The effect of Ai Chi and Halliwick on Postural Balance and Muscle Strength in Stroke Survivors

Randomized Controlled Pilot Trial

By Noh DK, Lim JY, Shin HI, Paik NJ. from Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.


To evaluate the effect of an aquatic therapy programme designed to increase balance in stroke survivors.


A randomized, controlled pilot trial.


Rehabilitation department of a university hospital.


Ambulatory chronic stroke patients (n = 25):13 in an aquatic therapy group and 12 in a conventional therapy group.


The aquatic therapy group participated in a program consisting of Ai Chi and Halliwick methods, which focused on balance and weight-bearing exercises. The conventional therapy group performed gym exercises. In both groups, the interventions occurred for 1 hour, three times per week, for eight weeks.


The primary outcome measures were Berg Balance Scale score and weight-bearing ability, as measured by vertical ground reaction force during four standing tasks (rising from a chair and weight-shifting forward, backward and laterally). Secondary measures were muscle strength and gait.


Compared with the conventional therapy group, the aquatic therapy group attained significant improvements in Berg Balance Scale scores, forward and backward weight-bearing abilities of the affected limbs, and knee flexor strength (P < 0.05), with effect sizes of 1.03, 1.14, 0.72 and 1.13 standard deviation units and powers of 75, 81, 70 and 26%, respectively. There were no significant changes in the other measures between the two groups.


Postural balance and knee flexor strength were improved after aquatic therapy based on the Halliwick and Ai Chi methods in stroke survivors. Because of limited power and a small population base, further studies with larger sample sizes are required.

References: PMID: 18955428