Hydrotherapy

1
Hydrotherapy

• Chapter 5

2
Buoyancy

• Is a 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)

3
Center of Buoyancy

• 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

4
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

5
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

6
Specific heat

• 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

7
Hydromechanics of water

• Term used to refer to movement through water
• The faster the movement, the greater the
  resistance

8
Water temperature

• Chart pg 141
• Therapeutic warmth is considered to be 94 F,
  which is appropriate for performing therapeutic
  exercises

9
Equipment

• Extremity tanks
• Smallest tanks which holds up to 25 gallons of
  water
• Low boys
• Full-body tanks resemble a bathtub resting on
  the floor with enough room for pt to long-sit
• Hold as much as 200 gallons of water
• Hubbard tank
• Tanks that were created to accommodate a pt in
  supine position, and allow range of movement in
  both upper lower extremities
• Has lifting devices to get pt in and out of
  whirlpool

10
Equipment cont.

• Turbines
• Mix air water to provide agitation turbulence
  to the water
• Stimulation from the agitation to the skin
  receptors may promote an analgesic effect
• Turbines have adjustable height, direction of
  flow, strength of flow

11
Hydrotherapy treatment techniques

• Additives to prevent infection
• Tanks turbines must be thoroughly cleaned in
  between pts
• Most common agents used to prevent or reduce
  chances of infection are providone-iodine,
  chloramines-T, bleach
• Important to run turbine with disinfectant agent
  in water

12
Aquatic pools infection control

• Water not emptied from pool following every
  patient
• Recommendations
• Pts shower before entering pool to remove excess
  soil
• Have filtration system that is chlorinated
• Do not use with pts who are incontinent
• Do not use with pts with open wounds

13
Deep water exercises

• Open chain exercises are performed here
• Buoyancy-assistive devices can be worn to help pt
  maintain an upright posture in water

14
Middle-level to shallow-level exercises

• Promotes some weight bearing
• Considered closed-chain exercises
• Pain with exercises can be minimized

15
Bad Ragaz techniques

• Uses a buoyant ring to assist the patient in
  floating in the water
• Ring may be placed around the trunk, under the
  extremities, or may support the head and neck

16
Debridement

• Is the rapid removal of necrotic devitalized
  tissue to allow reepithelialization granulation
• Necrotic devitalized tissue impedes granulation
  prevents or slows migration of epithelial cells
  across the wound
• This tissue delays healing provides potential
  for bacterial growth
• Hydrotherapy can be utilized to debride, soften,
  loosen adherent tissue

17
Hydrotherapy for wound care

• Cleansing
• Removes dirt, foreign bodies, exudates, or
  residue from topical agents bacteria
• Hydration
• Provides a moist wound bed that will proceed more
  rapidly through the phases of healing
• Circulatory stimulation
• Increased circulation obtained with hydrotherapy
  is the result of thermal effects

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Hydrotherapy for wound care cont.

• Analgesia sedation
• Mechanical stimulation of skin receptors can
  assist in decreasing pain
• Thermal effects also assist
• Condition of surrounding tissues
• Assess for color, edema, temp, areas of pain or
  sensory changes, pulses
• Description of wound
• Document describe location, size, shape,
  margins, exudates
• Additives to whirlpool
• Most frequently used bactericidal additives are
  betadine, salt, and chlorazine