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Practice Topics/PID Exam 7 > Aquatic Therapy 1 > Flashcards

Aquatic Therapy 1 Flashcards

1
Q

Aquatic PT is what

A

Active or passive techniques using water as main medium

AMA says - therapeutic procedure which attempts to improve function through the application of aquatic therapeutic exercises

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2
Q

CPT code for aquatic?

A

YES!

97113

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3
Q

Aquatic therapy vs. exercise - THERAPY

A

Completed by a skilled/licensed PT/PTA
Focus on functional limitations/impairments
Most insurers will reimburse
Requires CDM

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4
Q

Aquatic therapy vs. exercise - EXERCISE

A

Performed by anyone
Maintain/improve general strength/conditioning
Self pay
Does not require CDM - is a progression from aquatic therapy

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5
Q

Buoyancy - ___ principle and what is it

A

Archimedes!

When a body is wholly or partially immersed in a fluid, the body will experience an upward thrust equal to the weight of the fluid displaced

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6
Q

Buoyancy - longer lever arm

A

With longer lever arm - increases!

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7
Q

Buoyancy - Density/mass

A

More mass = you will sink (less buoyant)

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8
Q

Buoyancy - Center of Buoyancy

A

COG - umbilicus

COB - more at T11 - so gives a little bit of a rotational force since they are not in alignment

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9
Q

Buoyancy - Effect of breathing

A

Increase air in system - breathe in - COB shifts down

So the more air in your lungs, the more buoyant you are

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10
Q

Buoyancy - ex of someone laying on their back and you want to get them standing - what do you do with breath

A

Breath out - decrease Buoyancy and they will stand

Other way (stand to supine) would have them breathe in to make them more Buoyancy

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11
Q

Clinical relevance of Buoyancy

A

Strengthening a weak muscle

Buoyancy can be used to -

  • Support a movement
  • Assist a movement (EASIEST - START HERE)
  • Resist a movement
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12
Q

Clinical relevance of Buoyancy - ASSIST IS THE EASIEST! - If working on shoulder flexion, how position to get the assist?

A

Standing (Buoyancy will help) - just think about Buoyancy and nothing else

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13
Q

Buoyancy - clinical relevance - order (after assisted is what)

A

Supported

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14
Q

Clinical relevance example with Buoyancy - want shoulder flexion - now supported, what position?

A

Sidelying

Water/Buoyancy is supported the arm

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15
Q

Clinical relevance example with Buoyancy - want shoulder flexion - now resist, what position?

A

Prone with 90 flex to ext

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16
Q

Buoyancy - clinical relevance - Body weight unloading - static - if up to C7 you are unweighted how much

A

90%

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17
Q

Buoyancy - clinical relevance - Body weight unloading - static - Xiphosternum

A

75 - 60%

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18
Q

Buoyancy - clinical relevance - Body weight unloading - static - ASIS/Umbilicus

A

50%

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19
Q

Buoyancy - clinical relevance - Body weight unloading - static - Symphysis pubis

A

40%

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20
Q

Buoyancy - clinical relevance - Body weight unloading - Slow walk - clavicular area

A

75%

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21
Q

Buoyancy - clinical relevance - Body weight unloading - Fast walk to get 75% offloading - be at

A

About C7

(compared to slow walk which was clavicular area for 75% off loading)

So if walk fast have to be deeper to get more offloading?

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22
Q

Buoyancy - clinical relevance - Body weight unloading - Slow walk - ASISs

A

25%

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23
Q

Buoyancy - clinical relevance - Body weight unloading - Fast walk - 50% off loaded - be at

A

Xiphoid process

24
Q

Buoyancy - clinical relevance - Pain - benefit?

A

Decrease splinting/guarding
Motor activity for postural muscles
Decreased compressive forces on joints

25
Q

Buoyancy - clinical relevance - Post surgical - benefit?

A

Early gait training

Access to body parts

26
Q

Buoyancy - clinical relevance - Balance/Strengthening - benefit?

A

Promote ease of handling patients
Can work on eccentric control when use buoyant equipment

(concentric without equipment)

27
Q

Relative density is what

A

Ratio of the mass of an object to an equal volume of water

28
Q 
Relative density of water is what?
Fat?
Bone?
Muscle?
Human body avg?
A 
Water = 1.0 
Fat = 0.8
Bone = 1.5
Muscle = 1.5
Human body avg. = 0.95 - 0.97
29
Q

Relative density - person with more adipose will float or sink?

A

Float

More adipose - they are less dense than water, so they will float

30
Q

Relative density - person with more muscle will float or sink?

A

Sink

Muscle is more dense than water

31
Q

Relative density - people typically tend to

A

Float

Human = 0.95 to 0.97 so less than 1.0, so float!

32
Q

Relative density - clinical relevance

mm vs adipose
OP
kyphosis/scoliosis
spastic
flaccid
resp status
pt comfort
A

Body size/composition

  • Inc mm bulk vs. adipose
  • OP = FLOAT (losing mass of bone)
  • Kyphosis/scoliosis SINK (bony mass in one area, won’t take in as much air) - scoliosis - tend to rotate
  • Amputation (rotate to amp side)

Spasticity vs. Flaccid (spastic = SINK - short lever arm and tight, flaccid = FLOAT)

Respiratory status (INC air in lungs = FLOAT more)

Pt comfort in water (sink if fearful)

33
Q

Hydrostatic pressure =

A

Pascals law!

When a body is immersed in water, there is a pressure exerted by the fluid upon the tissues at rest and at a given depth

34
Q

Hydrostatic pressure - TWO things affect the pressure - what are they

A

Density of the fluid
- Denser the fluid, the more pressure
Depth of the immersion
- the deeper you go, the more pressure

35
Q

Hydrostatic pressure - salt water pool vs. regular

A

More hydrostatic in salt water pool

36
Q

Hydrostatic pressure = greatest external pressure

A

4 feet at the deepest point (so at feet) - 88 mm of pressure

Increase in venous return
Hydrostatic pressure is greater than venous return - this is good for decreasing edema

37
Q

Hydrostatic pressure - clinical relevance - resp implications

A

Will make it harder to breathe!
Harder for them to take deep breath because of pressure on the wall
Facilitates exhalation!

38
Q

Hydrostatic pressure - clinical relevance - resp implications - Vital capacity

A

If they have vital capacity lower than 1500 ml they will have trouble breathing in pool - so either float them, or don’t go as deep

39
Q

Hydrostatic pressure - clinical relevance - resp implications - edema

A

Beenfit for those with venous insufficiency - will help with return up to core

40
Q

Hydrostatic pressure - clinical relevance - resp implications - cardiac

A 
Results in increased preload to heart
increased SV (same CO though - so HR goes down)
41
Q

Hydrostatic pressure - clinical relevance - resp implications - sensory system

A

Effect with desensitization - getting pressure in that area

42
Q

Good to do if want to increase return to core from LEs

A

Exercise in deep water

43
Q

Viscosity is what

A

Friction that occurs between the molecules of a liquid and causes resistance to the flow of a liquid

44
Q

Viscosity - moledules adhere to

A

surface of body moving through the liquid

45
Q

Viscosity - water vs. air

A

Water is 12 x more viscous than air
So harder to move in water than air

But easier in water than air because of buoyancy

46
Q

Hydrostatic pressure - Pt on dialysis or lasix - with the venous return to the core

A

Need to watch for them becoming hypotensive

47
Q

Viscosity - if you have more movement in the water - you add

A

more turbulence which creates more drag

48
Q

Change viscosity by changing what

A

Medium - more viscous in salt water

Temp - inc temp, dec viscosity

49
Q

Viscosity - clinical relevance

A

Strengthening
Weight bearing
Balance

50
Q

Viscosity - clinical relevance - Strengthening

A

Progressive resistance exercise program
Resistance = force exerted (isokinetic)
Exercise resistance in 3 dimensions

51
Q

Viscosity - clinical relevance - Weight bearing

A

Drag - stimulates skin receptors, GTOs and mm spindles

Rapid mvmnt with resistive devices = quasi WB moment

52
Q

Viscosity - clinical relevance - Balance

A

Movement is slowed down

Slows down the movement

53
Q

Hydromechanics is what

A

Properties and characteristics of fluid in motion
Laminar flow
Turbulent flow
Drag

54
Q

Hydromechanics - Laminar flow =

A

Fluid molecules slide over one another, move parallel

EASIER than turbulent

55
Q

Hydromechanics - Turbulent flow =

A

Fluid molecules do not move parallel

HARDER than laminar

56
Q

Hydromechanics - Drag =

A

Effect of turbulence and fluid viscosity acting on object in motion
Superman cape = walking against drag

57
Q

Hydromechanics - clinical relevance - you can increase of dec resistance by changing what

A

Change frontal SA (streamline/laminar vs turbulent)
Change velocity (double velocity, takes 8x the power)
Change lever arm (longer is harder)
Oppose momentum (quick reversals)
Use slipstream effect (drafting - easy to walk behind someone than be the person in front)
Use rebound effect
Work against jets

Practice Topics/PID Exam 7 (9 decks)

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