Research Report: Efficacy and Safety of a Novel Aquatic Device for Children With Postural Dysfunction

Background and Purpose: Children with postural dysfunction often enjoy aquatic activities but are limited in their ability to play and interact in the water due to limited motor control and safety concerns. The purpose of this study was to explore the benefits of postural contexts provided by a novel aquatic device (Water Strider) in children with postural dysfunction. Providing stable vertical support is hypothesized to improve overall environmental interactions/social engagement and increase safety, autonomy, and motivation for movement (kicking and reaching). Methods: The proposed device provided external support that could be modified on the basis of user-specific level of head and trunk control. Feasibility, safety, and efficacy of the device were tested for 9 children (aged 2-8 years) with postural dysfunction (7 with cerebral palsy). For this purpose, a 10-minute aquatic trial for baseline aquatic activities along with use of the Water Strider was performed for comparison with video behavior coding to quantify arm and leg movements, assistance, and hazardous events (water in eyes or water in mouth). Results: Total assistance required significantly decreased from baseline (100%) to the Water Strider (21%; F 1,8 = 384.4, P ≤ .001), and significantly fewer instances where children were found to have water in their mouth occurred across all participants (baseline: 12 events; Water Strider: 0 events). Significant increase in total leg movement/reciprocal kicking ( F 1,8 = 8.84, P < .001; F 1,8 = 11.1, P = .003) and decrease in arm movements ( F 1,8 = 0.036, P < .001) with relation to the level of trunk control were also observed.