Hydrotherapy

By: Mr.SARAVANAN J REDDY.,MPT., PT.,

ASSISTANT PROFESSOR
 AQUATIC EXERCISE
 DEFINITION;
 use of multidepth immersion pools or tanks
that facilitate application of various established
therapeutic interventions .
 Including
 Stretching
 Join mobilization
 Balance and gait training
 Endurance training
 Goals and indications for aquatic
exercise.
 Facilitate the ROM exercise
 Initiate resistance training
 Facilitate weight bearing function
 Enhance delivery of manual techniques
 Provide three dimensional access to the patient
 Provide cardiovascular exercise
 Initiate functional activity
 Minimize the risk of injury or reinjury
 Enhance the pt relaxation
 Precautions and
contraindications
PRECAUTIONS:
 Fear of water

 Neurologic disorders

 Seizures

 Cardiac dysfunction

 Small open wounds and lines

 Contraindications
 Incipient cardiac failure and unstable angina
 Respiratory dysfunction; vital capacity less
than 1ltr
 Several vascular disease
 Danger of bleeding or hemorrhage
 Severe kidney disease
 Open wounds
 Uncontrolled bladder and bowel
 Water and airborne diseases like influenza,
gastrointestinal infections, typhoid, and
poliomyelitis.
 contraindications
 Uncontrolled seizures; safety issues for
clinicians and pt if immediate removal from
pool.
 Properties of water
 The unique Properties of water and immersion
have profound physiologic implications in the
delivery of therapeutic exercise

 The static and dynamic properties water as

affect the human immersion and exercise.
 Physical properties of water
 The properties provided by
 Buoyancy
 Hydrostatic pressure
 Viscosity
 and surface tension ;have effect on the body in
the aquatic environment
 Buoyancy
 Is a upward force that works in the opposite
direction to gravity
 Gravity pulls downward, buoyancy pushes
upward from the bottom
 A relative “weightlessness” occurs when a
body is immersed in water (Amount depends
on % of body below surface)
 Center of Buoyancy

 Is reference point of an immersed object up on

which buoyant(vertical) forces of fluid predictably
act.
The COB is a point or location on the human body
that needs to be maintained within a base of support
to establish & maintain an upward & stable posture
 Similar to center of gravity
 COB located in chest region
 Center of buoyancy
 In the vertical position ,the human center is
located at the sternum.
 In vertical position posteriorly placed
buoyancy device will cause the patient to lean
forward; anterior buoyancy will cause the pt
lean backward.
 A pt with a unilateral lower extremity
amputation will lean towards the residual limb,
when in vertical position.
 Center of buoyancy
 Patients bearing weight on the floor of the pool
will experience aspects of both COB and
COG.[sitting ,kneeling ,standing.]
 Hydrostatic pressure
 Is pressure exerted by water on an object
immersed in the water
 Because hydrostatic pressure is proportional to
the depth of immersion, exercises are easier to
perform closer to the surface of the water
where the pressure is less
 Assists in venous return, heart rate reduction,
& centralization of peripheral blood flow
 viscosity
 Viscosity is friction occurring between
molecules of liquid resulting in resistance to
flow.
 Resistance from Viscosity is proportional to
the velocity of the movement.
 Water’s viscosity creates resistance with all
active exercise
 Increasing surface area moving through water
will increase resistance
 Surface tension
 The surface of a fluid acts as a membrane
under tension, surface tension is measured as
force per unit.
 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 surfaces.
 Surface tension
 An extremity that moves through the surface will
perform more work than if kept under water.

 Using equipment at the surface of water will

increase the resistance.
 Specific gravity
 Is the weight of a particular substance compared with
the weight of an equal volume of water
 Specific gravity of a person increases when there is
increased bone mass and muscle mass and decreases
when there are greater amounts of adipose tissue
 An object with low specific gravity (less than 1.0)
will float
 Objects with high specific gravity ( greater than 1.0)
will sink
 The human body has a specific gravity of 0.87 – 0.97
 Thermodynamics

 Water temperature will have an effect on the

body ,therefore performance in an aquatic
environment.
 Is the amount of heat, in calories, required to
raise temp of 1 gram of substance 1 degree C.
 Specific heat of water = 1.0
 Cool water temps are best for long exercise
session, warm water is indicated for short-
duration exercises
 Water retains heat 1000 times more than the
air
 Difference in temperature between an
immersed object and water will equilibrate
with minimal changes in temperature of water.
 Heat transfer increases with velocity.
 Hydromechanics of
water

 Term used to refer to movement through water

 The faster the movement, the greater the
resistance
 Water temperature

 Therapeutic warmth is considered to be 94 F,

which is appropriate for performing
therapeutic exercises
 SPECIAL EQUIPMENT FOR
hydrotherapy EXERCISE
 A large variety of equipment exists for use with aquatic
exercise. Aquatic equipment is used to provide buoyant
support to the body or an extremity, challenge or assist
balance, and generate resistance to movement. By
adding or removing equipment, the practitioner can
progress exercise intensity. Collars, Rings, Belts, and
Vests
 Collars, Rings, Belts, and
Vests Equipment
 designed to assist with patient positioning
by providing buoyancy assistance can be
applied to the neck, extremities, or trunk.

 Inflatable cervical collars are used for the

supine patient to support the neck and
maintain the head out of the water
 cont
 Flotation rings come in various sizes and are used to support
the extremities in any immersed position.

 Often the rings are used at the wrists and ankles during manual
techniques to assist with patient positioning and relaxation.

 Belts and vests are used to position patients supine, prone, or

vertically for shallow and deep water activities.
 Swim Bars
 Buoyant dumbbells (swim bars) are available in short
and long lengths.

 They are useful for supporting the upper body or trunk in

upright positions and the lower extremities in the supine
or prone positions.

 Patients can balance (seated or standing) on long swim

bars in deep water to challenge balance, proprioception,
and trunk strength.
 Gloves, Hand Paddles, and
Hydro-tone Balls
 Resistance to upper extremity movements is achieved by
applying webbed gloves or progressively larger paddles to the
hands . These devices are not buoyant and, therefore, only
resist motion in the direction of movement.

 Hydro-tone bells are large, slotted plastic devices that increase

drag during upper extremity motions.

 The bells generate substantially more resistance than gloves or

hand paddles.
 Fins and Hydro-tone Boots

 The application of fins or boots to the feet during lower

extremity motions generates resistance by increasing the
surface area moving through the water.

 Fins are especially useful for challenging hip, knee, and ankle
strength.

 Hydro-tone boots are most effective during deep water walking

and running
 Kickboards
 Kickboards may be used to provide buoyancy in the
prone or supine positions, create resistance to walking
patterns in shallow water when held vertically, or used to
challenge seated, kneeling, or standing balance in the
deep water
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