Hydrotherapy Flashcards
(71 cards)
1
Q
hydrotherapy comes from words
A
“Hydro”
“Therapeia”
2
Q
Physical properties of water:
A
Specific heat Thermal conductivity Buoyancy Resistance Hydrostatic pressure
3
Q
Specific heat
A
Amount of energy needed to inc temp of a given weight of material by a given no of degrees
j/g/deg celsius
4
Q
Thermal conductivity
A
Ability of material to transfer heat through conduction
cal/sec)/(deg celcius/cm
5
Q
Water = specific heat: ? ; thermal conductivity: ?
A
Water = specific heat: 4.19 ; thermal conductivity: 0.0014
6
Q
Air = specific heat: ?; thermal conductivity: ?
A
Air = specific heat: 1.01; thermal conductivity: 0.000057
7
Q
Water: air ratio => specific heat: ? ; thermal conductivity: ?
A
Water: air ratio = specific heat: 4.14 ; thermal conductivity: 24.56
8
Q
very cold to cold
A
0-18 ℃/32-64℉
9
Q
Cool: acute inflammation
A
18-26 ℃/64-79℉
10
Q
Tepid: exercise, acute inflammation if can’t tolerate cold
A
26-33 ℃/79-92℉
11
Q
Neutral warmth: open wounds, medically-compromised pts, dec. tone
A
33.5-35.5 ℃/92-96℉
12
Q
mild warmth: inc. mobility of burns
A
35.5-37℃/96-99℉
13
Q
hot: pain control
A
37-40℃/99-104℉
14
Q
very hot: inc. tissue extensibility, chronic conditions
A
40-43℃/104-110℉
15
Q
should not be used
A
> 43℃/>110℉
16
Q
Buoyancy
A
Archimedes’ principle: When a body is immersed in fluid at rest, it creates an upward thrust equal to the amount of fluid displaced
Specific gravity: density of material to density of water ratio
If specific gravity < water, it can float in water
17
Q
specific gravity of water
A
1
18
Q
specific gravity of salt water
A
1.024
19
Q
specific gravity of ice
A
0.917
20
Q
specific gravity of air
A
0.00121
21
Q
specific gravity of human body
A
0.974
22
Q
specific gravity of subcutaneous fat
A
0.85
23
Q
someone with more subcutaneous fat will find it —- to float in water
A
easier
24
Q
Resistance
A
d/t viscosity of water
Resistance to flow/thickness
Adhesion of molecules
25
The larger the surface area that moves against the water, the --- you feel the resistance
The larger the surface area that moves against the water, the more you feel the resistance
26
The faster you move, the --- you feel the resistance
The faster you move, the more you feel the resistanceq
27
Cleansing effect
Remove debris from wound
| Dissolved surfactants and anti-microbials in water
28
musculoskeletal effects
assistive , dec weight bearing
d/t buoyancy
Strengthening (resistive)
Effects on bone density loss
It’s easier for patients to move
Places stress on bones
Prevents bone density loss
Less fat loss
29
cold effects
Decreases metabolism
Pain relief
Inflammation control
30
warm effects
Relaxes muscle
Increases flexibility
Improves circulation
Increases tissue extensibility
31
Cardiovascular effect
```
Venous circulation is inc.
Compresses veins in distal extremities
Hydrostatic pressure
Inc cardiac volume
Inc cardiac output
Dec. heart rate
Dec. systolic BP
Dec. rate of O2 uptake (VO2)
```
32
Respiratory effects
Dec. vital capacity
Immersed at neck level: inc hydrostatic pressure
Thoracic wall has difficulty expanding
Increases circulation to chest cavity
Blood accumulates more to the heart, more to the lungs
Increases work of breathing because it needs to provide oxygen to the increased amount of blood
Inc. work of breathing
Dec. exercise-induced asthma
High humidity of air
33
Renal effects
```
Diuresis (frequent urination)
Sodium and potassium excretion
Increases renal blood flow
Blood is focused in central body
Decreases ADH which increases production of urine
Beneficial for reduction of edema
```
34
Psychological effects
Warm: relaxing
Cold: energizing
35
Uses
Superficial heating or cooling via conduction or convection
Pain control
Reduction of WB
Thermal effects
Edema control
hydrostatic pressure
Water exercises
Can be assistive or resistive
Water gives more safety for patient
Balance is easier
Wound care
Rehydration, softening of schar and debridement of wound
36
Contraindications for local immersion
Maceration around wound
Excessive softening of tissue
Results to breakdown
Bleeding
37
Precautions for local immersion
```
Impaired sensation
Temp factor
Infection
Impaired cognition
Recent skin grafts
(Can remove skin grafts)
```
38
Contraindications for full body immersion
Cardiac instability
(Congests heart)
Infection spread in water
(Unless pt owns pool)
Bowel incontinence
(Could assist in faster evacuation of the bowel)
Severe epilepsy
Suicidal patients
39
Precautions full body
Confused or disoriented
PT should be with pt in pool
Alcohol ingestion
Limited strength, endurance, balance
Medications for cv disease
Urinary incontinence
Hydrophobia
Respiratory compromise
Don’t immerse thoracic area
40
Adverse effects
```
Drowning
Burning
Fainting
Bleeding
Hyponatremia (extensive wound burn)
Salt should be added in water
Aggravated if water is hypotonic
Infection
Add antimicrobials in water and pt is the only one who uses it
Aggravation of edema in UE
Asthma exacerbation if humidity is not controlled
```
41
Application techniques
Whirlpool tanks
42
Butterfly valve:
allows air to flow
43
Turbine ejector:
water output with air, turbulence
44
Throttle:
used to move turbine left or right
45
Suspension bracket:
attaches turbine to tank
46
Why is turbulence needed?
Allows for the assistive or resistive functions of the water
47
hubbard dimensions
full body
6ftx8ftx4ft
425-700 gallons
48
extremity dimensions
distal extremity
15'x28-32'x18-25'
10-45 gallons
49
high boy dimensions
mid-thoracic; doesn't allow full LE ext.
20-24" x 36-48" x 28" x
60-105 gallons
50
low boy dimensions
mid thoracic; allows full LE ext
24' x 28' x 18'
75-105 gallons
51
typical duration of hydroptherapy immersion
20-30 min
52
contrast bath temperatures
warm: 38-43 deg
| cold water: 13-18 deg
53
technique of contrast bath
hot for 3-4 mins
cold for 1-2 mins
lasts 20-30 mins total
last immersion for acute to subacute: cold
for subacute to chronic: warm
usually ends c warm
54
Exercise pool uses
Optimizes functions
Allows full body immersion
Swimming pools: 100 ft long x 25 feet wide x 8 feet depth
Sloping bottom
55
exercise pool common temps
Temp: 26-36 deg, common = tepid
Warm: 34-36 deg for low intensity exercises
Cool: 26-29 deg for more intense exercises
56
non-immersion irrigation devices pressure
4-5 psi
57
non-immersion irrigation device uses
Sprays water to open wound
pressure : 4-5 psi
Pulsatile irrigation device delivers fluid at controlled pressure + Removes contaminated fluid
PULSED LAVAGE
58
room temp and relative humidity for safety
A room temperature of 25-30 deg c relative humidity of 50% is ideal
59
Infection control safety
```
Appropriate cleaning protocol
Use clean water
Drain and clean tank and turbines after each use
Commonly contaminated areas
Bottom of pool
Overflow pipes
Agitators
Thermometer
Edges
Drainage
```
60
documentation
Hydrotherapy using x temp x duration x exercise done x body part to rationale
61
goals for aquatic exercise
```
Facilitation of ROM exercise
Initiate resistance training
Facilitate weight bearing
Enhance delivery of manual techniques
Easy access of body parts of pt
Facilitate CV endurance exercise
Initiate functional replication
Minimize risk of injury or re-injury
Enhance relaxation
```
62
Precautions aquatic exercise
```
Hydrophobia
Neurological disorders
Difficulty controlling movements
Fatigability
Seizures
Must be controlled seizures
Cardiac dysfunction
Angina or abnormal BP
Low intensity exercises
Small open wounds and lines
Must be covered
```
63
contraindications aquatic exercise
```
Incipient cardiac failure or unstable angina
Respiratory dysfunction
Severe peripheral vascular disease
Danger of bleeding or hemorrhage
Severe kidney disease (fluid loss)
Open wounds, colonoscopy, skin infections
Uncontrolled bladder or bowel
Water and airborne infections
Uncontrolled seizures
```
64
Surface tension
Greater surface equals greater resistance
| Surface acts as membrane under tension
65
exercises at surface are -- difficult than exercises under
more
66
hydronamics
Laminar flow
slow
Turbulent flow
fast
Drag
When a person thrusts forward, there is an opposition called drag
67
rate of temp change is dependent on
mass and specific heat
68
specific heat
amount of heat required ot raise the temp of 1 gram of substance by 1 deg
69
center of buoyancy at vertical position
sternum
70
non-buoyant devices
gloves
hand paddles
hydro-tone bells
hydro-tone boots
used for resistance
71
ROM is easier in water thru
reduction of joint compression
dampening pain
