Water-based therapeutic exercise in stroke: a scoping review

Abstract

Purpose

To (1) describe the state of the literature on water-based therapeutic exercise (WBTE) for people living with stroke, (2) describe the content and structure of interventions, (3) summarize the effects of interventions described in the literature, and (4) identify gaps in the literature limiting application and implementation.

Materials and methods

Scoping review methodology described by Arksey and O’Malley (2005) and Levac et al. (2010). Electronic databases were searched for articles with eligibility criteria including: (1) adult stroke survivors (18 years or older) of any type (ischemic/hemorrhagic) or stage (acute/chronic) in any setting, and (2) the study intervention involved WBTE to address a post-stroke deficit.

Results

40 articles were included in this review. Five trials had a treatment control, 20 had an active comparison. Calculated intervention effect sizes demonstrated a strong effect of WBTE on balance and gait related outcomes in 80% of controlled and comparison trials.

Conclusions

This scoping review highlights common parameters of WBTE interventions and provides an inventory of the differences in the treatment approaches utilized in this population. Opportunities for future work include the development of a standardized treatment protocol, qualitative or mixed methodology research, and greater inclusion of more individuals with more severe stroke-related impairments.

IMPLICATIONS FOR REHABILITATION

• Water-based therapeutic exercise is an approach that may allow stroke survivors to carry out challenging activities in a safe and accessible environment.

• Water-based interventions for stroke survivors appear to have a beneficial impact on walking and balance.

• Given that an aquatic environment offers an opportunity for individuals with more significant physical impairments to carry out early practice of walking and balance related tasks, clinicians should explore the feasibility and effectiveness for this subset of stroke survivors.

Keywords:

• Adults
• stroke
• water-based
• aquatic exercise
• intervention strategies

Acknowledgements

The author(s) received no financial support for the research, authorship and/or publication of this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.