EFFECTS OF A 53-HOUR ADAPTIVE SWIMMING AND DIVING PROGRAMME USING THE IDA METHOD IN TWO INDIVIDUALS WITH ABLEPHARON-MACROSTOMIA SYNDROME: A TWO-PARTICIPANT CASE SERIES

Ana Golez, MD, PhD*

Background: Ablepharon-macrostomia syndrome (AMS) is an exceptionally rare congenital disorder associated with variable craniofacial, ocular, auricular, cutaneous and systemic abnormalities. Information concerning rehabilitation, adaptive physical activity, swimming and diving in individuals with AMS is extremely limited. Aquatic environments may facilitate movement through buoyancy and provide multidirectional resistance during active movement. Objective: To describe the characteristics of an intensive adaptive swimming and diving programme using the IDA method and clinically observed functional changes in two individuals with AMS. Materials and Methods: Two individuals with AMS participated in 53 hours of individually adapted swimming and diving activities delivered over 24 days. The programme included aquatic adaptation, buoyancy-assisted movement, postural-control activities, propulsion, swimming, SCUBA diving, breath-hold diving and progressive modification of physical assistance. Diving exposure was characterized using recorded depth and breath-hold data. Results: Both participants completed the programme. Participant 1 participated in SCUBA and breath-hold diving, reaching a maximum SCUBA depth of 9.9 m and a maximum breath-hold depth of 6.0 m. The mean recorded diving depth was 2.43 m and the longest recorded breath-hold was 1 min 26 s. Participant 2 participated exclusively in SCUBA diving, reaching a maximum depth of 1.5 m, with a reported mean depth of 1.35 m. Clinically observed changes included greater active aquatic movement, functional physical capacity, postural control, participation and reduced direct assistance during selected activities. Conclusion: The 53-hour individually adapted programme was associated with positive functional observations in two individuals with AMS. Causal conclusions cannot be drawn because of the very small sample, descriptive design and possible contribution of concurrent rehabilitation, learning and familiarization. The detailed diving data demonstrate the individualized nature of the intervention and provide a basis for future research.