Efectividad de la terapia acuática en la función motora gruesa en población infantojuvenil con parálisis cerebral : una revisión narrativa
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Fecha
2023
Profesor/a Guía
Facultad/escuela
Idioma
es
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Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
La parálisis cerebral (PC) es la principal causa de discapacidad en la población
infantil, afectando diversas áreas del desarrollo entre ellas la función motora
gruesa; equilibrio y marcha. Hay evidencia actual de los beneficios de la terapia
acuática y de cómo puede ser un complemento a la terapia convencional.
El objetivo de esta revisión fue describir la efectividad de las intervenciones
acuáticas, determinar mejoras significativas en los resultados de la función
motora gruesa, en relación a las técnicas y métodos, protocolos de intervención
y dosificación.
Se analizaron 9 estudios aleatorizados controlados, seleccionados por un experto
y cuyos sujetos tenían PC espástica clasificados según GMFCS de I a IV entre
los 2 y 20 años.
El análisis indica que posterior a la terapia acuática se observan mejoras
significativas en el promedio de los ítems GMFM. Dentro de los métodos que
contribuyeron a mejoras se encuentra Halliwick que contempla ejercicios,
natación o caminar en el agua y ejercicios acuáticos sin un protocolo específico
como ejercicios pasivos y activos de extremidades y tronco. Se obtuvieron
mejoras de 35 a 100 minutos de sesión, y de 12 a 30 sesiones en total. En
conclusión, la mayoría de los estudios reportan mejoras de la función motora
gruesa en al menos una dimensión de la GMFM, con terapias protocolizadas y
no protocolizadas. No se logra concluir que tipo de terapia resulta más efectiva
ya que las medidas de resultado y las características de los sujetos en
clasificación topográfica y funcional era diversa, no pudiendo establecer
comparaciones. Una dosificación mínima de 2 veces por semana, 35 minutos de
intervención en un total de 16 sesiones (9,3 horas en total) pareciera mejorar la
función motora gruesa siendo transferible a tierra inmediatamente, sin embargo,
no se tiene información si los resultados se mantienen a mediano o largo plazo.
Cerebral palsy (CP) is the main cause of disability in the child population, affecting various areas of development, including gross motor function; balance and gait. There is current evidence of the benefits of aquatic therapy and how it can be a complement to conventional therapy. The objective of this review was to describe the effectiveness of aquatic interventions, determine significant improvements in the results of gross motor function, in relation to techniques and methods, intervention protocols and dosage. Nine randomized controlled studies, selected by an expert and whose subjects had spastic CP classified according to GMFCS from I to IV between the ages of 2 and 20 years, were analyzed. The analysis indicates that after aquatic therapy, significant improvements are observed in the average of the GMFM items. Among the methods that contributed to improvements is Halliwick, which includes exercises, swimming or walking in the water, and aquatic exercises without a specific protocol, such as passive and active exercises of the extremities and trunk. Improvements were obtained from 35 to 100 minutes of session, and from 12 to 30 sessions in total. In conclusion, most of the studies report improvements in gross motor function in at least one dimension of the GMFM, with protocolized and non-protocol therapies. It is not possible to conclude which type of therapy is more effective since the outcome measures and the characteristics of the subjects in topographic and functional classification were diverse, and it was not possible to establish comparisons. A minimum dosage of 2 times a week, 35 minutes of intervention in a total of 16 sessions (9.3 hours in total) seems to improve gross motor function, being immediately transferable to ground, however, there is no information if the results are maintained in the medium or long term.
Cerebral palsy (CP) is the main cause of disability in the child population, affecting various areas of development, including gross motor function; balance and gait. There is current evidence of the benefits of aquatic therapy and how it can be a complement to conventional therapy. The objective of this review was to describe the effectiveness of aquatic interventions, determine significant improvements in the results of gross motor function, in relation to techniques and methods, intervention protocols and dosage. Nine randomized controlled studies, selected by an expert and whose subjects had spastic CP classified according to GMFCS from I to IV between the ages of 2 and 20 years, were analyzed. The analysis indicates that after aquatic therapy, significant improvements are observed in the average of the GMFM items. Among the methods that contributed to improvements is Halliwick, which includes exercises, swimming or walking in the water, and aquatic exercises without a specific protocol, such as passive and active exercises of the extremities and trunk. Improvements were obtained from 35 to 100 minutes of session, and from 12 to 30 sessions in total. In conclusion, most of the studies report improvements in gross motor function in at least one dimension of the GMFM, with protocolized and non-protocol therapies. It is not possible to conclude which type of therapy is more effective since the outcome measures and the characteristics of the subjects in topographic and functional classification were diverse, and it was not possible to establish comparisons. A minimum dosage of 2 times a week, 35 minutes of intervention in a total of 16 sessions (9.3 hours in total) seems to improve gross motor function, being immediately transferable to ground, however, there is no information if the results are maintained in the medium or long term.
Notas
Actividad Final de Graduación (Magíster en Neurorrehabilitación)
Palabras clave
Parálisis Cerebral en Niños, Rehabilitación, Ejercicios Acuáticos, Uso Terapéutico, Investigaciones.