Comparative Study Between Aquatic Therapy and Land-Based Exercises in Hemiplegic Patients After Stroke: A Randomized Controlled Trial

Am J Phys Med Rehabil. 2025 Apr 1;104(4):305-311. doi: 10.1097/PHM.0000000000002589. Epub 2024 Jul 2.

Abstract

Objective: This study aimed to assess the effects of aquatic therapy in individuals with hemiplegia compared with those of a conventional land-based exercise program.

Design: This was a blinded, randomized controlled study of chronic stroke patients with hemiplegia. The participants were randomized in to aquatic therapy (experimental) or conventional therapy (control) groups. The aquatic therapy group conducted the exercise program in a swimming pool, and the conventional therapy group performed to an exercise on the land environment three times per week for 6 wks. Both interventions focused on posture, balance, and weight-bearing exercises. Outcomes included the Berg Balance Scale, Brunnstrom Scale, Motricity Index, muscle strength tests, Modified Ashworth Scale, Postural Assessment Scale for Stroke, Trunk Control Test, and Functional Independence Measure. In addition, postural sway was evaluated by using the variables of center of pressure displacements in the mediolateral and anteroposterior directions.

Results: The findings of the present study show that the experimental group (26 patients) exhibited significant improvements in spasticity compared with the control group (25 patients) ( P = 0.01). The conventional therapy group also achieved significant improvements ( P < 0.05) in anteroposterior deviation, mediolateral velocity, and total velocity of center of pressure in a sitting position with eyes closed.

Conclusions: Land-based exercises were more beneficial in the spasticity of chronic stroke patients.

Trial registration: ClinicalTrials.gov NCT01460277.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Aged
  • Exercise Therapy* / methods
  • Female
  • Hemiplegia* / etiology
  • Hemiplegia* / physiopathology
  • Hemiplegia* / rehabilitation
  • Humans
  • Hydrotherapy* / methods
  • Male
  • Middle Aged
  • Muscle Spasticity / etiology
  • Muscle Spasticity / rehabilitation
  • Postural Balance / physiology
  • Stroke / complications
  • Stroke / physiopathology
  • Stroke Rehabilitation* / methods
  • Swimming
  • Swimming Pools
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT01460277