Guidelines for giving enema

 Select appropriate size of catheter

 Select smooth rectal tube

 Lubricate the catheter before insertion

 Select appropriate temperature of solution

 Provide left lateral position during procedure as it facilitates instillation of the fluid

 The length of catheter should be inserted is depends upon the age of the client

 The time of enema should be retained in the rectum is depends on the purpose and type of
enema

 The amount of fluid flow is also depends on the type of enema

 Avoid entry of air into the rectum

 The height of the can should be adjusted to regulate the flow of enema solution

Hydrotherapy
1. 1. HYDROTHERAPY Physiotherapists can help people maintain movement and function of
joints and muscles with exercises, hydrotherapy (exercise in warm water), relaxation
techniques, acupuncture) and various other treatments.

2. WHAT IS HYDROTHERAPY? Hydrotherapy, otherwise known as Aquatic Physiotherapy, is

a specific form of physiotherapy treatment conducted in a heated pool. Aquatic
Physiotherapy treatment (individually or in groups) incorporates individual assessment,
diagnosis and the use of clinical reasoning skills to formulate a treatment program
appropriate to each patient’s needs.

A series of gentle therapeutic exercises (distinct from swimming or aqua-aerobics) carried

out in a heated pool allow greater comfort and range of movement as the water supports
body weight. Therapeutic exercises can be progressed safely using the resistance of the
water to strengthen the muscles and improve stability.
 BENEFITS OF HYDROTHERAPY: Aquatic Physiotherapy can help relieve pain, promote
relaxation, mobilize joints, strengthen muscles, develop balance and coordination, and
improve general fitness. What are the therapeutic benefits of Hydrotherapy & exercise in
warm water? Muscular relaxation and decreased muscle spasm. Decreased pain due to
warmth and support. Gravity is countered by buoyancy. Increased muscle strength and
endurance due to the greater resistance in water. Improvement in swelling, due to
hydrostatic pressure. Enhanced balance and stabilization. Improved enjoyment and
confidence to move better. The warmth and the buoyancy make stretches more effective It's
easier to stay upright because the effect of gravity is less Exercising in water requires less
effort Afterwards you usually have a really good night's sleep! Most importantly, water gives
you freedom of movement.

HOW DOES HYDROTHERAPY WORK? The warmth increases circulation, reduces muscle
spasm, and helps to relieve pain. Patients do not need to be able to swim in order to benefit
from Aquatic Physiotherapy. An aquatic program is often a stepping stone for patients to
progress onto gym or land based exercise programs. The rehabilitation program can also
include appropriate exercises to maintain fitness, while recovering from sports injuries or
orthopaedic surgery.

WHAT CONDITIONS CAN HYDROTHERAPY BENEFIT? Some of the many conditions that
can benefit from an individualised Aquatic Physiotherapy program include: Back
pain/sciatica/ lumbar instability o Whiplash & other neck pain of Sports injuries
Tendinopathy o Balance/coordination problems o Shoulder and arm pain Osteoarthritis
Rheumatoid Arthritis & Fibromyalgia o Ankylosing Spondylitis Parkinson’s Disease Stroke
Cerebral Palsy Back and pelvic pain during pregnancy Work and accident related injuries
Rehabilitation after bone fractures, joint replacement or tendon repair Aquatic Physiotherapy
has been shown to bring pain relief, combined with long lasting improvements in joint
mobility and muscle strength.

SAFETY TIPS: 1. Consult your doctor or physiotherapist before you try exercising in water.
2. The area around the pool is likely to be wet and slippery. Take care when walking on a
wet floor, don't run or rush. You can wear flip flops or beach shoes and if you normally use a
stick or crutch, it's much safer to use a walking frame instead, as a stick can very easily slip
when wet.

3. It is possible to overdo things in the water, especially when you first start, because it feels so
much easier. Begin gently and gradually build up the length of time you spend in the pool.

4. Only do the exercises shown by your physiotherapist. Do not perform your dry land
exercise programme in water: not only is it not effective, but it could even do more harm than
good.

5. Do not use hydrotherapy if you have: unstable blood pressure, uncontrolled diabetes,
angina at rest or shortness of breath at rest.

6. If you have compromised lung function you may find the pressure of the water on the
chest and ribcage too much when in the deep end.

7. If you suffer with asthma or angina, always take your inhalers and sprays with you and
leave them on the pool side, so they are there should you need them.