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Aquatic rehabilitation therapy can improve strength and functional ability. Previous studies measured outcomes on land but did not measure underwater functional ability. 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. 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. 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  &lt; .001) and Medical Research Council sum (r = 0.298,  p  = .01) scores. The functional components of the Halliwick-ICF assessment scale demonstrated validity with physical function on land, suggesting its usefulness in aquatic therapy.

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