SPLASH study: exploring the outcomes of sedentary hydrotherapy with adults with severe, profound and multiple learning disabilities as perceived by in/formal caregivers

PURPOSE: There is some evidence for the use of hydrotherapy in neurological conditions, however evidence for use with adults with Learning Disability (LD) is lacking. This limits service provision of hydrotherapy to those who may well benefit. This study explored caregivers' perceptions of biopsychosocial changes following the use of hydrotherapy with adults with Severe LD (SLD), and Profound and Multiple LD (PMLD). MATERIALS AND METHODS: Using qualitative methods, in/formal caregivers of adults with SLD/PMLD, recruited through public advertising (posters/leaflets/social media) and Diverse Abilities charity, participated in virtual semi-structured interviews and an online-questionnaire. The International Classification of Functioning, Disability and Health framework informed the interview topics, which included health, function, welfare, and support. A questionnaire provided sociodemographic context, while interview data were analysed through reflexive thematic analysis. RESULTS: Twenty-three caregivers participated: five family, nine health-professionals, eight paid, one volunteer. Four overall themes were identified: physical experiences, communication and expression, caregiver experience, and inclusion, with each theme incorporating multiple interrelated subthemes. CONCLUSION: Hydrotherapy is perceived to have positive impacts in all three domains of the biopsychosocial model of disability of adults with SLD/PMLD. Further research is needed to develop service provision.