HYDROTHERAPY

HYDROTHERAPY
• Hydrotherapy is one
of the oldest forms of
therapy
• Hydrotherapy involves
treatment of one
individual
• Aquatic therapy is the
treatment of more than
one patient at a time
PHYSICAL PRINCIPLES AND
PROPERTIES OF WATER
• BUOYANCY “ A force that works in the
opposite direction of gravity”
– feeling of weightlessness
– affected by body density, postural alignment,
and vital capacity of the lungs
 CENTER OF BUOYANCY
Functionally similar to center of balance
• COB is located in the chest region
• Point when body is underwater
• Defined as the location on the human body that needs
to be maintained within a (BOS) to establish and
maintain an upright posture
• Buoyancy devices or floatation devices can be used to
help a patient maintain their COG within the BOS an
maintain an upright position.
 Center of Gravity
• Functionally similar to COB
• Refers to point when body is out of water
• Located anterior to sacral vertebrae
 Hydrostatic pressure
• Hydrostatic pressure - “ pressure exerted by
water on an object immersed in the water”
• Pascal’s Law: “pressure of a liquid is
exerted equally on an object at a given depth
& object will experience pressure that is
proportional to the depth of immersion.
• Pressure increases 0.433lb/in2 for each foot
of depth.
• assists venous flow
 Hydrostatic pressure con’t
• decreases heart rate
• helps control inflammation
• Centralization of peripheral blood flow
• Hydrostatic pressure is proportional to depth
of immersion therefore:
exercises are easier to perform closer to the
surface
 SPECIFIC GRAVITY
• It is the weight of a particular substance
compared with the weight of an equal volume of
water.
• Also known as relative gravity or relative
density
• Affected by the density of an object
• Objects closer to H2O specific gravity of 1.0 will
float
• “THE SKINNY”
– THE MORE MUSCLE MASS/BONE THE MORE
YOU SINK
– THE MORE ADIPOSE TISSUE THE MORE YOU
FLOAT
 Specific Gravity con’t
• How would specific gravity affect ones
ability to exercise in water?
 VISCOSITY
• VISCOSITY - The measure of frictional
resistance caused by cohesive forces
between the molecules of liquid
• Resistance is created by viscosity of the fluid
and is influenced by the speed of movement
through it.
• Water has higher viscosity than air but less
than that of oil, so its easier to move through
air than water, then oil.
 How can we use this?

• increase resistance by increasing the

speed
• water has a low viscosity, easy to exercise
• increase resistance by increasing the
lever arm

• increase resistance by increasing the

surface area
 Specific Heat
• The amount of heat in calories, needed to
raise the temperature of 1 gram, 1 degree

• Since water has a higher thermal capacity

than air, there is greater heat loss in H2O as
compared to air at the same temp.
 Specific Heat
• Heat loss is greater in water than out in the
air
• Cooler water is best for long periods of
exercise
• Warm water for shorter periods of ex.
• Cautious with obese patients, because their
adipose tissue acts as as insulator
 HYDROMECHANICS
• Refers to movement through water
– It is a function of velocity of movement, the
surface area and direction of movement of
immersed object.
• Turbulence :product of several forces acting on
an object immersed in water.
• Laminar flow, drag & resistance forward
movement all act on the body moving the water.
• Frontal resistance: as body moves through water
creates a positive pressure
Fig. 5-2
 Water Temperature
• Therapeutic warmth: 94 deg F (34.4 deg C)
This is appropriate for performing Ther.
Ex’s.
• Benefits:
Acts as superficial heating, can elevate pain
thresholds and act decrease muscle spasms.
Using inappropriate temp selection could
decrease effectiveness of treatment and cause
adverse response. Refer to Fig. 5-3
 EQUIPMENT
• HIGH BOY
• EXTREMITY ( are the smallest ones)
• LOW BOY (full body tanks)
– Turbines: mix air & water to provide agitation
& turbulence to water
• HUBBARD TANK (whirlpool tanks)
• POOLS / AQUATIC THERAPY
 Therapeutic Aquatic Pools
• Vary in depth and size
• Water temp ranges from 86deg F to 94deg F
• Goals for this can be the same as Land
therapy goals
• Main idea: Water eliminates gravity,
therefore this is ideal for early interventions
for many musculoskeletal and neurological
conditions.
 INDICATIONS

• BURNS
• WOUND CLEANING
• WOUND HYDRATING
• STAINS/ SPRAIN
• BUOYANCY ASSIST
• MS PATIENT
• RELAXATION / ANALGESIA
• BANDAGE REMOVAL
• INCREASED CIRCULATION
 CONTRAINDICATION

• SPLIT THICKNESS GRAFT LESS THAN 3-5 DAYS

• FULL THICKNESS GRAFT LESS THAN 7 -10 DAYS
• CELLULITIS
• EDEMATOUS TISSUE
• PATIENT INTOLERANCE
• SYNCOPE
• HIGH/LOW BP
• ETOH ON PATIENTS BREATH
 CLEANING
• HOSPITAL AND CLINICS HAVE PROTOCOLS FOR
INFECTIOUS CONTROL, AND CLEANING
• TUBS AND TURBINES MUST BE CLEANED AFTER EACH
USE
• TURBINES MUST ALSO BE CLEANED SEPERATELY FOR
ADEQUATE CLEANING
• ACCREDITATION COMMITTEES SET STANDARDS
• CULTRURES NEED TO BE TAKEN AT PERIODIC
SCHEDULED TIMES
• Physiological effects of water are the same
as other heat and cold modalities
• Additional points
– Immersion: causes arterioles/ capillaries to
dilate, this will cause the BP to drop
• Consequence is fainting
 Therapeutic Pool
• Exercise
– Softens impact
– Most exercises can be performed in the pool
– Reduced weight bearing, 60 inches of water
will reduce by 5 12% of that of dry land
 Benefits
• Relaxation
• Circulation
• ROM
• Strength
• Improve gait
• Improve coordination
 Disadvantage
• Pools can be contaminated
• Costly
• Cleaning is time consuming/ costly
• Fall precautions
• Skin irritations
• Drowning
The End
• Next Week

• Diathermy and Ultraviolet