multiple sclerosis (ms) and aquatic therapy tiffany dean temple university therapeutic recreation...
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Multiple Sclerosis (MS) and Aquatic
Therapy Tiffany Dean
Temple UniversityTherapeutic Recreation Major
Learning Outcomes
Define Multiple Sclerosis (MS) and describe the effects it causes.
Explain ways in which Aquatic Therapy is beneficial for individuals with Multiple Sclerosis
Identify Precautions that should be considered before an individual with MS participates in Aquatic Therapy.
Overview of Multiple Sclerosis
Multiple sclerosis (MS) is a chronic autoimmune disorder affecting movement, sensation, and bodily functions. It is caused by destruction of the myelin insulation covering nerve fibers (neurons) in the central nervous system (brain and spinal cord).
“Most common cause of neurological disability in young & middle aged adults affecting an estimated 400,000 people in the U.S.” (Salem, et al, 2011).
Types & Symptoms of MS
Symptoms visual disturbances
sensation in extremities
weakness or clumsiness in leg or hand
Spasticity
Difficulty with bladder control
Vertigo
Gait disturbances
Stiffness
Fatigue of limbs
Types
Relapsing-Remitting Pattern
Primary Progressive Pattern
Secondary Progressive Pattern
Progressive-Relapsing Pattern
Overview of Aquatic Therapy
Aquatic therapy is a form of physical therapy that is performed in a pool.
The goal of this particular form of therapy is to assist in restoring the person's strength and movement through the use of buoyancy, resistance, and heat.
It aims to rehabilitate patients after injury or those with chronic illness.
http://www.youtube.com/watch?v=bZQUYaG0Zqc
Types of Aquatic Activity
Balance exercises Ai Chi (Water Tai Chi) Halliwick techniques
Relaxation and stretching Stretching Ai chi Aquatic body work: Watsu,
Jahara, or Healing Dance
Strengthening exercises Deep or shallow water techniques Bad Ragaz Ring Method Use of drag or resistance
equipment
Sample Aquatic Exercises
Marching—stand with your side to the pool wall. Hold onto the wall if needed for balance. Lift one leg up and down, then the other. Repeat 5 to 8 times.
Side leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if needed for balance. Lift leg out to the side 5 to 8 times. Do the other leg.
Back leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if needed for balance. Lift leg straight back 5 to 8 times. DO NOT arch the back. Do the other leg.
Runner's stretch—stand facing the side of the pool. Hold the edge of pool for balance. Step one leg back. Both feet flat on floor. Keep the heel of the back leg on the floor. Bend the knee of the forward leg. Lean forward from the ankles. You should feel a stretch in the lower leg or calf muscles. Hold for 20-30 seconds. Do 1 to 2 times. Switch legs.
Equipment for Aquatic Therapy
Flotation devices
Ankle weights
Water barbells
Kickboards
Water shoes
Therapy bars
Benefits for Individuals with MS
Water Quality Benefit Buoyancy: The feeling of being lighter in the water; of floating.
• Provides support for weak limbs.• Movement takes less effort. A greater
range of motion can be achieved.• Promotes muscle relaxation.
Viscosity: The sensation that there is resistance to your movements; that you move slower through the water.
• The resistance of water can be used to improve muscle strength.
• Slower movement in water provides an opportunity to work on skills such as balance and coordination which may be harder to do on land.
Hydrostatic pressure: The sensation of compression while the body is in the water. Pressure increases with depth.
• Compression can provide support for standing activities, such as walking, with less effort than on land.
Temperature Control • Cooler water can help maintain lower core body temperature even during vigorous activity. This is especially helpful for people with heat sensitivity issues.
Other Benefits…
Decreases stress
Pain relief
Improved flexibility
Ease depression
Boost self-esteem
Improved posture
Increased circulation
Increased cardiovascular functioning
Research Study
Conducted by Physical Therapy Departments of Long Island University & Hunter College in 2011
Purpose: to examine the effects of group aquatic exercise in individuals with MS.
Methods: 11 participants, 5-week program, 2/wk for 1hr
Results: Improved gait speed, grip strength, muscle strength, walking speed, balance, & mobility
Conclusion: Aquatic Therapy is beneficial in improvement in motor functioning of individuals with MS.
Precautions
Bowel incontinence with firm stools
Communicable diseases (cold flu, Hepatitis)
Autonomic dysreflexia Sensitivity to disinfection
chemicals Sensitivity to heat/
humidity Rashes, skin conditions
with flaking or open areas Hydrophobia Controlled seizures, Open wounds Compromised immune
system
Interested in Aquatic Therapy Certification?
Aquatic Therapy & Rehab Institute (ATRI)
How to get started http://www.atri.org/How%20to%20Get%20Started12.pdf
ATRI Certification
Membership $45
Resources
Butler, C. (2002). Walking in Water. Inside MS, 20(3), 66.
Chamberlayne, N. (2006). Come on in, the water's fine!. Inside MS, 24(4), 34-35.
Merck Manual Staff (2013). Overview of Multiple Sclerosis. Accessed via www.merckmanuals.com/professional/neurologic_disorders/demyelinating_disorders/multiple_sclerosis_ms.html?qt=muliple%20sclerosis&alt=sh
Salem, Y., Scott, A., Karpatkin, H., Concert, G., Haller, L., Kaminsky, E., & ... Spatz, E. (2011). Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study. Disability & Rehabilitation, 33(9), 720-728. doi:10.3109/09638288.2010.507855
Weiss, Thomas C. (2010). Aquatic Therapy- Facts and Information. Accessed via http://www.disabled-world.com/medical/rehabilitation/therapy/aquatic-therapy.php
Using Aquatic Therapy to treat individuals with Multiple Sclerosis
“If I could live in the water, I would.” –Mary Ann Lee.
Resources: • Americans w/ Disabilities Act
www.ada.gov
• The National MS Society
www.nationalmssociety.org/index.aspx
• Moss Rehab
www.mossrehab.com
• ATI Physical Therapy
www.atipt.com
• Oxford Rehab Center
www.oxfordrehab.com
• ATRI Certification www.atri.org
• ATRA's Aquatic Therapy
Treatment Network
www.atra-tr.org
• Aquatic Resources Network
www.aquaticnet.com
•http://recreationtherapy.com/articles/aquaticstherapy.htm
Overview of Aquatic Therapy • Aquatic therapy is a form of physical therapy
that is performed in a pool.
• The goal of this particular form of therapy
is to assist in restoring the person's strength and
movement through the use of buoyancy,
resistance, and heat.
•Types of Aquatic Therapy include: Ai Chi, Halliwick
Method, Watsu, Bad Ragaz Ring Method, etc.
Benefits of Aquatic
Therapy
• Improved muscle strength• Improved
walking speed• Enhanced
balance & coordination
• Decreases stress
• Pain relief• Improved
motion • Improved
flexibility• Promotes
muscle relaxation
• Ease depression• Boost self
esteem
Just so you know…
• Aquatic Therapy Certification will look great on your resume!• Aquatic Therapy has the power to change someone’s life!
Tiffany DeanTemple University