Aquatic Physiotherapy Flashcards
What is aquatic physiotherapy?
Aquatic physiotherapy is the specific practice of physiotherapy in the water carried out by a physiotherapist. Aquatic physiotherapy treatment incorporates individual assessment, diagnosis, and use of clinical reasoning skills to formulate a treatment program appropriate to the client
What is the cardiovascular response to immersion?
Yydrostatic pressure compresses the superficial veins of the lower extremities, pelvis and abdomen, resulting in a shift in blood volume to the thorax and heart – this increases central blood by approx 700mls. Hydrostatic pressure also increases cardiac volume by increasing heart size by 30% and increasing SV by 35-45%
What is the respiratory response to immersion?
Pulmonary vascular engorgement plus hydrostatic pressure decreases lung capacity and volumes (VC, TLC, FRC, RV), causing the inspiratory muscles to work harder
What is the renal response to immersion?
Stimulation of renal blood flow occurs in hydrostatic pressure. This creates a decrease in renal sympathetic activity leading to decreased renal vascular pressure (creating diuresis – increased urine output, natriuresis – increased sodium excretion, and kaliuresis – increased potassium excretion). Effects increase with increased depth and immersion time
What is the pain response to immersion?
The heat of hydrotherapy pools reduces muscle spasms, as well as increasing collagen extensibility (point of pain stimulation changes). The buoyancy of the water reduces gravity, which in turn reduces the mechanical and compressive forces on joints, making movement easier (greater joint range mobilises synovial fluid across articular cartilage). The hydrostatic pressure/hypervolaemia reduces oedemas
What are the properties of water that provide treatment opportunities?
Buoyancy: reduces load/offloads weight bearing
Drag: creates resistance for muscle strengthening (skin resistance, turbulence, drag forces)
Hydrostatic pressure: compression assists with managing lower limb oedema
Heat of water: assists with pain relief
What are the contraindications to aquatic physiotherapy?
Open skin, infectious conditions (tumour/infection), assistance required for pool in/out mobility, inability to communication, fear of water, risk of falling, low swimming ability, heart conditions, high blood pressure
How can you use buoyancy to assist in strength training?
Buoyancy assisted (BA) movement, buoyancy eliminated (buoyancy counterbalanced) movement (BCB), buoyancy resisted (BR) movement, and against buoyancy with floats (BR+F) movements
How can we increase exercise intensity in the water?
Change the water depth, add weights/floats, increase ROM, change speed, or vary the working axis/plane
What evidence is there for aquatic physiotherapy?
- Moderate quality evidence for small, short-term effects on pain for hip/knee OA patients
- Limited evidence showing aquatic physio improves exercise capacity and QOL for COPD patients
