Aquatic exercise

Question 1

what are some Goals or indications of aquatic exercise?

Answer 1

• facilitate ROM
• initiate resistance
• facilitate WB activities
• enhance delivery of manual techniques

Question 2

Precautions for aquatic ex

Answer 2

• fear of water
• neurological disorders
• seizures
• cardiac dysfunction
• small open wounds and lines

Question 3

Contraindications of aquatic ex

Answer 3

• incipient cardiac failure or unstable angina
• respiratory dysfunction VC< 1L
• severe PVD
• danger of bleeding
• severe kidney disease
• open wounds, colostomy or skin infections
• uncontrolled bowel and bladder
• water and airborne infections
• uncontrolled seizures

Question 4

WHat are the properties of water?

Answer 4

• Buoyancy
• Hydrostatic pressure
• viscosity
• surface tension

Question 5

buoyancy

Answer 5

• upward force that works against gravity

- clinical significance: unloads joint, allows 3D access to patient

Question 6

hydrostatic pressure

Answer 6

• pressure exerted on immersed object
• clinical significance:
• • limits effusion
• -assists with venous return
• -induces bradycardia
• centralizes peripheral blood flow
• -easier to do ex near surface where pressure is less

Question 7

viscosity

Answer 7

• FRiction occurring between molecules of liquid resulting in resistance to flow
• Clinical significance:
• • extremity moved through the surface more work than under water only
• using equipment at surface requires more work

Question 8

Hydromechanics

Answer 8

• physical properties and characteristics of fluid in motion
  1. Laminar flow
  2. turbulent flow
  3. drag

Question 9

Laminar flow

Answer 9

• all molecules move parallel to one another

- usually during slow movement

Question 10

Turbulent Flow

Answer 10

• movement where molecules do not move parallel to each other
• faster movements

Question 11

Drag

Answer 11

-Cumulative effects of turbulence and viscosity acting on an object in motion

Question 12

Clinical significance of drag

Answer 12

-as the speed increases, resistance to motion increases (in water)

• moving water past patient requires patient to work harder
• application of equipment can increase resistance

Question 13

thermodynamics: Specific heat

Answer 13

• amount of energy needed to raise 1g of substance by 1 deg Celsius

Question 14

Clinical significance of specific heat thermodynamics

Answer 14

• water retains heat 1000 times more than air
• water can maintain its temp with minimal change even when different objects are immersed
• water conducts temperature faster
• heat transfer increases with velocity

Question 15

Center of buoyancy

Answer 15

• the reference point of an immersed object on which buoyant forces of fluid act
• –Ex the sternum in a vertical patient

Question 16

clinical significance: Unilateral manual resistance

Answer 16

• patient revolves around the PT in circular motion
• Unilateral lower extremity amputation, patient will lean toward side of residual limb in vertical position
• Patients bearing weight on floor of pool experience both center of buoyancy and center of gravity

Question 17

Aquatic temp Rule of thumb

Answer 17

1. Cooler temp for high intensity
2. warmer temps for mobility and flexibility ex and muscle relaxation
3. ambient air temp should be 3 deg C higher than water

Question 18

Temperature regulation

Answer 18

• Patient has harder time regulating due to immersion
• water conducts heat 25 times faster to or from the patient
• patient perceives small changes in water temp more than in air
• water temp can penetrate deep into patient, inversely can penetrate deep into patient, inversely proportional to subcutaneous fat thickness
• Patients unable to maintain core temp if water is <25 deg C
• > 37 deg C may be too hot for intense activity
• Hot water increases cardiovascular demand
• In waist deep water @37 deg C, heart rate stimulated to incr and overcomes centralization of peripheral blood flow
• @37 deg C cardiac output incr even at rest

Question 19

Mobility and Fucntional Control Exercise Temp

Answer 19

• 26-33 deg C
• use warmer water for acute painfuk patient
• incr relaxation
• elevate pain threshold
• decr muscle spasm

Question 20

Aerobic Conditioning temp

Answer 20

• 26-28 deg C
• maximizes ex efficiency
• incr stroke volume
• decr heart rate
• if exercising at >80% target heart rate use 22-26 deg C

Question 21

stretching in water

Answer 21

-Patient is supine in waist deep water or sitting on step
-buoyancy devices at neclm waist, feet
-

Question 22

strengthening in water

Answer 22

• usually in waist deep water/ deeper water depending on device
• manual or mechanical resistance

Manual: usually distal segment of extremity os fixated. Body moves when muscle contract. drag of body creates resistance

Question 23

Buoyancy assisted independent strengthening

Answer 23

(BA)

- vertical movement directed parallel to vertical forces of buoyancy that assist motion

Question 24

Buoyancy supported (BS) independent strengthening

Answer 24

-Horizontal movement with vertical buoyancy forces eliminating or minimizing need to support extremity against gravity

Question 25

Buoyancy resisted (BR) independent strengthening

Answer 25

movement directed against vertical forces of buoyancy creating drag (w/o equipment)

Question 26

Buoyancy superresisted (BSR) independent strengthening

Answer 26

-use of equipment to increase drag against vertical forces of buoyancy

Question 27

aerobic conditioning

Answer 27

• usually occur w/ patient suspended in deep water
• or in mid-level water 4-6 ft depth
• jogging
• swimming strokes
• immersed cycling
• immersed treadmill

Question 28

Physiological Response to deep water walking/running

Answer 28

• cardiovascular response: dampened elevation of HR, ventilation, VO2 max
• during low intensity exercise, cardiac patients may have less cardiovascular stress

Question 29

training effects of aquatic ex

Answer 29

• carryover gains in VO2 max

- maintenance of leg strength and max oxygen consumption in healthy runners

Question 30

exercise monitoring in aquatic ex

Answer 30

• Borg Rate of perceived exertion

- HR normal adult 60-100