Aquatic Exercises Lecture Part 1

AQUATIC EXERCISES DEFINITION OF AQUATIC EXERCISE  Aquatic exercise refers to the use of water (in multidepth immersion pools or tanks) that facilitates the application of established therapeutic interventions, including stretching, strengthening, joint mobilization, balance and gait training, and endurance training. GOALS AND INDICATIONS FOR AQUATIC EXERCISE Facilitate range of motion (ROM) exercise;  Initiate resistance training;  Facilitate weight-bearing activities;  Enhance delivery of manual techniques;  Facilitate cardiovascular exercise;  Initiate functional activity replication;  Minimize risk of injury or reinjury during rehabilitation;  Enhance patient relaxation;  PRECAUTIONS AND CONTRAINDICATIONS TO AQUATIC EXERCISE Fear of water Neurologic disorders Seizures Cardiac dysfunction Small open wounds & lines intravenous CONTRAINDICATIONS  Onset of cardiac failure & unstable angina  Respiratory dysfunction  Severe peripheral vascular disease  Danger of bleeding or hemorrhage Severe kidney disease  Open wounds, skin infections  Uncontrollable bowel/bladder  Water & airborne infections or diseases  Uncontrolled seizures  PHYSICAL PROPERTIES OF WATER        Buoyancy: Buoyancy is the upward force that works opposite to gravity; Clinical significance: Buoyancy provides the patient with relative weightlessness and joint unloading by reducing the force of gravity on the body. In turn, this allows the patient to perform active motion with increased ease. Buoyancy provides resistance to movement when an extremity is moved against the force of buoyancy. This technique can be used to strengthen muscles. The amount of air in the lungs will affect buoyancy of the body. Buoyancy will be increased with fully inflated lungs and decreased with deflated lungs. Body composition will also affect buoyancy. Obese patients will have increased buoyancy due to fat tissue having a lower specific gravity. Patients with increased bone density will have less buoyancy than those with decreased bone density. CLINICAL TIP Rotator cuff HYDROSTATIC PRESSURE Definition. Hydrostatic pressure is the pressure exerted by the water on immersed objects.  Clinical significance :Increased pressure reduces or limits effusion, assists venous return, induces bradycardia, and centralizes peripheral blood flow.  VISCOSITY Viscosity is friction occurring between molecules of liquid resulting in resistance to flow.  Clinical significance. Water’s viscosity creates resistance with all active movements.  ■ Increasing the velocity of movement increases the resistance.  ■ Increasing the surface area moving through water increases resistance.  SURFACE TENSION Definition. The surface of a fluid acts as a membrane under tension. Surface tension is measured as force per unit length.  Clinical significance. The effect of surface tension includes the following.  ■ An extremity that moves through the surface performs more work than if kept under water.  HYDROMECHANICS  Hydromechanics comprise the physical properties and characteristics of fluid in motion.  Components of flow motion. Three factors affect flow;  They are laminar flow, turbulent flow, and drag.  ■ Laminar flow. Movement in which all molecules move parallel to each other, typically slow movement.  ■ Turbulent flow. Movement in which molecules do not move parallel to each other, typically faster movements.  ■ Drag. The cumulative effects of turbulence and fluid viscosity acting on an object in motion.  Clinical significance of drag. As the speed of movement through water increases, resistance to motion increases.  ■ Moving water past the patient requires the patient to work harder to maintain his or her position in pool.  ■ Application of equipment (glove/paddle/boot) increases drag and resistance as the patient moves the extremity through water. CLINICAL TIP  Increasing resistance to motion. If the goal is to increase muscular force production during the early part of knee extension,the clinician should consider the use of a hydro-boot or similar device to increase the drag force on the leg/foot.