VCU DPT - Agents (Hydrotherapy)

define buoyancy

upward force of water on object immersed/partially immersed that is EQUAL to the weight of water it disperses

this is the definition of ___________:

the upward force a water exerts on an object that is equal to the amount of water the object is displacing

buoyancy

with buoyancy, if something is 75% immersed then we will see a ___% weight bearing reduction

75

the amount immersion is equal to amount of upward force

what is clinical significance of buoyancy

allows the patient to perform motion easier, and will be helpful for those with larger weoghts

what populations is aquatic PT great for

partial weight bearing patients

obesity

fall risk

also OA, CVA, TBI

we are _____% weight bearing at immersion up to _____ landmark:

a) C7

b) xiphoid process

c) ASIS

a) 10%

b) 33%

c) 50%

explain why at immersion up to ASIS we are 50% weight bearing

because the reduction of weight bearing it equal to amount of us that is underwater

since about 1/2 of body is under water at ASIS, we will have a 50% reduction of weight bearing

when we move our arms down, does that help us move up or down

up

because we push down on water, so it pushes up on us

which has a higher specific gravity, pure water or average human body?

what happens as a result of this

pure water

this means that we float in water, but it is close

pure water specific gravity is 1

avg. human body is 0.974

what does this mean

it mean we float in water, but just barely

viscosity is _________

internal frcition present in liquids, secondary to chesive forces between molecules

viscosuty and drag represents:

_______ to motion

is it or is it not velocity dependent

resistance

it is

what does it mean by having viscosity and drag being velocity dependent

the faster the movement is, the greater resistance you face

how can the "velocity dependent" nature of viscosity and drag end up being protective to patients

because they will naturally move slower to put on less resistance if it is painful, decreasing force and pain

what is cohesion

the tendency of H20 molecules to adhere to each other

attraction of water molecules is _____ at surface

resistve forces change _________ to the size of object moving through surface

parallel

proportional

what are the clinical significances of cohesion

moving through the surface is MORE WORK than moving underwater

the bigger the object, more resistance it faces

which is more work:

moving through the surface

moving underwater

through surface

surface tension

______ is the circumferential water pressure exerted on immersed body/body part

hydrostatic pressure

does water push on all sides equally?

yes, hyodrstatic pressure and pascal's law said so

pressure is ______ on all sides

hydrostatic pressure will _______ with increased water depth

more depth = _______ resistance to movement

equal

increase

more

the deeper you are, the _____ pressure is on you, and there is _____ resistance

therefore, deep water exercise is _____ challenging than shallower water

more

more

more

does higher hydrostatic pressure have effect on edema?

venous return?

it might, help increase

help increase

what is turbulence

the movement of body part through water creating circular motion (eddy), producing frictional drag

moving through turbulent water will __________ resistance

increase

using equipment will _________ resistance and _____ drag as patient moves in water

increase x2

if we move through water past the patient, the patient will have to work ___(less/more)____ to maintain posture

harder

water transfers heat through ______ and _________

conduction and convection

t/f: if the water is too warm, our body can cool via evaporation

FALSE

can not

water transfer of heat is effective due to __________

high specific heat and thermal conductivity

warm water temps will result in vaso_______

cold water temps will result in vaso _______

dilation

constrictio

warm water temps are equal to or greater than _______

result in vaso___________

if temp higher than body temp, will ______ HR

temps greater than 105 deg F result in what

95.9 deg F

dilation

increase

rapid fatigue, overheating

cold water temps are equal to or less than ______

result in vaso ___________

what effect will it have of HR

temps less than 66 deg result in what

80.6 deg F

constriction

bradycardia

analgesia, anesthestia

immersion of temp at body temp will have ______ effect on HR

immersion of temp higher than body temp results in _____ effect on HR

immersion of temp lower than body temp and cool will result in ____ effect on HR

no

increase HR

slow HR (Bradycardia)

what are the cardiovascular effects of hydrostatic pressure

pressure results in venous blood displaced proximally, increasing cardiac volume and increasing stroke volume and cardiac output

will monitoring HR be an accurate relfection of patient effort and exercise tolerance

no

use RPE instead

what is the effect of hydrotherapy on respiratory system (2)

decreased maximum oxygen uptake

increased total work or breathing, esp as water goes up past chest

what is effect of hydrotherapy on renal function?

neurological system?

diuersis stimulated; go to bathroom before in pool

may have temperature dependencies

what effects does hydrotherapy have on the musculoskeltal system

higher oxygen delivery to muscles

better removal of metabolic waste

\decreased muscle spasm

increased strength

is hydrotherapy fun

hell yes

how does aquatic therapy faciliatate ROM and flexibility

manually stretch is easier, as limb weighs less

how is aquatic therapy good for postural control and alignment

the patient is in a 3d space, so is getting feedback provided to them constantly

aquatic therapy can help

- _______ resistance training, weight bearing

initiate

does aquatic therapy help with cardiovacular endruance?

what aboiut functional activities?

yes to both

t/f: some of the unique benefits to aquatic therapy include

3D access to patient

enhanced patient relaxation

pain reduction

injury risk minimzed during rehab

true

name some benefits of water exercise for...

a. orthopedic rehab

b. neruo rehab

c. cardiovasuclar fitness

d. pregnancy

e. asthma

f. age issues

a. decreased weight bearing, resistance easily changed, anything you do has mm pull on bone to make both stronger

b. propriception, improved saftely and balance

c. better conditioning if unfit on land

d. lower weight bearing, less elevation of HR w exercise

e. less exercise asthma than other exercise

f. better balance, strength, fitness, mobility

what does literature say abt water therapy for general ortho patients

it says it is as effective as land therapy, and good for OA too

t/f: lower limb amputations, pediatrics, and parkinsons disease all benefitted from aquatic therapy per literature

true

name some contraindications for aquatic therapy (7)

bowel bladder incontinence (catheters okay, but MUST be clamped)

infectious disease

severe cardiovascular dz

trachesostomy

uncotrolled seizure

reduced vital capacity

active blleding

are the following precuations or contra indications for aquatic theraopy

bowel bladder incontinence (catheters okay, but MUST be clamped)

infectious disease

severe cardiovascular dz

trachesostomy

uncotrolled seizure

reduced vital capacity

active blleding

contra

precautions for aquatic therapy (8)

aspiration risk

catheters, lines and leads

cog. impairement

tetrapledgia

open wound

dry skin

fear of water

sesntivitiy to heat (MS)

are the following precuations or contra indications for aquatic theraopy

aspiration risk

catheters, lines and leads

cog. impairement

tetrapledgia

open wound

dry skin

fear of water

sesntivitiy to heat (MS)

precuation

for aquatic therapy what is optimal pool temp

90-94 deg F

cool temp pools are better for _____ intensity

temp range

higher

86-94

warm temp pools are better for __________ mobility, flexibility, relaxation

temp range

increasing

96-98

with warmer temp, what changes with heat dissapation

it decreases

temp over ____ increases cardiovascular demands, where as temps lower than ______ will pose difficulty maintaining core temp

98.6

77

with deep water, name some equipment

floatation belt/vest

floatation DB

fins

boots

bells

with mid water, name some equipment

forced current

elastic tubing

noodles

kickboard

swimbars

with aquatic therapy,

movement horizontal and upward to surface is _________

floation devices __(can/can not)___ be given to weak patients

encourage trunk ___________

fluid and rhytmic _________

easier

can

stability

motions

with aquatic therapy and stretching,

it is made _______ by the water

easier

- buoyancy

t/f: aquatic therapy promotes reciporcal movements

true

with aquatic therapy, resistance is able to be controlled ________ via ______

manually

buoyancy and velocity

with aqutic therapy,

resistance _____ with increased velocity

slower movements = _____ resistance

a hand held paddle will _____ resistance

when the paddle slices the water we _____ resistance

increases

less

increase

decrease

with aquatic therapy, ataxic movements are __________ against the resistance of water

slower and more controlled

does aerobic conditioning get benefits from aquatic therapy

of course

deep water walking/running

immersed equipment exists

swimming

with this, it is important to determine ___________ first

keep patient's _____ above water

how should patient's pain level be

should you stretch after

comfort level

head

it should not be increased w/ aquatics

great time to do it

do you NEED to be certified

no, but likely should get more trianing

con ed courses, lifegaurd certified

which of the following is whirlpool not recommended for

sprains/strains

status post ortho surgeries

OA/RA

wounds

wounds

with whirlpool, the temp desired is:

heating

cooling

heating: 97-104 deg F

cooling: 56-80 deg F

how long does whirlpool duration last, for both heating and cooling

heating: 20 minutes

cooling: 10-15 min

paramters for whirlpool, temp and duration

a) heating

b) cooling

a: 97-104 deg F, 20 min

b) 56-80 deg F, 10-15 min

if patient has edema, whirlpool might be not great because it is often in a ___________

dependent position

describe how pulsed lavage with suction works

the pulsatile jet goes around the wound bed, and the concurrent suction will create negative pressure in the wound bed

portable and done at bed

lasts about 5-15 min

pulsed lavage w/ suction:

indications is wounds from WHAT

arterial/venous insuffecincy

neuropathic ulcers

infected wounds

fasciotomies

trauma

ETC

pulsed lavage w suction, is it good for:

burns?

abdominal surgeries?

pressure injuries?

yes to all!

name some pros and cons of pulsed lavage w/ suction

pros: decreased risk of tissue damage, pressure set precisley, decreased risk of cross contamination, limb not dependent, portable, treats smaller area

cons: can not easily treat large wounds, cost of single use attachments

a pro of pulsed lavage w/ suction is that it is really good at treating ____(small/large)_____ areas

small, specific