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Hind D, Parkin J, Whitworth V, et al. Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation. Southampton (UK): NIHR Journals Library; 2017 May. (Health Technology Assessment, No. 21.27.)

Cover of Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation.

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Background

Physiotherapy is thought to help children with Duchenne muscular dystrophy (DMD) stay physically active. Aquatic therapy (AT; also known as hydrotherapy), that is, physiotherapy in warm water, allows exercise and stretching that are not possible on land. It is not clear that AT works, so NHS access is limited.

Objectives

To see if a full-scale controlled trial (experiment) was feasible, we wanted to enrol 40 children to a pilot study, 20 of whom would have AT. We also tested the design and procedures.

Methods

All children were asked to do stretching and exercise at home. We planned that half would have AT in hospital pools for half an hour, twice a week, for 6 months. We measured how well they could use their legs at the beginning and end of the study. After this, children, parents and physiotherapists told us how they felt about AT and the study.

Results

We screened 348 children with DMD for the study. Only 12 could enter the study. This number is too low to show whether or not AT works. Those involved said that it should be offered nearer to their homes than we managed. The cost to the NHS for 6 months of hydrotherapy treatment was £1970–2734 per child.

Conclusions

An insufficient number of children could be found for a full-scale study run only from hospitals. Local AT programmes should be designed by specialist physiotherapists in liaison with children, parents, community physiotherapists and teaching assistants. Standard trial designs may not be feasible. Other research designs might be needed to test AT.

Copyright © Queen’s Printer and Controller of HMSO 2017. This work was produced by Hind et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK436174
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