Effect of Aquatic Bilateral Exercise on the Function of Upper Extremity in a Child with Hemiplegic Cerebral Palsy : Single-subject Experimental Study

This study aimed to assess the effects of an aquatic bilateral exercise program on upper extremity function in a child with hemiplegic cerebral palsy (CP). The participant was a 5-year-7-month-old girl diagnosed with left spastic hemiparetic CP. A single-subject A-B-A experimental design was employed. Outcome measures included the Melbourne assessment and assessment of motor and process skills (AMPS) to evaluate upper extremity functions, as well as changes in shoulder and elbow flexion angles during reaching tasks. The intervention consisted of an aquatic bilateral exercise program based on the Halliwick 10-point program. Following the intervention, Melbourne assessment scores improved by 45.38%, with gains maintained during the follow-up phase (23.69%). Additionally, mean shoulder and elbow flexion angles changed from 64.86° to 69.21° and from 125.29° to 140.34° after the intervention, respectively. In the AMPS, the ADL (actvie daliy living) motor skill score increased from 0.54 points before the intervention to 0.84 points after the intervention. However, the ADL process skill score decreased from 0.90 to 0.71 points. These findings suggest that aquatic bilateral exercise may be beneficial for improving upper extremity function in hemiplegic CP. Further studies are warranted in this area.