The Effect of Hydrotherapy on Health of Cerebral Palsy Patients: An Integrative Review

Objectives: Hydrotherapy treatment is a type of complementary therapy which is administered in conjunction with other conventional modes of treatment for the treatment and rehabilitations of cerebral palsy patients. Though it has gained increasing popularity in many countries around the world, its application in Iran is still rare. The aim of this study was to perform an integrative review of the extant literature in the field of hydrotherapy and its applications for the improvement of ICF (International Classification of Functioning, Disability and Health) in spastic diplegia cerebral palsy patients. The review encompassed multifactorial analysis of the articles published between 2000 and 2016. Methods: All related articles published in Iran as well as other countries from across the world (during the last sixteen years) with the keywords: hydrotherapy, cerebral palsy, participation, play, motor function, body function and body structure, were extracted from databases such as Science direct, PEDro, CINAHL, PubMed, ProQuest, magiran. The articles thus obtained were selected for evaluation and analysis.  Results: More than 33 papers were found from the literature search (as specified above). Of these, 18 articles were eliminated due to unrelated materials and addressing methods other than hydrotherapy rehabilitation. Of the remaining 15 papers that directly corresponded to the effect of hydrotherapy on improving ICF of spastic diplegia cerebral palsy patients, 11 articles were investigated in this review. The abstracts were evaluated first, followed by the full texts of the 11 articles that met the inclusion criteria. Discussion: The results of the review showed that hydrotherapy when applied along with other conventional methods of rehabilitation, exerts positive effects on all areas of ICF. Hydrotherapy can be used in children and adolescents with spastic diplegia cerebral palsy, but the exercises chosen must be in accordance with the physical and cognitive conditions of the patients. However, studies in some areas of ICF are limited and further studies in this field are felt.