The Effects of Water Rehabilitation on Post-Stroke Patients

Background on Stroke

Stroke is the leading cause of serious, long-term disability in the United States and the majority of them are caused by a blockage of blood flow to the brain. Stroke is very common among the US population; more than 795,000 people suffer from a stroke each year. Almost all post-stroke patients deal with impairments involving vision, balance, speech, hearing, and paralysis. This can make stroke rehabilitationdifficult and potentially dangerous if not done right. These impairments have a significant effect on overall function and quality of life, so it is critical for them to receive the best care and rehabilitation possible so they can to improve these disabilities.

Exercise During Post-Stroke Rehabilitation

Although it is important to regain strength and use body weight, incorporating water-based exercises may be necessary for some patients and will allow them to perform better. Once the patient shows progress in strength, balance, fitness, etc. they may start to transition into more land-based exercises. However, when beginning water-based exercise can be implemented into rehabilitation for post-stroke patients by practitioners and has shown many benefits for this population. It is important to make sure any exercise done during rehabilitation is supervised by a licensed clinician.

Research on Using Aquatic Therapy in Rehabilitation

There are many studies done on this topic which all suggest that aquatic therapy can cause significant improvements in the assessments done on post-stroke patients during rehabilitation. Muscle strength, cardiorespiratory fitness, and function are a few of the factors assessed in stroke patients. Lee (2018) conducted a study that compared the progress of these factors when combining aquatic therapy with land-based exercise versus land-based exercise alone. There were many assessments used to measure how the different programs worked and overall the aquatic therapy group showed greater improvements in all categories. Other factors like lower-extremity function and quality of life showed significant improvements after an aquatic therapy program in a study done by Matsumoto (2016). Some of the assessments used were the Berg Balance Score, Modified Ashworth Scale, Timed Up and Go Test, 36-Item Short Form Health Survey, etc. to measure things like balance, lower-extremity function, walking and gait abilities, postural sway, muscle strength, cardiorespiratory fitness, and quality of life. Overall we saw positive effects when aquatic therapy was incorporated.

Why is This Important?

Patients recovering from stroke will work with many different health care practitioners, mainly physical therapists and occupational therapists, but this research is important to anyone that will be working with disabled stroke patients. The implied benefits of using aquatic therapy is improved mobility, greater strength, pain relief, less energy consumption, balance training, and muscle relaxation; all of which would greatly benefit both the patient and the clinician. Hopefully this research inspires clinicians to start implementing aquatic therapy programs to improve patient progress.

                                                                                                 

What Can Be Done in The Future?

There was a lot of research and studies done on this topic; however, it mainly looked at things involving physical function.There was very little research that examined the effects of aquatic therapy on cardiovascular fitnessin stroke patients. This is something research on this topic could expand upon because cardiovascular health affects things like weight, heart disease, and blood pressure. Since these are all risk factors for stroke and many stroke patients deal with these issues, research on cardiovascular fitness may find the best way to reduce these problems as much as possible and improve overall quality of life.

Providing The Best Care for Patients

After reviewing the literature found on this topic, it is evident that incorporating aquatic therapy into rehabilitation programs will largely benefit both post-stroke patients and the clinicians working with them. It is critical for emerging health care professionals and providers to stay up to date on evidence based practices and current research to provide our patients with the best care they can receive to ensure a quick and efficient recovery. This can be done through analyzing studies, conducting your own research, attending conferences, etc.With that being said, I’m hopeful that aquatic therapy becomes part of a standard rehabilitation program for stroke patients in the future because of the significant improvements it has shown in these studies.

Alison Coleman, 22, Student at Westfield State University

I am currently in my senior year at W.S.U. majoring in Movement Science with a concentration in Sports Medicine. My current goal is to get into grad school and earn my OTD (Doctorate of Occupational Therapy). In the future I would like to work in an out-patient rehabilitation clinic and stroke survivors.

References

Lee, S.Y., Im, S.H., Kim, B.R., & Han, E.Y. (2018). The effects of a 

motorized aquatic treadmill exercise program on muscle strength, cardiorespiratory fitness and clinical function in subacute stroke patients: A randomized controlled pilot trial. American Journal of Physical Medicine & Rehabilitation, 97(8), 533-540.

Matsumoto, S., Uema, T., Ikeda. K., Miyara, K., Nishi, T., Noma, T., & 

Shimodozono, M. (2016). Effect of underwater exercise on lower-extremity function and quality of life in post-stroke patients: A pilot controlled clinical trial. The Journal of Alternative and Complementary Medicine, 22(8), 639.