Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial

Objective: To investigate the effects of hydrotherapy on walking ability and balance in patients with chronic stroke. Design: Single-blind, randomized controlled pilot trial. Setting: Outpatient rehabilitation clinic at a tertiary neurological hospital in China. Subjects: A total of 28 participants with impairments in walking and controlling balance more than six months post-stroke. Intervention: After baseline evaluations, participants were randomly assigned to a land-based therapy (control group, n=14) or hydrotherapy (study group, n=14). Participants underwent individual sessions for four weeks, five days a week, for 45minutes per session. Main measures: After four weeks of rehabilitation, all participants were evaluated by a blinded assessor. Functional assessments included the Functional Reach Test, Berg Balance Scale, 2-minute walk test, and Timed Up and Go Test. Results: After four weeks of treatment, the Berg Balance Scale, functional reach test, 2-minute walk test, and the Timed Up and Go Test scores had improved significantly in each group (P<0.05). The mean improvement of the functional reach test and 2-minute walk test were significantly higher in the aquatic group than in the control group (P<0.01). The differences in the mean values of the improvements in the Berg Balance Scale and the Timed Up and Go Test were not statistically significant. Conclusion: The results of this study suggest that a relatively short programme (four weeks) of hydrotherapy exercise resulted in a large improvement in a small group (n=14) of individuals with relatively high balance and walking function following a stroke.