Aquatic Cycling for a Child With Hemiplegic Cerebral Palsy: A Case Report

Abstract

Introduction and Purpose: Cerebral palsy (CP) causes multisystem deficits including abnormalities in muscle tone, motor control, postural control, and balance, which lead to functional limitations. Research demonstrates that aquatic physical therapy (APT) aids in mitigating negative effects of CP in children. Land-based adapted cycling (LBADC) programs use adapted bicycles to facilitate movement, strength, and endurance, with promising results in children with CP. Aquatic cycling (AC), using a stationary bicycle submerged in water, posits benefits in adults. No study has investigated the combination of APT and cycling for children. The purpose of this case report is to present the outcomes of an AC program for a child with CP. Case Description: The patient was a 9-year-old boy diagnosed with hemiplegic CP, Gross Motor Function Classification System level II presenting with hypertonicity, and decreased motor control and strength throughout his right side, resulting in limitations in endurance and functional mobility. AC sessions consisted of 20 minutes of stationary AC, with a 5-minute warm-up and cooldown. Outcomes: A total of 10 AC sessions yielded improvements in strength and functional ability. Timed Up and Go test scores improved by 1.3 seconds, exceeding the minimal clinically important difference of 1.2 seconds. The 6-Minute Walk Test score increased by 284 ft, exceeding the minimal detectable change (MDC). Strength improvements were obtained at the right hip abductors and ankle dorsiflexors and bilateral knee flexors, exceeding the MDC of 1.7 lb. Discussion: This is the first study to investigate the effect of AC for a child with CP. Results indicate that AC sessions were beneficial in improving the patient's strength, endurance, and gait efficiency and may be an effective way to engage children with CP in therapeutic exercise.