The effect of 8 weeks of aqua and land functional training on the balance and proprioception of the ankle joint on children with diplegia cerebral palsy

Background and purpose: Children with spastic cerebral palsy have many problems in terms of movement and balance. The crooked structure of children with spastic cerebral palsy disturbs the balance function. Due to the constant muscle tension in these people, a permanent spasm is seen in their flexor muscles. This condition, along with other features of the disease, puts people in a state of poor mobility. Recently, training in water and on land has become very popular in both the fields of sports and rehabilitation, especially people with limited mobility. The aim of this study was to investigate the effect of the exercise protocol combining water and land exercises on the balance and proprioception of the lower limbs of children with cerebral palsy and diplegia. Materials and methods: thirty children with diplegia cerebral palsy were selected by available sampling and randomly divided into two experimental groups of 15 people (age: 9.33±1.63 years, height: 1.32±0.06 meters, weight: 33.88±3.63 kg) and control group (age: 9.46±1.30 years, height: 1.30±0.05 m, weight: 32.04±3.52 kg) . In order to evaluate the static balance or dynamic standing balance using the functional reaching test, in order to evaluate the dynamic balance, the standing and walking time test was used, and joint proprioceptive evaluation (dorsiflexion) was used before and after the exercises. The experimental group performed exercises on the ground including strength exercises, balance exercises and functional exercises and exercises in water for 8 weeks and 4 sessions per week. To analyze the data, analysis of variance tests with two-way repeated measurement were used at a significant level (p≤0.05). Results: After 8 weeks of land and water combined exercises, there was a significant improvement in the functional balance test (p<0.05) and ankle joint proprioception (p=0.001), as well as a significant reduction in time The standing and walking test was observed (p=0.001). No significant difference was observed in any of the variables of the control group (p˃ 0.05). Conclusion: The results of the present study showed that performing strength, aqua exercises, functional and balance exercises in a combined way and together, can probably have a better effect on improving balance, proprioception and finally movement and walking performance of children. Also, performing combined water and land exercises can improve the balance and proprioception of children with cerebral palsy and diplegia, and by improving the balance and proprioception of these children, the movement problems and falls of these children can be reduced, and it is an effective step in improving The health and lifestyle of these children. Therefore, it is recommended to trainers and therapists to perform these combined exercises