New research on aquatic therapy and the brain

New research on aquatic therapy and the brain
New research on aquatic therapy and the brain

This information on water and the brain is too good not to share. Most families of children who have cortical visual impairment (CVI) seem to report that their child “loves water.” This research, shared by our aquatic occupational therapist (OT) tells us why. The information comes from the International Conference for Evidence Based Aquatic Therapy (ICEBAT), recently held in Las Vegas, Nevada.

Recently, I attended a world-wide evidence-based conference on aquatic therapy. This was the first time this conference has ever been held in the US. It was very exciting to learn about the recent research being done on the effects of water on the brain! 

We run a unique, yet evidence-based, type of therapy practice where we have grown the aquatic side based on the amazing results we see using the water as a therapy tool. Most kids we see have a far better response, more fun, and learn more in the water than on land. Water is good for so many obvious reasons. However, it is not common to see occupational therapy for children in the aquatic environment (the conference was mostly focused on adults and aquatic PT) and it is especially not common to see it done in the way we do it. When you see kids in our sessions it looks a lot like traditional therapy but in the water with toys and games everywhere! 

Everyone jokes about the “magic” of aquatic therapy. Well, it really is not magic but a lot of interesting science that helps kids to succeed in this environment. Here are some interesting points based on new research about water and the brain:

•  Water immersion to the shoulders increases cerebral blood flow (blood flow to the brain) by 7% – you will often see us working on skills at the side of the pool  while immersed in the water (sometimes for other reasons or to target another skill we stand or are more out of the water).

•  This increased blood flow to the brain further increases another 7% when you introduce mild to moderate exercise (bringing the total up to 14%). This is why we normally do an active warm up – moving back and forth across the pool kicking or moving arms and legs.

•  The increased blood flow to the brain is thought to be the reason for increased cognitive, language, engagement and social skills seen in the water environment.

•  Acetylcholine is a neurotransmitter that acts within the central nervous system – it can speed up and slow down nerve signals. In the central nervous system it mainly speeds up signals and assists in learning, memory, arousal and neuroplasticity. Water immersion increases acetylcholine.  This makes the water a prime environment for learning a variety of motor skills – even skills that kids have not been able to attain on land.

•  Water immersion promotes neural plasticity and motor learning – this effect lasts for up to 4 hours after getting out of water. This means that working on skills such as dressing are enhanced in terms of motor learning when working on this after being in the water. This also means that your child’s brain is ultimately prepped for more motor learning for four hours after therapy so this is a good time to play games, toys, work on skills, etc.

•  Serotonin (a neurotransmitter that helps to regulate mood, social behavior, memory and more) and dopamine (a neurotransmitter that helps to regulate movement and emotional responses, and more) both increase during water immersion. That is why you often see us “warm up” with getting rings or toys from the bottom of the pool. For kids who cannot yet go under we work on getting these with feet. The pressure of the water when under combined with the increased blood flow to the brain prep your child for the remainder of the session.

•  Reduction in proprioceptive feedback from the buoyancy of the water creates a sensory conflict and stimulates the sensory systems involved in balance and contributes to sensory awareness.

•  Water immersion decreases blood pressure, decreases stress, increases relaxation and decreases the “fight or flight reaction” which makes the water a perfect place to work on stressful things – it is easier to talk about and plan for potential stressors (toilet, hand dryers, showers, dogs, etc) in the water and then tackle the stressor after.It also makes it the perfect place to work on social skills since everyone is more relaxed as social skills can be stressful.

Advanced Therapy Network Resource, PLLC

7 thoughts on “New research on aquatic therapy and the brain

  1. I found this article particularly interesting! I have been a swim teacher and water aerobics instructor for 13+ years and am currently working on helping with program development around CVI at a pediatric site that has access to a small aquatic therapy pool – this article drew my attention to utilizing that resource! Could I request to have the citations for those research (evidence-based) sources sent to me? Thank you!


    1. Hi Kayley, this was from our aquatic OT, her notes on information presented at the conference. I can try to get specific links. I would love to hear more about your aquatic program for kids with CVI. Could you please email me at Thanks!


      1. I too would really love the research sources for this. Would you mind if I also emailed?


  2. Do you have a picture of your pool environment and how it is adapted for a few phases of CVI? Any favorite toys or activities?


    1. I do not have photos to share. It is a public pool, indoor, and pretty low visual complexity. The sensory complexity of the pool is something else, depending on how busy the pool is at certain times of day (we tended to be there at slower times). An example of compensating for complexity would be having the child with CVI facing a white wall when working on an exercise such as throwing. Or the OT wearing a yellow rash guard so that my son could find her more easily. Or using an Elmo visual target when working on throwing, and throwing a ball in the child’s preferred color. Also, always observing the child and making appropriate adjustments as you go along. Hope that helps.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s