Effectiveness of aquatic therapy on balance and functionality in children with Duchenne and Becker muscular dystrophy : a prospective controlled pilot study.

OBJECTIVE

To investigate the effects of combining aquatic therapy with a home exercise program on balance, functionality, and quality of life in children with DMD/BMD, compared with a home exercise program alone.

METHODS

Sixteen patients aged 5-18 years with DMD/BMD were included. Those at the top of the waiting list were assigned to the intervention group (n = 8), and those further down to the control group (n = 8). The intervention group received 30-minute Halliwick-based aquatic therapy three times per week for five weeks in a 30°C pool, in addition to a home exercise program. The control group performed a home exercise program alone while awaiting aquatic therapy. The home exercise program consisted of joint range-of-motion and stretching exercises only (30 minutes/day, five days/week). Exercises were performed under caregiver supervision, and adherence was assessed by caregiver report and investigator questioning. Outcomes assessed at baseline and week 5 included weekly fall frequency, balance (Pediatric Berg Balance Scale; Functional Reach Test), activity (ACTIVLIM), physical performance (10-m walk; 4-step tests), quality of life (PedsQL Neuromuscular Module), and muscle strength (manual muscle testing) and joint range of motion.

RESULTS

Significant improvements in balance, activity, physical performance, and quality of life were observed in the intervention group, alongside a reduction in weekly fall frequency (p < .05). In the control group, the only significant change was increased forward reach distance in the Functional Reach Test (p < .05). Between-group comparisons showed greater gains in balance, functionality, and quality-of-life scores in the intervention group (p < .01). Hip extensor strength increased significantly only in the intervention group. No adverse events occurred.

CONCLUSION

Combining aquatic therapy with a home exercise program was safe and well tolerated and was associated with greater short-term improvements in balance, functionality, and quality of life than a home exercise program alone, with reduced fall frequency over five weeks. These findings support integrating aquatic therapy into DMD/BMD management and justify larger randomized controlled trials to confirm efficacy and guide optimal regimens.

CLINICAL TRIAL REGISTRATION NUMBER: NCT06186310.