The swimming program effects on the gross motor function, mental adjustment to the aquatic environment, and swimming skills in children with cerebral palsy: A pilot study

Abstract

The aim of this research was to determine the swimming program effects on the gross motor function, mental adjustment to the aquatic environment and the ability to move in the water and swim in children with cerebral palsy. The sample consisted of seven children (4 boys and 3 girls) with spastic cerebral palsy and an average age of 9y 5mo ± 1y 3 mo. The swimming program lasted 6 weeks, with two swimming sessions per week. Each session lasted 45 minutes. The swimming program included the application of the Halliwick Method and swimming exercises which are used in a healthy population. The GMFM test was used for the assessment of gross motor functions. The WOTA2 test was applied to assess mental adjustment and swimming skills. The Wilcoxon matched pairs test was used to determine the statistically significant differences between the initial and final measuring. The results have indicated that there was statistically significant differences in the E dimension (p=0.04) and the total score T (p=0.03) of the GMFM test, then for mental adjustment to the aquatic environment WMA (p=0.02), ability to move in water and swimming skills WSW (p=0.03) and the overall result WTO (p=0.02) of the WOTA2 test. The applied swimming program had a statistically significant effect on the improvement in walking, running and jumping as well as the overall gross motor functions of children with cerebral palsy. The applied program also contributed to a statistically significant influence on the increase in mental adjustment to the aquatic environment and the ability to move in water and swim.

Cilj ovog istraživanja je utvrđivanje efekata programa plivanja na grubu motoričku funkciju, prilagodljivost na vodenu sredinu i sposobnost kretanja u vodi i plivanja kod dece sa cerebralnom paralizom. Uzorak ispitanika je činilo sedmoro dece (4 dečaka i 3 devojčice) sa spastičnim oblikom cerebralne paralize, prosečne starosti od 9 god. i 5 meseci ± 1god. i 3 meseca (Mean±SD). Progam plivanja je trajao 6 nedelja sa učestalošću od dva puta nedeljno. Svaki čas vežbanja je trajao 45 minuta. Program plivanja je podrazumevao primenu Halliwick metode i vežbi plivanja koje se primenjuju kod zdrave populacije. Za procenu grube motoričke funkcije korišćen je GMFM test. Za procenu psihičke prilagodljivosti na vodenu sredinu i plivačkih veština korišćen je WOTA2 test. Za utvrđivanje statistički značajnih razlika između inicijalnog i finalnog merenja u primenjenim testovima korišćen je Wilcoxon matched pairs test. Rezultati su pokazali da je došlo do statistički značajnih razlika u dimenziji E (p=0.04) i u totalnom rezultatu T (p=0.03) GMFM testa, zatim u mentalnoj prilagodljivost na vodenu sredinu WMA (p=0.02), sposobnosti kretanja u vodi i plivanja WSW (p=0.03) i u ukupnom rezultatu WTO (p=0.02) WOTA2 testa. Primenjeni program plivanja je imao značajne pozitivne efekte na poboljšanje sposobnosti hodanja, trčanja, skakanja i ukupne grube motoričke funkcije kod dece sa cerebralnom paralizom. Doprineo je i značajnom povećanju psihičke prilagodljivosti na vodenu sredinu i poboljšanju sposobnosti kretanja u vodi i plivanja