Effects of Aquatic Rehabilitation Exercise Using a Wearable Device on Tic Severity, Physical Activity, and Anxiety in Children and Adolescents with Tourette Syndrome: A Cross-sectional Pilot Study

OBJECTIVES This study investigated the effects of a 12-week wearable device-based aquatic rehabilitation exercise program on tic severity, physical activity, and anxiety in children and adolescents with Tourette syndrome.METHODS Sixteen participants diagnosed with Tourette syndrome were divided into an exercise (<i>n</i> = 8) and a control group (<i>n</i> = 8). The exercise group participated in a 50-minute aquatic rehabilitation exercise program three times per week for 12 weeks, while the control group maintained their usual daily activities and treatment. Physical activity was assessed using a wearable device, tic severity was evaluated using the Yale Global Tic Severity Scale (YGTSS), and anxiety was measured using the Screen for Child Anxiety Related Emotional Disorders. Data were analyzed using tests of baseline homogeneity, paired t-tests, and repeated-measures analysis of variance. Significance was set at <i>p</i> < 0.05.RESULTS Results showed that the exercise group demonstrated increased physical activity, including daily steps and active time, along with reductions in motor tic scores, vocal tic scores, and the YGTSS Total Tic Score (<i>p</i> < 0.05). Anxiety scores also decreased post-intervention, and significant group-by-time interactions were observed in major outcome variables (<i>p</i> < 0.05).CONCLUSIONS These findings suggest that wearable device-based aquatic rehabilitation exercise may be a useful supportive exercise intervention for promoting physical activity and reducing tic severity and anxiety in children and adolescents with Tourette syndrome.