The effect of task-oriented in-water exercise on occupational performance and participation in children with cerebral palsy

This study was planned in a crossover design to examine the effect of task-oriented in-water exercise program (TOIWE) applied with preferred occupations by children with CP on occupational performance and participation. The study included 12 children (age=11.91±3.39 years, 8F) aged 6-18 years with CP (GMFCS 1-3, MACS 1-3). Children were divided into two groups, "A" and "B", by simple randomization. Canadian Occupational Performance Measure (COPM) was used to plan the GOSIP and the five most important activities for children were identified. On the basis of these activities, GOSIP was applied to the study group, while the control group applied conventional rehabilitation exercise. Exercises were performed twice a week for 40 minutes a day for 16 weeks. The same method was repeated in the second period of 16 weeks by crossing the groups. Children's occupational performance was assessed using the Canadian Occupational Performance Measure (COPM), participation was assessed using the Pediatric Outcomes Data Collection Instrument (PODCI), motivation was assessed using the Pediatric Motivation Scale (PMS), and enjoyment of aquatic exercise was assessed using the Physical Activity Enjoyment Scale-Short Form (PACES-SF). When the mean scores of the dependent group COPM scores of both groups were compared after GOSIP, a significant difference was found (p<0.05). No significant difference was found when dependent group PODCI mean scores were compared (p>0.05). GOSIP was found to be more motivating than conventional rehabilitation exercises (p<0.05), while no significant difference was found in the PACES-SF results. As a result, while GOSIP made a significant difference on occupational performance, it didn't make a significant difference on participation. More studies examining the effect of aquatic exercise on occupational performance and/or participation in CP are needed.