aquatic excs
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Chapter 17
Aquatic Physical Therapy
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Physical Properties of Water Buoyancy
Main Controlling Variables:
1. Position or direction of movement inwater2. Water depth3. Lever arm length4. Flotation or weighted equipment use
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Position and Direction of Movement
Movements toward the surface Buoyancy assisted.Movements parallel to the bottom ofthe pool Buoyancy supported(gravity minimized).Movements toward the bottom of
pool Buoyancy resisted.
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Depth, Lever Arm Length, or BuoyantEquipment Can Alter Resistance
or Assistance
Shallower water Less support.
Deeper water More support, but increasedfrontal resistance.
Modifications can be made through use ofbuoyant equipment.
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Buoyancy and Lever Arm
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Buoyancy and Flotation
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Resistance Is Influenced By:
1. Velocity of movement (mean muscleactivity alters when velocity reaches
a threshold (See Table 17-1)2. Surface area3. Water depth
4. Direction of movement
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Physiologic Changes with Immersion(Changes vary with immersion depth)
1. Decreased peripheral blood flow, vitalcapacity.
2. Increased heart volume, intrapulmonary
blood volume, right atrial pressure, leftventricular end-diastolic volume, strokevolume, cardiac output.
3. Decreased or unchanged heart rate.
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Physiologic Response to Exerciseand Immersion
Physiologic adaptations aresimilar to land training.
Increased cardiac loading due tohydrostatic pressure.
Depth of immersion affectsdegree of cardiac changes.
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Examination and Evaluation for AquaticRehabilitation
Full land-based examination must be performed.
Also consider:Basic safety (ability to enter water, comfort, etc.)Precautions (cardiac history, etc.)Contraindications to aquatic environment (fever,infections, rashes, etc.)
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Therapeutic Exercise Intervention Mobility Impairment
Progress simple ROM exercises towardfunctional limitations.Use lever arm length and buoyant equipment to
alter resistance.Observe land mechanics before pool exercise toensure proper technique.
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ROM(Hamstrings and Shoulder Extensors)
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Balance Impairment
Ideal environment for balance training.Variety of activities can be performed.
Loss of balance is slowed dramatically. Allows for increased reaction time.
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Aquatic Therapy to Improve Balance
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Aquatic Rehab to Treat FunctionalLimitations
As patient improves, modify activities toaddress functional limitations.
E.g., decrease level of water as sittingactivities improve. As normal mechanics improve, decreasewater levels to replicate land-basedenvironments.
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Land-Based Functional Activities inWater
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Contraindications/Precautions
Individuals withexcessive fearOpen wounds
Rashes Active infectionsIncontinence
Tracheostomy
CV changesDiuresisOverexercise
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Summary
Pool provides a unique environment forrehabilitation.The properties aquatic therapy provides
can be used in many ways to achievetherapeutic goals.Physiologic responses, temperature, andhydrostatic pressure must be considered forsafety.
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Summary (cont.)
Aquatic therapy can accommodate activities andprogress from early-functional stages.
Balance is challenged with most movementsand stabilizing muscles must be considered.
Pool program should include a land-based
program for a well-balanced transition to theland environment.