Week 9 Hydrotherapy

Question 1

water has a ____ specific heat and ____ ____ - heat transfer by conduction and convention

Answer 1

high; thermal conductivity

Question 2

what is buoyancy?

Answer 2

-an upward thrust against gravity
-when a body is immersed in liquid it experiences an upward force equal to the weight of the displace liquid (the body appears to weigh less in the water than in air)
-can help with the stress of exercise on the joints and muscles

Question 3

how does water apply resistance?

Answer 3

-work has to be done in the opposite direction of buoyancy to experience resistance
-the greater the speed of the liquid = the higher the viscosity.
-resistance depends on the speed and shape of the object. there will be more resistance on larger more spread out objects

Question 4

what is hydrostatic pressure in relation to hydrotherapy?

Answer 4

-the force the water places on the body part (equal in all directions)
-the further the depth of the water the more pressure applied to the body.
-hydrostatic pressure is dependent on the depth of the submerged part and density of the liquid. motion will be easier at the waters surface

Question 5

what is viscosity?

Answer 5

-the internal friction of liquids (cohesive forces between molecules)
-varying speed pf exercises changes resistance
-increases in proportion to the relative speed of the body’s motion
-increases with area of contact

Question 6

what are the physiological effects of hydrotherapy?

Answer 6

-cleansing
-musculoskeletal
-cardiovascular
-respiratory
-renal
-psychological

Question 7

what are the cleansing effects of of hydrotherapy?

Answer 7

-softens materials (scars or wounds)
-exerts pressure
-debriding agent for exudate or necrotic tissue
-antimicrobial or surfactant additives may be used

Question 8

what are the musculoskeletal effects of hydrotherapy?

Answer 8

-buoyancy decreases weight bearing
-resistance provides force for strengthening
-hydrostatic pressure increases resting muscle blood flow by 100%-225% during immersion of the body up to the neck

Question 9

what are the cardiovascular effects of hydrotherapy?

Answer 9

-venous blood displaces proximally from the extremities (enhanced venous return)
-with immersion to the neck, central blood volume increased by ~60%; cardiac volume increase by ~30% (~30% increase in cardiac output); lower heart rate response to exercise
-RPE should be used to guide intensity since HR response in blunted

Question 10

what are the respiratory effects of hydrotherapy?

Answer 10

-increased work of breathing
-chest wall compression
-increased circulation in chest cavity
-humidity reduced exercise-induced asthma

Question 11

what are the renal effects of hydrotherapy?

Answer 11

-increased urine production
-increased renal blood flow
-increased central blood volume
-decreased ADH and aldosterone

Question 12

what are the psychological effects of hydrotherapy?

Answer 12

relaxing or invigorating depending on temperature

Question 13

what are the uses of hydrotherapy?

Answer 13

-superficial heating or cooling
-water exercise
-pain control
-edema control
-wound care

Question 14

what are the advantages of using hydrotherapy for superficial heating and cooling?

Answer 14

-perfect contact with skin
-does not need to be fastened to the body
-allows movement

Question 15

what are the disadvantages of using hydrotherapy for superficial heating and cooling?

Answer 15

dependent position may aggravate edema

Question 16

what is water exercises used for?

Answer 16

-to increase circulation, muscle strength, joint viscoelasticity, flexibility, range of motion, ambulation, coordination, cardiovascular and vascular conditioning, psychological wellbeing
-leads to decreased pain, muscle spasm, and stiffness

Question 17

what temperature should the pool be for exercise?

Answer 17

79 to 90 degrees

Question 18

how does hydrotherapy help with pain control?

Answer 18

-provides high level of sensory stimulation to gate transmission of pain
-cold water may reduce inflammation
-decreased weight bearing may reduce joint compression

Question 19

how does hydrotherapy help with edema control?

Answer 19

-due to hydrostatic pressure
-results in change in circulation and renal function
-requires deep immersion
-cold way may also cause vasocontraction and reduce vascular permeability (avoid hot water immersion)

Question 20

how does hydrotherapy help with wound care?

Answer 20

-accelerate wound healing
-facilitates rehydration, softening, debridement
-may improve circulation

Question 21

what are some considerations for wound care with hydrotherapy?

Answer 21

-immersion vs nonimmersion
-+/- additives
-pain, particularly with debridement of burns
-negative pressure wound therapy (wound vac)

Question 22

what temperature should the water be for reduce inflammation?

Answer 22

32-79 degrees

Question 23

what temperature should the water be for exercise?

Answer 23

79-92 degrees

Question 24

what temperature should the water be for open wounds, control tone?

Answer 24

92-96 degrees

Question 25

what temperature should the water be for burn, after epithelialization?

Answer 25

96-98 degrees

Question 26

what temperature should the water be for pain control, increase soft tissue extensibility?

Answer 26

99-110 degrees

Question 27

what pressure should nonimmersion irrigation be at?

Answer 27

control pressure at 4-15 psi

Question 28

what are some safety issues of hydrotherapy?

Answer 28

-whirlpool must be properly grounded
-pay close attention to infection control
-ensure proper training for pool exercise

Question 29

what are some contraindication for local immersion hydrotherapy?

Answer 29

-maceration around a wound
-bleeding

Question 30

what are the contraindications for full body hydrotherapy?

Answer 30

-cardiac instability
-infectious conditions that may be spread by water
-bowel and incontinence
-severe epilepsy
-suicidality

Question 31

what are the contraindication for negative pressure wound therapy?

Answer 31

-necrotic tissue
-untreated osteomyelitis
-malignancy in the wound
-untreated malnutrition
-exposed vessels, nerves, or organs
-nonenteric and unexplored fistulas
-exposed anastomotic sites

Question 32

what are the precautions for local immersion hydrotherapy?

Answer 32

-impaired thermal sensation in immersed area
-infection in immersed area
-confusion or impaired cognition
-recent skin grafts

Question 33

what are the precautions for full body in hot/very warm water?

Answer 33

-pregnancy
-multiple sclerosis
-poor thermal regulation

Question 34

what are the precautions for full body immersion at any temperature?

Answer 34

-confusion or disorientation
-alcohol ingestion
-limited strength, endurance, balance, or ROM
-medications
-urinary incontinence
-fear of water
-respiratory problems

Question 35

what are the precautions for nonimmersion hydrotherapy?

Answer 35

-maceration
-may be ineffective

Question 36

what are the precautions for negative pressure wound therapy?

Answer 36

-anticoagulant therapy
-difficult hemostasis
-confusion, disorientation

Question 37

what are the adverse effects of hydrotherapy?

Answer 37

-drowning
-burn, fainting, bleeding
-hyponatremia (loss of salts in pt with extensive burn wounds)
-infection
-aggravation of edema
-asthma exacerbation

Question 38

what should be included in documentation for hydrotherapy?

Answer 38

-type of hydrotherapy
-patient position or activities
-water temperature
-treatment duration
-response to intervention
-if applicable: fluid pressure, water additives