Halliwick is a concept, originally developed to teach clients with a (physical) disability to swim and to make them independent in water. The concept was founded by the late James McMillan, an engineer in fluidmechanics. His main aims were participation and independence.
Independence is an important prerequisite for participation in therapeutic, vocational or recreational activities in a group: the willingness to lose balance and knowing how to stand up again are core elements.

A Ten-Point-Programme is used to reach these goals. The most important part of this programme is rotational control, also basis for a second part of the Halliwick Concept: Water Specific Therapy (WST). This part is focused on postural control, normalising muscle stiffness and facilitation of movement. Halliwick is mainly used in neurorehabilitation

Neurorehabilitation

Neurorehabilitation is a complex medical process which aims to aid recovery from a nervous system injury, and to minimize and/or compensate for any functional alterations resulting from it....

 and pediatrics

Pediatrics

Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...

. It has resemblances to Bobath and Conductive education

Conductive education

Conductive Education, or CE, is an educational system that has been specifically developed for children and adults who have motor disorders of neurological origin such as cerebral palsy. It is based on the premise that a person who has a motor disorder may not only have a medical condition...

Halliwick is a problem-solving approach. Possibilities and constraints of the client are analysed in order to use a systematic intervention (Ten-Point-Programme and/or WST) to help the client gain functional increases.

The Ten Point Programme

Mental Adjustment

Sagittal Rotation Control

Transversal Rotation Control

Longitudinal Rotation Control

Combined Rotation Control

Upthrust or Mental Inversion

Balance in Stillness

Turbulent Gliding

Simple Progression

Basic Swimming Movement

Fluidmechanics

The fluidmechanical properties of water are the basis for the intervention techniques. As examples:

- turbulent moving water provides resistance, therefore the client will lose balance slowly and has time to react

- the buoyancy provides an easy way to change position, which influences the vestibular system as in sensory integration

- buoyancy forces counteract gravity forces and create rotational torques (metacentric

Metacentric

Metacentric could refer to:* Metacentric height: the distance between the center of gravity of a ship and its metacenter.* Metacentric Centromere: the position of a centromere on a chromatid...

 effects). These torques can be used to increase load on connective tissue.

Appplications

Mostly Halliwick is dynamic to facilitate movement and sensory input. Halliwick also has a static part, in which e.g. selective activation of muscles and stabilisation of specific joints is exercised.
Halliwick is holistic: the concept can be used to address objectives at all levels of the International Classification of Functioning, Disability and Health ICF

ICF

ICF is an acronym with several meanings:* Immunodeficiency, centromere instability and facial anomalies syndrome.* Insulating concrete form, building construction systems that use concrete in a permanent form made of a rigid insulation....

.

In neurological

Psychiatric rehabilitation

Psychiatric rehabilitation, also known as psychosocial rehabilitation, and usually simplified to psych rehab, is the process of restoration of community functioning and well-being of an individual who has a psychiatric disability...

 and paediatric rehabilitation

Physical therapy

Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

, clients can experience early mobility. The mechanical advantages of water support the abilities of the trunk in a mobilising and stabilising way. In this sense Halliwick is a constraint-induced movement therapy without the disadvantage of gravity compensation.
Many activities easily can be repeated and varied and clients can learn balance- and stumble- strategies, which have carry-over effects to dry land. This application in fall prevention is extended by using obstacle courses or Ai Chi (Noh 2008).

Halliwick also enables a graded activity programme: with low mechanical impact and increasing physiological demand, chronic low back pain patients and others can increase their functional capacity in a mostly joyful way.

External links

• The history of the development in the UK (1949 – 1970) can be found at http://www.halliwick.org.uk/html/history.htm