Eight studies (115 participants) were included in the review comprising two randomised controlled trials (RCTs), three non-RCTs, one cohort study, one case series, and one case report. Sample sizes ranged from one to 46 participants. The average score for quality on the PEDro quality scale was 4.6 points (range 2 to 7 out of 10 points).
All eight studies reported that aquatic interventions, either as a major component or as a stand alone intervention, were beneficial for children and adolescents with cerebral palsy.
Improvements in activity were reported for gross motor skills (three studies including one RCT); maintenance of improvement in gross motor function at six weeks to three months after the intervention (two studies); and increased swimming skills for kindergarten children (two studies including one controlled trial).
Improvements in function were reported for greater walking efficiency (three studies); increases in lower-extremity muscle strength (two studies) and balance (two studies); better respiratory function (one study) and reduced spasticity in adolescents (one RCT). Improvements were also reported for range of motion with an increase in passive range of motion of lower-extremity joints (one study), and improved active and passive range of motion (one RCT).
Positive impacts on participation were reported in six studies (including one RCT) with improvements in performance, satisfaction, social functioning and self-perception.