Lec 14: Aquatic Rehab (Pt 1)

Buoyancy:

• Define:

• Decreases what in proportion to what?

• Define:

  • Upwards force exerted by a fluid that opposes the weight of the immersed object

• Decreases:

  • Effective weight

  • Degree of immersion

Buoyancy:

• What are the 2 Rehab benefits of Buoyancy?

• Reduce weight bearing

• Increase ROM

Degree of Unloading:

More immersed = More unloading

Hydrostatic Pressure:

• Define:

• Increases with what 2 things?

• Define:

  • Pressure exerted on an object

• Increases:

  • Liquid density

  • Immersion deoth

Hydrostatic Pressure:

• What are the 3 Rehab Benefits of Hydrostatic Pressure?

• Aides in edema management

• Vasoconstriction

  • Colder Water = Constriction

  • Warmer Water = Dilation

• Increase Stroke Volume

Thermal Shift:

• Define:

• Water conducts heat ____ faster than air.

• Define:

  • Movement of heat between the body and surrounding water

• 25x

Thermal Shift:

• Be cautious with populations with what?

  • 2 MC pop:

• Impaired thermoregulation

  • Children/Infants (Cold/Warm)

  • Pregnancy (Warm)

Thermal Shift:

• What are the 2 Rehab Benefits of Thermal Shift?

• Pain Reduction

• Warm Up Muscles and Jts for Movement

Viscosity:

• Define

• Water has (More or Less) molecules than air

• Define:

  • Thickness or resistance to flow in a fluid

• MORE

Viscosity:

• What are the 3 main Rehabilitation Benefits of Viscosity?

• Natural resistance to movement

• Increase time to react to postural perturbation

• May be able to try more challenging activities than on land

Turbulence:

• Define:

• Irregular or disturbed flow in water

  • Jolting Motion

Turbulence:

• What are the 2 Rehabilitation Benefits of Turbulence?

• Increase resistance or challenge balance

• Proprioception and core stability

Surface Tension:

• Define:

• Resists what of objects from the water?

• DefineL

  • Cohesive force between water molecules at the surface

• Entry OR Exit

Surface Tension:

• What is the main Rehab Benefit of Surface Tension?

• Can provide mild resistance at the surface

  • Ex. Shoulder Push Down with water weights

    • Gets resistance from surface to water

Refraction:

• Define:

• Objects can appear in what 2 ways?

• Define:

  • Bending of light as it passes from one medium to another (air to water)

• Shifted or Distorted

Refraction:

• What is the main Rehab Benefit of Refraction?

  • Esp when?

• Can affect visual perception

  • Esp if observing outside of the pool

Contraindications:

• (Pt 1 - 3)

• Uncontrolled Cardiovascular Issues

  • Cardiac Failure

  • Unstable Angina

  • Uncontrolled HTN

  • Compromised Vital Capacity

• Uncontrolled Seizures

  • Poses drowning risk

• Open or Infected Wounds

  • Open skin infection

    • OR

  • Significant open lesion

Contraindications:

• (Pt 2 - 3)

• Contagious Systemic or Waterborne Infections

  • Diarrhea in the PAST 2 WEEKS

• Tracheostomy or Absence of a Cough Reflex

  • Risk of Aspiration

• Incontinence

  • Fecal or Urinary

  • May be ok if pt able to manage

Contraindications:

• (Pt 3 - 3)

• Severe Respiratory Compromise

  • OR low vital capacity

• Acute Medical Conditions

  • Recent Cerebral Hemorrhage

  • Acute Inflammatory Disease

  • Recent Sx

• Severe Anxiety/Fear of Water

  • Hydrophobia

Precautions:

• (Pt 1 - 2)

• Cardiovascular

  • Monitor for Angina, HTN, Edema, Fluid Shifts

• Neurological

  • Cerebral Epilepsy

    • Use Flotation

  • MS

    • Avoid temps > 88 deg

  • Dizziness/Vertigo

Precautions:

• (Pt 2 -2)

• Skin Conditions

  • Minor Wounds

    • Must be covered

  • Chemical Sensitivities

  • Recent Radiation Tx (Cancer)

• Pregnancy

  • Avoid warm water

  • Monitor Thermoregulation

Precautions:

• (Pt 3 - 2)

• Diabetes or Renal Issues

  • Monitor fluid balance and skin integrity

    • May want to wear water shoes to protect feet

• Cognitive or Behavioral Challenges

  • Ensure ability to consent

  • Maintain safe and appropriate therapy environment