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Q: Our daughter has SMA type II that causes marked muscle weakness. I have read a few papers lately stating that hydro twice a week would be optimum for her. She is currently undergoing hydrotherapy every week to two weeks, and really enjoys it. I would love for her to up this amount to twice weekly.
Response It has been recognized for a long time that children with muscle weakness do better, over a longer period of time, if they are able to exercise. When the muscles are very weak, water exercise is one of the best methods. This is because the water reduces the effect of gravity and the child can do more.
All children with SMA need to be monitored by a Physiotherapist to ensure that they have the types of aids that they need to maximize their function. The PT is in charge of joint safety. But the child with SMA is not the same as a child with Cerebral Palsy. The SMA children are weak, but their motor planning by their brains is normal. The therapy they need is primarily exercise for strengthening. Once or twice a week strengthening has little effect in athletes. There is no reason that the child would need less than what is normally recommended for strength training in the able bodied. The standard is alternate day training.
An aquatic therapist can be of great help getting you started and helping you progress the program she does in the water. Jane Styer-Acevedo is a recognized expert in both aquatic physical therapy and water exercise. Her website www.ndtaquatictherapy.com is a good source of further information to justify this type of intervention. If you Google Aquatic therapy in SMA, there are several case reports that would also be helpful in making a case for water exercise. Water floatation devices, such as the WET VEST, make it easy for her to play and exercise in the water under family supervision. Look at the website www.hydrofit.com for ideas of things you can use to help her in the water.
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