Can aquatic physiotherapy improve aerobic capacity in adolescents with cerebral palsy?

The intervention is a 10 week aquatic training program performed in a dedicated paediatric tertiary hospital hydrotherapy pool at Perth Children's Hospital (PCH). The program is based on high intensity interval training. The properties of water will add resistance to fast paced movement providing simultaneous aerobic and strength training. Participants will participate in a supervised group setting. This program will be offered 3 days/week with participants expected to attend 2 days/week for 10 weeks duration. Adherence to the program will be monitored through the weekly attendance sheets where participants will be asked to report any additional exercise. The program to improve aerobic capacity and muscle mass will follow previously published parameters utilised in land based exercise training. The 40 - 50 min class will include a warm up; High Intensity Interval Training (HIIT); a cool down and stretches. During the HIIT phase, participants will exercise at two different intensities. Participants will have an individualised heart rate (HR) goal set by their HR at peak uptake of oxygen (VO2 peak) recorded during a maximal cycle cardiopulmonary exercise test. High intensity will be defined as between 80-95% of VO2 peak HR. Rest is defined as minimal activity. Rate of perceived exertion (RPE) will be recorded. HR will be continuously monitored through a water resistant heart rate device which will be paired to an external monitoring device. Intervals of 60 seconds high intensity activity will be followed by rest of a similar time duration and will be repeated 10 times. Participants will rotate through a circuit of activities each interval. These will be individually adapted to enable the participant to participate within their movement capabilities. Activities include water running, jumping, lower limb kicking and upper limb weights under water.