Validation of the functional component of the Halliwick-ICF assessment scale.

Introduction: Aquatic rehabilitation therapy can improve strength and functional ability. Previous studies measured outcomes on land but did not measure underwater functional ability.Purpose: This study aimed to validate the functional component of the Halliwick-ICF assessment scale, and to compare the scale between underwater and on-land activities.Methods: Rehabilitation and medical charts of individuals with brain lesions and/or spine injuries who underwent aquatic therapy were retrospectively reviewed. Twenty-one functional components of the Halliwick-ICF assessment scale items were categorized through exploratory factor analysis: center of gravity alteration, basic functional activity, and progressive basic functional activity. Confirmatory factor analysis was performed to evaluate the validity of the functional components of the Halliwick-ICF assessment scale. Spearman's correlation analyses were conducted using Medical Research Council sum and modified Barthel index scores.Results: Ninety-five participants (mean age: 53.4 years, range: 27-73 years) were included in the analysis. Convergence and discrimination validity for all three factors were established. Total scores of the scale showed correlations with the modified Barthel index (r = 0.636, p < .001) and Medical Research Council sum (r = 0.298, p = .01) scores.Conclusion: The functional components of the Halliwick-ICF assessment scale demonstrated validity with physical function on land, suggesting its usefulness in aquatic therapy.