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Midterm - 7 POOL Therapy
Midterm - 7 POOL Therapy
CASTRO, PTRP
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.
functional recovery by providing an environment that augments a patients and/or practitioners ability to perform various therapeutic interventions.
Relaxation of muscles
Gate theory mechanisms Psychological factors
Precautions
Fear of Water Fear of water can limit the effectiveness of any immersed activity. Fearful patients often experience increased symptoms during and after immersion because of muscle guarding, stress response, and improper form with exercise. Neurological Disorders Ataxic patients may experience increased difficulty controlling purposeful movements. Patients with heatintolerant multiple sclerosis may fatigue with immersion in temperatures greater than 33C.51 Seizures Patients with controlled epilepsy require close monitoring during immersed treatment and must be compliant with medication prior to treatment
Prepared by: SONIA C. CASTRO, PTRP
Precautions
Cardiac Dysfunction Patients with angina and abnormal blood pressure also require close monitoring. For patients with cardiac disease, low-intensity aquatic exercise may result in lower cardiac demand than similar land exercise. Small Open Wounds and Lines Small, open wounds and tracheotomies may be covered by waterproof dressings. Patients with intravenous lines, Hickman lines, and other open lines require proper clamping and fixation.
Contraindications
Incipient cardiac failure and unstable angina.
liter.
Severe peripheral vascular disease. Danger of bleeding or hemorrhage. Severe kidney disease: Patients are unable to adjust to
Contraindications
Uncontrolled bowel or bladder: Bowel accidents
both clinician and patient if immediate removal from the pool is necessary.
BUOYANCY
Definition. Buoyancy is 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 weightlessness and joint unloading, allowing performance of active motion with increased ease. Buoyancy allows the practitioner three-dimensional access to the patient.
Prepared by: SONIA C. CASTRO, PTRP
Hydrostatic Pressure
Definition. Hydrostatic pressure is the pressure exerted
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.
Prepared by: SONIA C. CASTRO, PTRP
Viscosity
Definition. Viscosity is friction occurring between
Clinical Significance Waters viscosity creates resistance with all active movements. A shorter lever arm results in increased resistance. During manual resistance exercises stabilizing an extremity proximally require the patient to perform more work. Stabilizing an extremity distally requires the patient to perform less work. Increasing the surface area moving through water increases resistance.
Prepared by: SONIA C. CASTRO, PTRP
Surface Tension
Definition. The surface of a fluid acts as a membrane
under tension. Surface tension is measured as force per unit length. Properties
The 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 An 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. by: SONIA C. CASTRO, PTRP Prepared
Hydromechanics
Definition. 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.
Prepared by: SONIA C. CASTRO, PTRP
Exercise Equipment
Assistive devices
Floatation cuffs Pull buoys Vests and belts
Resistive devices
Water shoes Fins Boots
Kickboards
Water dumbbells
Webbed gloves
Paddles Bells
reduction.
The Burdenko Method: used for athletic training and as a therapeutic methods for people with disabilities. Concept includes integrating land and water therapy, using a vertical position, focusing on the whole body and homework.
Prepared by: SONIA C. CASTRO, PTRP
improve movement and enhance human functioning. This method aims to increase ease and ROM, improve flexibility and coordination and encourage the individual to rediscover innate capacity for graceful efficient movement.
Halliwick: an approach to teaching people with physical and/or
learning difficulties to participate in water activities, to move independently in water and to swim.
Lyu Ki Dou: various hands-on healing modalities along with Ai
exercises consist of spiral and diagonal patterns and must incorporate three components of motion: flexion or extension, adduction or abduction and rotation.
Water Pilates: Pilates exercises adapted for the pool. This
body conditioning program is designed to improved strength, flexibility and range of motion (ROM) and laso encourages musculoskeletal alignment.
Unpredictable Command Technique (UCT): has a goal
of progressing the clients so that two or more motor movements are done simultaneously.
Prepared by: SONIA C. CASTRO, PTRP
includes work below the water surface with the aid of nose clips. Wassertanzen means water dance
Water Yoga: performed in warm, waist-to-chest depth
that is experienced in a very warm water (approx 94F) pool. It is for pain reduction, increase ROM, increased circulation, psychological problems, relaxation and reduction of stress.
Yogalates: combines Yoga, Pilates, Ai Chi. The objectives
are increase body awareness, strength, ROM , relaxation and inward focus.
Prepared by: SONIA C. CASTRO, PTRP
intervals Use deep breathing to increase vital capacity Use GRADUAL progressive overload Work on balance Work on strength Work on flexibility Longer cool down
Girls in London. The Halliwick concept is an approach to teaching all people, in particular, focusing on those with physical and/or learning difficulties, to participate in water activities, to move independently in water, and to swim. Children learned to swim independently with increase in head control, trunk stability, breath control, endurance, and self esteem. Concept one of most widely utilized methods of aquatic therapy.
Prepared by: SONIA C. CASTRO, PTRP
PHILOSOPHY OF HALLIWICK
Goal: Achieve maximum independence in the water and on land through self reliance. Uses a systems theory to implement a psycho-sensory motor approach in water. Focus is that swimming is a means to independence. Encourages active participation without flotation devises.
control in expiration to prevent inhaling or swallowing water. Facilitates forward head movement and head control. Support is given at shoulder girdle, never at head. Gradually support is decreased. Final stages of mental adaptation include, jumping, walking, and turning.
supine to standing.
Longitudinal rotation produces a roll in supine to
position and maintaining their balance while the instructor introduces turbulence in the water.
Phase 2 challenges swimmers to develop postural
control, spinal range of motion, spinal stabilization, strength, greater control in reaching for objects, righting and supportive reactions, trunk dissociation, scapular depression, maintaining neutral pelvic alignment, head righting reactions, control over lateral rotation, and moving in three dimensional patterns.
3. Transversal Rotation Control (formerly Vertical Rotation) the ability to control any rotation made about a fronto-transversal axis.
4. Sagittal Rotation Control the ability to control any rotation made about a sagittotransversal (anterior/posterior) axis. 5. Longitudinal Rotation Control (formerly Lateral Rotation) the ability to control any rotation made about a sagitto-frontal (longitudinal) axis.
Prepared by: SONIA C. CASTRO, PTRP
Exercises for the Lower Extremity Ambulation and Balance Activities (Shallow Water)
Forward Walking
Backward Walking Toe Walking
Heel Walking
Lunges Carioca Running
Exercises for the Lower Extremity Ambulation and Balance Activities (Shallow Water)
Exercises for the Lower Extremity Ambulation and Balance Activities (Deep Water)
Forward Kick Leg Side Lift Hamstring Curl Kick Out exercise Side Kick Out Small Squats Flamingo Toes exercises Leg Circles Side Weight Shifting Front Weight Shifting Marching
Prepared by: SONIA C. CASTRO, PTRP