17.hydrotherapy new
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Aquatic exercise uses water properties like buoyancy and viscosity to facilitate therapeutic interventions. Buoyancy provides weightlessness and joint unloading while resistance to movement comes from hydrostatic pressure, viscosity, surface tension, and drag. Water temperatures between 26-35°C are best for exercises while cardiovascular training is optimal at 26-28°C. Contraindications include unstable medical conditions, infections, and inability to regulate fluids, while precautions involve neurological/respiratory disorders. Traditional pools are large group spaces while individual pools are smaller, self-contained units. Proper hygiene before and after sessions is important.
17.hydrotherapy new
- 1. DEFINITION Aquatic exercise refers to the use of multidepth immersion pools or tanks that facilitate the application of various established therapeutic interventions, including stretching, strengthening, joint mobilization, balance and gait training, and endurance training. Properties of water such as buoyancy, hydrostatic pressure, viscosity, and surface tension have a direct effect on the body in the aquatic environment.
- 2. Buoyancy The upward force that works opposite to gravity. Properties: Archimedes’ principle states that an immersed body experiences upward thrust equal to the volume of liquid displaced. Clinical Significance: Buoyancy provides the patient with relative weightless-ness and joint unloading, resists or assists movements.
- 4. Hydrostatic Pressure Pressure exerted on immersed objects. Properties: Pascal’s law states that the pressure exerted by fluid on an immersed object is equal on all surfaces of the object. As the density of water and depth of immersion increase, so does hydrostatic pressure. Clinical Significance : Increased pressure reduces or limits effusion, assists venous return, induces bradycardia, and centralizes peripheral blood flow. The proportionality of depth and pressure allows patients to perform exercise more easily when closer to the surface
- 5. Viscosity Friction occurring between molecules of liquid resulting in resistance to flow. Properties: Resistance from viscosity is proportional to the velocity of movement through liquid. Clinical Significance: Water’s viscosity creates resistance with all active movements. Increasing the velocity increases resistance. Increasing the surface area of movement through water increases resistance.
- 6. Surface tension Surface of a fluid acts as a membrane under tension. Surface tension is measured as force per unit length. Properties: Attraction of surface molecules is parallel to the surface. The resistive force of surface tension changes proportionally to the size of the object moving through the fluid surface. Clinical Significance: Extremity that moves through the surface performs more work than if kept under water. Using equipment at the surface of the water increases the resistance.
- 7. Hydromechanics Comprise the physical properties and characteristics of fluid in motion. Components of Flow Motion Laminar flow. Movement where all molecules move parallel to each other, typically slow movement. Turbulent flow. Movement where 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.
- 8. Clinical significance: 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/her position in pool. Application of equipment (glove/paddle/boot) increases drag and resistance as the patient moves the extremity through water.
- 9. Thermodynamics Specific Heat Specific heat is the amount of heat (calories)required to raise the temperature of 1 gram of substance by1°C Center of Buoyancy The center of buoyancy is the reference point of an immersed object on which buoyant (vertical) forces of fluid predictably act.
- 10. Center of Buoyancy Definition. The center of buoyancy is the reference point of an immersed object on which buoyant (vertical) forces of fluid predictably act.
- 11. Thermodynamics: Aquatic exercises, including flexibility, strengthening, gait training, and relaxation, may be performed in temperatures between 26 C and 35 C. Cardiovascular training should be performed in water between 26 C & 28 C, helps to maximizes exercise efficiency, increases stroke volume, and decreases heart rate. Exercise performed in warm water (33 C) may be beneficial for patients with acute painful musculoskeletal injuries due to the effects of relaxation, elevated pain
- 12. Centre of buoyancy is located in sternum. Generally use immersion times of 20mins slowly increasing from 10mins. Temperatures between 36C and 37 are considered high and used for RA patients excluding acute stage. Temperatures greater than 37 C increases cardiac output significantly and raises the core temperature. Temperatures less than 25 C also considered critical as it doesn’t help to maintain normal core temperature.
- 13. Goals Facilitate range of motion (ROM) exercise Initiate resistance training Facilitate weight-bearing activities Enhance delivery of manual techniques Provide three-dimensional access to the patient Facilitate cardiovascular exercise Initiate functional activity replication Minimize risk of injury or reinjury during rehabilitation Enhance patient relaxation
- 14. Indications Decreased range of motion Increased muscle tone Reduced cardiopulmonary endurance Decreased functional activity Muscle weakness
- 15. Contraindications Incipient cardiac failure and unstable angina. Respiratory dysfunction; vital capacity of less than 1 liter. Severe peripheral vascular disease. Danger of bleeding or hemorrhage. Severe kidney disease Patients are unable to adjust to fluid loss during immersion. Open wounds, colostomy, and skin infections such as tinea pedis and ringworm.
- 16. Contraindications Uncontrolled bowel or bladder: Bowel accidents require pool evacuation, chemical treatment, and possibly drainage. Water and airborne infections or diseases: Examples include influenza, gastrointestinal infections, typhoid, cholera, and poliomyelitis. Uncontrolled seizures: They create a safety issue for both clinician and patient if immediate removal from the pool is necessary
- 17. Precautions Fear of water Neurological disorders Respiratory disorders Cardiac dysfunction Small open wounds and lines
- 18. Traditional Therapeutic Pools Traditional therapeutic pools measure at least 100 feet in length and 25 feet in width. Depth usually begins at 3 to 4 feet with a sloping bottom, progressing to 9 or 10 feet. ■ This larger type pool may be used for groups of patients and the therapists conducting the session while in the pool.
- 19. Entrance to larger therapeutic pools includes ramps, stairs,ladders, or mechanical overhead lifts. These pools have built-in chlorination and filtration systems
- 20. Individual Patient Pools Pools designed for individual patient use are usually smaller,self-contained units. These self-contained pools are entered via a door or one to two steps on the side of the unit. The therapist provides instructions or cueing from outside the unit. ■ In addition to built-in filtration systems, these units may include treadmills, adjustable currents, and varying water depths.
- 21. BEFORE ENTERING THE POOL Utilize the washroom Shower Wait until your physiotherapist directs you to enter the pool
- 22. AFTER THE HYDROTHERAPY SESSION Should shower Have a drink Rest for several minutes Tell your physiotherapist if you unwell or light headed.