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Efficacy of an Aquatic Exercise Program for 3 Cases of Rett Syndrome

Escobar Torres, Lourdes MD; Sanders, Mary E. PhD, CDE; Belenguer Benitez, Charo; Melendez Ortega, Agustin PhD

doi: 10.1097/PEP.0000000000000655

Purpose: To examine functional, physiological effects of participating in an aquatic exercise program by 3 girls, diagnosed with Rett syndrome (RS), to explore areas for possible new research.

Summary of Key Points: RS is a severe neurodevelopmental disorder, which causes multiple disabilities and serious impairments in neuromotor and cognitive abilities. Three girls (4, 6, and 7 years), diagnosed stage III RS, participated in 20 months of aquatic exercise, with individually tailored, full body exercises, progressively targeting functional, cardiorespiratory, muscle, and flexibility training. Assessments included resting and exercise heart rates, anthropometric measures, functional, clinical aspects, and psychosocial abilities.

Conclusions: The participants improved functional ability, mood status, relations with family and schoolmates, joint mobility, muscle strength, and endurance during functional activities. Periodic evaluation of exercise heart rates averaged an increase in intensity of 33% above baseline, indicating cardiorespiratory stimulus. This pilot program provides clinical rationale for future studies and clinical interventions for RS children.

Examine functional, physiological effects of participating in an aquatic exercise program by 3 girls diagnosed with Rett Syndrome to explore areas for possible new research.

Department for Equality and Inclusive Policies (Dr Escobar Torres), Generalitat Valenciana, Castellon, Spain; School of Medicine and School of Public Health (Dr Sanders), Community Health Sciences, University of Nevada, Reno, Nevada; Aquatic Fitness Association of Castellón (Ms Belenguer Benitez), Castellón, Spain; ImFine Research Group (Dr Melendez Ortega), Polytechnic University of Madrid, Spain.

Correspondence: Mary E. Sanders, PhD, CDE, 1742 Antelope Ave, Pagosa Springs, CO 81147 (

Translator: Diane Schofield Associate of the Chartered Institute of Linguists, London, UK.

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The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association