Abstract: Background/Purpose: There are 800,000 new or recurring strokes per year in the U.S. Strokes are the fourth leading cause of death, and number one cause of adult disability10. The purpose of this literature review is to find which type of intervention is best for improving balance in post stroke patients. Specifically, the following PICO question is of interest: does aquatic therapy improve balance better than conventional land based therapy for patients post stroke?' Case Description: The patient, a 68-year-old male, suffered a right acute pontine infarct CVA with right internal carotid stenosis and ulcerative plaque resulting in left hemiplegia. Deceased functional strength was demonstrated in the left lower extremity and the patient had decreased balance, proprioception and motor planning. Decreased balance was demonstrated by a Berg Balance score of 38/56. The patient underwent conventional balance and gait training on land. Outcomes: The patient had good outcomes with improvement of balance and gait, decreasing his need for an assistive device. However, the patient did not meet his long-term goal of 50/56 for the Berg Balance and was therefore still at an increased risk for falls. The patient was ultimately discharged due to a plateau in progress. Upon discharge, the patient still had difficulty clearing obstacles, completing sharp turns during gait, and had decreased heel/toe rocker and clearance of the left foot during gait, increasing loss of balance episodes. Discussion: There is fair evidence to demonstrate that aquatic therapy may improve balance better than conventional land therapy for patients post stroke. Water has specific properties and advantages that land does not have to improve proprioception and reduce the fear of falling. The studies have lower power and the results cannot be generalized to the entire stroke population. The results are to be used with caution. Overall aquatic therapy is a safe, and cost effective adjunct treatment for balance post stroke.
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Stroke, Balance, Aquatic
Buszek, Brigit. "Does aquatic therapy improve balance better than conventional land based therapy for patients post stroke?." (2015). http://digitalrepository.unm.edu/dpt/105