# Salivary Cortisol Levels after Hydrotherapy and Land-Based Therapy as a Marker of Stress in Children with Psychomotor Developmental Disorders: A Pilot Study

## TL;DR

This pilot study examines whether hydrotherapy and land-based therapy affect stress levels in children with psychomotor developmental disorders by measuring salivary cortisol.

## Contribution

The study explores the use of salivary cortisol as a stress marker in children undergoing different therapy types for developmental disorders.

## Key findings

- Salivary cortisol levels remained within normal ranges after both hydrotherapy and land-based therapy.
- Cortisol levels decreased after therapy sessions compared to baseline.
- No statistically significant difference in cortisol levels was found between hydrotherapy and land-based therapy.

## Abstract

Background: The number of children experiencing postnatal situations of neurological risk (such as psycho-motor developmental disorders and delays) after birth has increased in recent years. These infants often require multiple pediatric interventions to address functional problems that might generate stress, anxiety, and discomfort. The aim of the present study is to determine whether the level of salivary cortisol, as a stress marker, increases after hydrotherapy and land-based therapy in children at risk of or currently presenting delayed psycho-motor development. Methods: Saliva samples were collected from 25 children (aged 3–36 months) between June 2022 and January 2023 at the Rehabilitation and Physical Medicine Clinical Management Unit of the Virgen de las Nieves University Hospital, Granada, Spain. Three samples were collected from each child, representing baseline, post-hydrotherapy and post-land-based therapy. Result: All salivary cortisol levels were within the normal range. Resting values were the highest, and both modes of therapy decreased salivary cortisol levels. There were no statistically significant differences between the two therapies. Conclusions: Both therapies appear to be useful for treating children with psychomotor developmental disorders without increasing stress during physiotherapy sessions. Although cortisol levels were slightly higher with hydrotherapy than with land-based therapy, this may be due to the small sample size.