Whirlpool Tanks - Design, Function, and Therapeutic Use

Whirlpool Tank  Whirlpools baths or tanks are stainless-steel tanks, which usually are utilized for immersion of all or part of the body, use agitated water to produce convective heat or cooling, massage, and gentle debridement.  The force of water agitation is controlled by knobs on the pump or turbine. Water direction can be controlled by changing the position of the output nozzle. Temperature may range from 36 to 41 °C. All whirlpools tanks have at least one turbine and can be stationary or mobile  Water for the tank can be agitated by turbines, which mix air and water. The body part is submerged and can be actively moved during the treatment. Mechanism of action 1. Water agitation stimulates the skin surface mechanically and thermally. This stimulation of the large diameter mechanoreceptors and thermoreceptors produce analgesic effect through the "Gate control mechanism". 2. The mechanical effect of the water irrigation is used for cleaning of open wounds and removal of débris and necrotic tissues. 3. Mechanical irrigation improves peripheral circulation in cases of ulcers secondary to poor circulation. N.B.: Vigorous irrigation can destroy delicate granulation tissues. o Subcutaneous tissue temperature increases by the water temperature which results in increasing blood flow. Types of whirlpool tanks  The limb tank is used for immersion of one upper limb, both upper limbs, or the distal lower limb.  The lowboy and highboy tanks are used for lower limb immersion or immersion of the trunk up to the mid thoracic level.  In the lowboy tank, the patient is in the long sitting position and can perform ROM exercises with both knees.  In the highboy tank, the patient is seated in chest-high water with flexed hips and knees. Fig. high and low boy whirlpool Whirlpool Water Temperature (A) Cold whirlpool: - 0°Cto26°C (32° F to 79° F). - Can be used in place of an ice pack or a cold pack, to treat acute inflammatory conditions of the distal extremities. Low temperatures can be achieved by adding ice to the whirlpool water; however, very low temperatures should not be used on large areas due to the increased risk of tissue damage. (B)Tepid water: - 26° to 33° C (79° to 92° F). - Should be used in the whirlpool if the water is being used solely as a medium for exercise. Warmer temperatures are likely to produce fatigue and colder temperatures can inhibit muscle contraction (C) Neutral warmth - 33° to 35.5° C (92° to 96° F). - Should be used for the treatment of open wounds and in patients with circulatory, sensory, or cardiac disorders. Neutral warmth may also be used to control tone in patients with neurologically based hypertonicity. (E) Hot whirlpool: - 37° to 40°C (99° to 104° F). - Is recommended for the control of pain and/or to increase soft tissue extensibility because this temperature range of whirlpool water has been shown to increase the temperature of subcutaneous tissue to within the range required to produce these effects. - 40° to 43° C (104°) to - The higher end of this temperature range is recommended for the treatment of chronic condition, such as osteoarthritis or rheumatoid arthritis in the non-acute phases, when small .areas are being treated, while the lower end of this range is recommended when large areas of the body are to be immersed. - The whirlpool temperature should not exceed 43° C (110° F) at any time because higher temperatures may cause burns. - The tank should be filled with water immediately before it is used to prevent the water temperature from changing excessively between filling and patient immersion. If an antimicrobial is being used, it should be added to the water as the whirlpool is being filled. Physiological effects of Whirlpool tank:  This tank combines the values of convective heat and gentle massage. The hydromassage can produce attenuation of pain and muscle spasm. By a) Producing vasodilatation. b) Improving local arterial and lymphatic circulation. c) Breaking down old adhesions after sprains or fractures. d) Cleansing and stimulating wounds (low temperature used), e) Mechanical removing of dirties, dead tissue and pus g) Causing regression of inflammatory processes, and h) Reduction of edema and effusion. Indications of whirlpool tank  Open contaminated wounds. - Contractures  Burns  degenerative arthritis - Muscle spasms -Acute musculoskeletal injuries  Skin ulceration and infection  Patients who are morbidly obese and immobilized who cannot be cleaned in another manner after immobilization or casting Contraindication of whirlpool 1. Diabetes and varicose vein 2. advanced arteriosclerosis. 3. advanced peripheral vascular disease Practical application of Whirlpool tank  Select the proper size and /or style of bath according to the size and need of the patient.