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Aquatic Therapy

Introduction

Aquatic therapy (AT) has been defined as "the use of water and specifically designed activities by qualified personnel to aid in the restoration, extension, maintenance and quality of function for persons with acute, transient, or chronic disabilities, syndromes or diseases." AT is generally provided under the supervision of a physical therapist, however, physical therapy assistants, recreational therapists, or rehabilitation specialists can implement the program. Aquatic exercise is also a program that is provided in a pool setting, but differs from AT in that it occurs in a group with general activities for all participants, whereas, AT focuses on a therapy plan designed specifically for an individual and is provided on a one-to-one basis.

 

How it Works

AT has the following advantages that typical physical therapy does not offer:

Buoyancy - The buoyancy gives the individual assistance and support. It allows a person to exercise with decreased stress on weight bearing joints, bones, and muscles and allows the joints to work through a greater range of motion.

Hydrostatic pressure - The pressure helps circulate blood from the lower extremities to the heart, often reducing any swelling in the ankles and feet.

Resistance - On land, resistance is felt in only one direction (that of gravity), overdeveloping some muscles and causing damage to others. The resistance water provides can be felt in any direction, thereby, promoting muscle balance and strengthening.

Heat - Most therapeutic pools are heated to 93-95 degrees. The warm water relaxes muscles, which reduces joint rigidity.

 

Benefits

Aquatic therapy has many benefits - physically and psychologically. Physical benefits include decreases in pain, muscle spasms, abnormal tone and rigid muscles, and joint compression. It also increases mobility, range of motion, balance and coordination, trunk stability and postural alignment, perceptual and spatial awareness, motivation and arousal, and muscular strength and endurance.

The psychological benefits associated with AT include improved body image and self esteem, enhanced mood, increased patience, stress and tension release, renewed energy, and promotes a positive attitude ( i.e., laughter and enjoyment).

With the many benefits of AT, it has been a successful therapeutic method for those with spasticity, brain damage, muscular diseases, strokes, neurological disorders, developmental disabilities, and degenerative disorders. (Note: There are some contraindications to AT, however, such as fever and infectious diseases, skin rashes and wounds that can not be protected, seizure or recent seizure activity, tracheostomy, and bladder or bowel incontinence.)

 

Examples of Activities

There are many different types of exercises to use in the pool during a therapy session. In the sitting position, the individual can:

• bat the ball back and fourth to increase balance and upper extremity strength and coordination;
• sit while having turbulence created in the water to increase balance;
• reach for an object to improve trunk control and balance;
• push an object forward, side-to-side and backward to increase trunk and upper extremity range of motion and reduce tone in the trunk; and
• perform all range of motion activities of upper and lower extremities for strengthening.

In the floating or standing position, the individual can:

• float quietly in the supine position with appropriate support from the therapist to increase relaxation and decrease spasticity;
• sway from side to side while floating supine to also decrease spasticity;
• perform extremity motions (leg kicking) to strengthen upper and lower extremities;
• float in the prone position to strengthen the neck, back, hips, shoulders, and abdomen;
• hold a floatation device and twist from side to side to strengthen the trunk and shoulders;
• catch a ball and reach for an object while standing to improve standing balance; and
• perform gait training such as weight shifting, sequencing, and backward, forward and sidestepping to practice for ambulation.

 

If you are considering aquatic therapy for your child, you will need to discuss the issue with your child’s physician (to begin AT, doctors’ orders are required). For more information on aquatic therapy, please visit the following helpful web sites:

• Aquatic Therapy and Rehab Institute http://www.atri.org
• Turning Point Rehabilitation Center http://www.smmc.com/pmr/therapies.html
• Great Plains Parkinson Corporation http://www.webco.net/apda/physical/aqua.htm
• University of Miami School of Medicine Rehab Team Site http://calder.med.miami.edu/providers/PHYSICAL/aqua1.html
• Triangle Aquatic Specialists http://hubcap.clemson.edu/~bburton/atherapy/index.html

 

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