Effects of aquatic therapy on postural control after stroke – a literature review

Abstract

Background and Objectives: Postural instability is a common consequence following stroke, for which a variety of therapeutic interventions have been developed. Numerous studies have reported positive effects of aquatic therapy on balance in stroke survivors; however, the findings are inconsistent due to the heterogeneity of therapeutic approaches and assessment methods. This literature review aims to map the effects of aquatic therapy on postural balance in stroke survivors, with a particular focus on the assessment tools employed.

Methods: A literature search was conducted in January 2024 in the Web of Science Core Collection, Web of Science Medline, PubMed, and Academic Search Complete databases. Of the 175 articles that met the inclusion criteria, 24 studies were selected for analysis after removing irrelevant results. These were evaluated based on the type of intervention, assessment methods, and therapeutic outcomes.

Results: Among the 24 included studies, 19 were randomized controlled trials, and 5 were non-controlled studies. The applied aquatic therapy methods varied widely. Due to the methodological heterogeneity of both interventions and assessments, a high-level synthesis was not feasible. Nevertheless, results indicate that aquatic therapy can effectively improve postural balance in stroke survivors.

Conclusion: Further research is warranted to define more precise goals for balance improvement in stroke rehabilitation. Comparing the outcomes of functional tests with those of instrumental assessments, and exploring the correlations between them, may provide valuable insights to guide future therapeutic strategies.