Aquatic Therapy

Indications for aquatic therapy

- ROM

- Resistance training

- Facilitate weight bearing

- Enhance technique of manual therapy

- Cardiovascular endurance

- Functional activity replication

- Minimize risk of injury

- Enhance relaxation

Precautions to aquatic therapy

- Fear of water

- Neurological disorders (ataxia, heat intolerance, epilepsy)

- Respiratory disorders (lung expansion inhibited in water)

- Cardiac dysfunction (angina, abnormal BP, heart disease, compromised pump mechanisms)

Can patients with wounds and/or lines participate in aquatic therapy

Small open wounds, tracheotomies are covered with waterproof dressings

IV lines, Hickman lines are clamped and fixated

Large open wounds and infections are contraindicated

Contraindications to aquatic therapy

Unstable angina

Respiratory dysfunction

Severe peripheral vascular disease

Open wounds without dressings

Bowel & bladder incontinence

Menstruation without internal protection

Water and airborne infections

Uncontrolled seizures

Weight bearing with immersion

C7- 10%

Xiphoid- 33%

ASIS- 50%

Buoyancy meaning

Upward force in water

Buoyancy significance

- Dec weight, joint unloading

- Resistance to movement

- Obese patients are more buoyant

Hydrostatic pressure meaning

"squeezing" of water on the body

Hydrostatic pressure significance

- Reduces effusion, assists venous return, induces bradycardia, centralizes peripheral bloodflow

- Inc depth = inc pressure

Viscosity meaning

Friction between molecules causing resistance to flow

Viscosity significance

Resistance with all active movements

Inc velocity = inc resistance

Inc surface area = inc resistance

Surface tension meaning

Surface of a fluid acts as a membrane

Surface tension significance

An extremity moving through surface performs more work than if kept under water

Hydromechanics meaning

Characteristics of fluid in motion

Hydromechanics significance

Moving water past the patient requires patient to work harder

Application of equipment increases drag

Thermodynamics meaning

Water tempurature's impact on the body

Thermodynamics significance

A patient moving through water loses temperature faster than a person at rest

Center of buoyancy meaning

Similar to center of gravity on land

Center of buoyancy significance

In water, COB is at sternum

Posterior places buoyancy device causes patient to learn forward; vice versa

Unilateral LE amputation makes patient lean towards residual limb

General water temperature principles (what temperature range must pool be kept in)

25dgs C to 37dgs C

For general flexibility, strengthening, gait training, relaxation, water should be kept between

26 - 35dgs C

For cardiovascular training, aerobic exercise, water temp should be kept between

26 - 28dgs C

Collars, rings, belts, vests are used to

assist with patient positioning by providing buoyancy

Gloves, hand paddles, and hydro-tone bells are used to

Create resistance to UE movements

Swim bars are used to

Support the upper body or trunk in upright positions or the LE in supine or prone

Fins and hydro-tone boots are used to

Create resistance to LE movements

Kickboards are used to

Provide buoyancy in prone or supine positions

Create resistance to walking patterns in shallow water

Challenge seated, standing, kneeling balance in deep water

What infection is common around therapeutic pools

Pseudomonas aeruginosa

CP response to water immersion: SV

increase

CP response to water immersion: CO

increase

CP response to water immersion: HR

stay same or decrease

CP response to water immersion: IRV

decrease

CP response to water immersion: FVC

decrease