Authors (including presenting author) :
Hon WL(1), Chan MYR(1), Lam J(1), Lee YW(1), Poon MC(1), Chan WW(1)
Affiliation :
(1) Allied Health Department (Physiotherapy), Hong Kong Children’s Hospital
Introduction :
Physiotherapy for children should be as enjoyable as playtime. For young patients with transverse myelitis (TM), the journey to independence can be challenging. By implementing a tailored hydrotherapy program, we aimed to enhance functional ability and independence while making rehabilitation a joyful experience. This article examines how hydrotherapy can be beneficial for kids, focusing on safety, feasibility, and the perceived benefits from the patient and her family.
Objectives :
This case study follows a 9-year-old girl whose struggle with TM resulted in lower limb and core muscle weakness and spasticity, confining her to a wheelchair. The retrospective report aimed at assessing how hydrotherapy can be a safe and enjoyable option for pediatric TM patients; to evaluate clinical outcomes and the impact of the hydrotherapy program on lower limb strength, functional performance, and quality of life; and to investigate satisfaction levels with the integration of hydrotherapy into rehabilitation.
Methodology :
Comprehensive physiotherapy was carried out weekly for 5 months. Hydrotherapy was incorporated after 3 months of land-based treatment to enhance functional ability. The program includes games that encourage her to use problem-solving skills while navigating the water with limited lower limb function. Each movement becomes playful and functional, fostering achievement and the freedom to walk, jump, and explore with reduced fall risks. Outcome measures include the “30-Second Sit-to-Stand” test for strength, the “Timed Up and Go” test for mobility, and “Patient-Reported Outcome Measurement Information System Pediatric-25 Profile v2.0 (PROMIS-25)” for quality of life, along with feedback via a satisfaction questionnaire.
Result & Outcome :
After the hydrotherapy program, patient’s 30-Second Sit-to-Stand test increased from 11 to 15 repetitions; Timed-Up-and-Go time decreased from 26 to 13 seconds; all PROMIS-25 domains, including physical function, anxiety, depressive symptoms, fatigue, peer relationship, and pain, improved. No adverse events were reported throughout the program. The patient's mother reported a satisfaction score of 8/10 regarding the benefits of hydrotherapy. This tailored hydrotherapy program proved to be a safe and enjoyable approach for our young patient with TM. Gains in lower limb strength, functional ability, and quality of life show that rehabilitation can be enjoyable. By embracing the playful essence of hydrotherapy, we can meet the unique needs of children with TM, paving the way for innovative care in pediatric physiotherapy.
