Hydrohappy (Stacey Braun)

The use of water as a form of therapy is not a modern concept by any means. The ancient Egyptian, Greek, and Roman civilizations all have forms of hydrotherapy recorded. In fact, Hippocrates - the father of modern medicine - prescribed bathing in spring water for sickness (Pappas et al). Conversely, the use of water as a form of therapy for children with cerebral palsy (or other disabilities) may be a newer concept.

It is well documented that children with cerebral palsy may be only capable of a limited number of movements. However, with the use if water, exercise becomes more feasible for these children. The buoyancy of water: reduces the effects of gravity, poor balance, and poor postural support (Kelly and Darrah). In fact, water can act as a brace and physically provide postural support. Though it may be important, support is not the only benefit of hydrotherapy.

Hydrotherapy has numerous benefits for children with cerebral palsy. Being in water  fosters the movement of limbs and it encourages stiff muscles to relax. This relaxing is aided by the warm temperate of the pool water. In addition, hydrotherapy can create a fantastic opportunity for sensory feedback (Thorpe and Reilly). Children can hear the sounds of splashing water and feel the warm water lap against their body. Furthermore, it has been stated that "perceptual and visual motor skills [also] improve because water slows down movement and gives children time to react" (Thorpe and Reilly).

Overall, it is without question that I noted each of the above benefits with the children's hydrotherapy session this week.

On Monday, after an approximately 30 minute long drive,  some of the Hope Home children and staff arrived via songthaew at Chiang Mai University's Faculty of Associated Medical Sciences. It is within this faculty that the Physical Therapy department is housed.

Following a swift change of attire, as a group we leisurely eased into the hydrotherapy pool. Initially, I found the water noticeably warmer than what I was used to. This temperature is due to the fact that hydrotherapy pools are generally between 33 and 34 degrees Celsius. This warm water is utilized because it  has a relaxing effect and can help decrease muscle tone.

Over the course of the next hour, a variety of activities were performed with the assistance of the physical therapy students. Initially, we began with getting comfortable in the water - floating and splashing around. Though some children acclimated immediately, others were very hesitant and required some coaching.

Afterwards, we formed a circle with each child/caregiver pairing. From this arrangement we sang songs while encouraging the children to move their limbs in the water. At this point in the program you could see each child's personality shine through. The loud and rowdy children needed to thrash about the wildest. The prim and proper princesses showed their enjoyment with grins and giggles.

Subsequently, after a period of time had passed we played a "fetch" type game. The physical therapy student leader dumped a bin of balls - containing a myriad of sizes and colours - into the water. They then instructed the children to collect the balls and place them back in the bin. Here I truly began to see the benefits of this treatment. Children who were do confined on land exhibited such independence and tenacity. Confidence that was initially in the shadows, rose to take centre stage. This moment illustrated in vivid colour the purpose of this therapy.

Finally, to conclude the session we did a series of races. All child/caregiver pairings lined up at one wall and then at the leaders command, moved to the parallel wall. We jumped. We spun. We thrashed about. We laughed. We grew. Whether it was physical, mental or emotional - we all grew.


Thorpe DE, Reilly M. The effect of an aquatic resistive exercise program on lower extremity strength, energy expenditure, functional mobility, balance and self- perception in an adult with cerebral palsy; a retrospective case report. J Aquatic Phys Ther. 2000; 8: 18- 24.

Kelly M, Darrah J. Aquatic exercise for children with cerebral palsy. Dev Med and Child Neurol. 2005; 47: 838- 842.

Geralis E. Children with cerebral palsy: A Parent’s Guide. 2nd ed. Woodbine House, Inc. Bethesda, USA. 1998.