Aquatic Therapy Lecture #2

Aquatic Therapy What it facilitates - Strengthening Balance Jt mobilization Endurance training Gait training Stretching Beneficial in - ROM exercise Resistance training WB activities Cardio exercise Functional activity replication Pt relaxation Minimizing risk of injury during rehab Buoyancy/off loading - Archimedes principle: Body experiences upward thrust equal to volume of liquid displaced Joint unloading by reducing gravity, resistance to increase muscle strength Influences by air in lungs and body comp Squats at different depths Greater the submersion the less effect of gravity on BW Viscosity / resistance - Greater velocity movements: greater resistance Greater surface area moving: Greater resistance Friction “thickness” of water affects how body moves (have to over come waters resistance) Foam dumbbell exercises, jogging Hydrostatic pressure/swelling - - Pascals law: Pressure is equal on all surfaces of the object. As density of water/depth of immersion increases so does the pressure Reduces effusion, assists with venous return, centralizes peripheral blood flow Exercises are easier to perform close to surface due to decrease in depth/pressure Wrapping an extremity and taking measurements (water pressure reduces swelling by applying external pressure that pushes fluid out of tissues and back into circulation) Water increases venous return by the hydrostatic pressure pushing fluid towards the heart Surface tension - Attraction of molecules is parallel to surface Extremity that breaks the surface performs more work than if it stays under the surface Laminar flow - All molecules move parallel to each other, little lateral movement, with slow motions Proportional to velocity of water movement Turbulent flow - Molecules do not move parallel to each other, rapid changes in pressure or velocity Drag - Cumulative effects of turbulence and fluid viscosity acting on an object in motion Speed move movement increases, resistance to motion increases Greater than 98.6 increases cardiac output 78.8-95 General temp, gait training, relaxing 71.6-78.8 for intense aerobic 78.8-82.4 for general aerobic Contraindications • Cardiac failure • Vital capacity of less than 1 liter • Severe peripheral vascular disease • Danger of hemorrhage • Severe kidney disease which results in inability to regulate fluid loss • Open wounds without occlusive dressings • Skin infections • Water or airborne infections • Contagious diseases Precautions • Fear of water • Neurological disorder • Temps greater than 91.4 degrees F • Respiratory disorder • Seizure • Cardiac dysfunction • Gastric tubes or suprapublic appliances • Colostomy • Bladder or bowel disorder • Menstruation without proper protection • Small open wounds • Intravenous lines Indications • Facilitate ROM • Begin resistance training • Facilitate WB activities • Provide 3-D access to patient • Enhance manual therapy techniques • Facilitate cardiovascular exercise • Improve strength • Initiate functional activity • Minimize risk of reinjury • Relaxation of the patient • Relieve pain • Allow patients to attempt movement patterns without fear or risk of fall Maintenance • Pools must be cleaned twice weekly to prevent pseudomonas aeruginosa • Chlorine and pH tests should be done twice daily • Walking surfaces around pool should be slip-resistant • Check area around the pool for puddles • Check equipment to ensure there is no damage prior to use • Check flotation/buoyancy devices • Safety procedures should be posted • EAP should be in place for this area