Effects of water-based exercise and land-based exercise program on walk and balance functions in hemiplegia patients

Objective: To compare the conventional rehabilitation program combined with aquatic rehabilitation to the conventional rehabilitation(CP) program and to measure the effects on walking, balance, strength, spasticity, motor recovery, functional status, and quality of life in stroke patients. Materials and Methods: 60 patients were included in the study. They were allocated into 2 groups. In the study group (n = 30), patients received aquatic therapy (2 times per week) combined with CP (3 times per week). In the control group (n = 30), patients received land-based exercise program 5 times per week. A total of 30 sessions were given in both groups. The patients were evaluated pre treatment and post- treatment. The evaluation parameters included Brunnstrom Recovery Scale (BRS), Modified Ashworth Spasticity Scale (MASS), Functional Independence Measure (FIM), Berg Balance Scale (BBS), Two minute Walk Test (2MWT), Time Up and Go Test (TUG) and Short Form-36 (SF-36) Health Survey At the same time we received Static Balance İndex and Dynamic Balance İndex Scores in Sportkat Kinesthetic Ability Trainer device and peak tork values for hamstring and quadriceps muscles in İsokinetic dynamometer (60 degree second and 120 degree second). Results: Post-treatment results showed significant improvement in all parameters (except for wrist MAS scores and SF 36 pain parameters) in both groups. However, when we compared the percentage changes of parameters at discharge relative to pretreatment values, the improvement observed in the vitalite parameters of the SF-36 in the study group was better (p <0.05). Comparisons of post-treatment values showed that the BBS and 2MWT values were significantly better in the control group than the study group (p <0.05). Conclusion: Combination of aquatic rehabilitation with conventional land based exercises (except for the SF-36 vitalite subparameter) did not add any additional benefit to conventional land based exercises. The only advantage is that the exercises made in water are more fun and motivating, so patients can be more energetic in their daily lives. Therefore, aquatic rehabilitation is a good alternative to conventional rehabilitation.