopmental disorders; Rehabilitation.

Publication types

Systematic Review
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Child
Executive Function*
Exercise Therapy / methods
Humans
Hydrotherapy* / methods
Motor Skills*
Neurodevelopmental Disorders* / rehabilitation
Social Skills*