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Practice Topics/PID Exam 7 > Aquatic therapy 2 > Flashcards

Aquatic therapy 2 Flashcards

1
Q

Surface tension =

A

Forces exerted between the surface molecules

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2
Q

Clinical relevance of surface tension

A

Strengthening - can break the surface
- Weak muscles
- Progressions
Sensory - Increase sensory input - can work under water initially and then work towards breaking the water - gives sensory input

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3
Q

Refraction =

A

bending of a ray as it moves from a less dense to a more dense medium

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4
Q

Refraction clinical relevance

A

Visual feedback - putting them in water stops them from being able to look at their feet when walking for example
Evaluation - you have to do an eval OUT of water for this reason - distorted views in water

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5
Q

Water temperature

A

Thermoneutral water for most people is 93 F

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6
Q 
Water temperature - special populations 
More active pts and pts with MS
Less active pts
Ther ex/arthritic conditions 
Pregnancy
A

More active pts and pts with MS - 82 to 88 F
Less active pts - 88 to 92 F
Ther ex/arthritic conditions - 92 to 96 F **
Pregnancy - 88 to 90 F

** Most pools are between 92 and 96 F

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7
Q

Water temp - clinical relevance

A

Cooler pool = if you want to get someone to be more alert

Warmer pool = relaxation

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8
Q

Physiological effects of immersion

A

Inc superficial circulation
Enhanced oxygen delivery and blood glucose to mm tissue
Increase diuresis (pt need to drink water)
Generalized mm relaxation
Dec pain and joint loading
Dec SNS activity
Dec edema
Greater potential change in core body temp

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9
Q

Effects of exercise and immersion

A

Decreased WB and impact stresses in the water
Less mm is recruited and a lower rate of work as compared to same activity as on land
Inc mobility often occurs due to dec WB stresses, relaxation
Provides a comprehensive challenge to balance, coordination, and kinesthetic mechanism

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10
Q

Cont effects of exercise and immersion

A

Provides ample opportunity for trunk and postural training
The buoyancy offers inc support of ROM and flexibility exercises
Equal resistance in all planes of motion, so that several mm groups can be worked simultaneously

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11
Q

CV systems effects

A

External water pressure exceeds venous system pressure at a relatively small depth
60% inc central volume (27-30% dentral volume)
Inc R atrial pressure

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12
Q

CV system effects cont.

A

Dec VC of blood vessels due to change in central volume
Inc pulmonary blood flow of large vessels
Inc blood volume of 33-60%
Dec in vital capacity and total lung capacity

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13
Q

CV system effects - Immersion to neck

A

35% inc in SV

32% inc in CO

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14
Q

CV system effects - HR dependent on

A

Dec HR dependent on water temp

77 F = drops 12-15 bpm
Thermoneutral = drop less than 15% HR
Warm temp = inc HR

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15
Q

Pulmonary system effects - submersion to neck

A

Pressure on rib cage dec circumference - 10%
Vital capacity dec 6-10%
Influenced by water temp
Total work of breathing inc about 60%

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16
Q

Pulmonary system effects - submersion to xiphoid

A

Expiratory reserve volume decreased by 75%

17
Q

Pulmonary system effects - diaphragm

A

will be elevated because of the pressure - so more work to get it down

18
Q

Pulmonary system effects - Diffusion capacity

A

is reduced

19
Q

Psychological benefits

A 
Overall physical benefits of exercise 
Interesting 
Relaxing
Greater accountability with the program
Fun to do 
Less chance of re-injury
20
Q

Economical/Social benefits

A

40-50% reduction in rehab time
Rehab begins earlier
Pt is able to return to functional activities sooner

21
Q

Indications for aquatic therapy

A 
Poor tolerance to exercise on land
WB difficulties - post op, fx/sprain
Arthritis
Chronic pain
Multiple injuries 
Elite athletes 
MSK injuries
Back pain
Weakness
Dec ROM
EVERYTHING!
22
Q

Precautions/Contraindications

* Usually contra

A 
Absence of cough reflex or mouth closure
Trach tube or open stoma*
IV lines, NG tubes, external collection devices
Any -ostomy 
Open, macerated skin, open wounds*
Rash.skin condition
Chemical sensitivity 
Environmentally communicable conditions *
B/B incontinence * 
Infectious resp disease *
Immuno compromised pt *
Seizure disorder *
Renal disease *
Active joint inflammation - RA, Hemophilia * 
Fear of water *
23
Q

Precautions/Contraindications - Numbers

Ejection Fraction
Vital Capacity
Fever

A

EF less than 25%
Vital capacity less than 1.5 L
Fever over 101

24
Q

Purpose of equipment

A

To offer needed support/balance
To decrease the support needed by staff
To increase the intensity of the exercise
To add variety to an exercise program
To make exercise more challenging or enjoyable
To make an exercise easier

25
Q

Two classifications of aquatic equipment

A

Equipment that uses buoyancy’s effect

Equipment that increases resistance by increasing the surface area

26
Q

Aquatic equipment - the amount of resistance is determined by

A

Size of equipment
Shape
Speed of movement of equipment

27
Q

Aquatic equipment - buoyancy

A 
Cervical pillow
Noodle
Ankle or wrist cuffs
Aquabelt 
Kickboard
Styrofoam dumbbells
Swimbar
Inflatable ring
Vests
28
Q

Aquatic equipment - resistance

A 
Swimmers paddle 
Aqaufins 
Kickboard 
Styrofoam
Dumbbells 
Swimbar
Ankle weights
Webbed gloves
Aquapaddles 
Hydrotone blades
29
Q

Documentation

A

Function, disabilities, and health that may be positively affected
Pt requires skilled intervention
Water offers a therapeutic environment for interventions which is not achievable on land
Improvements made in water carry over to land

30
Q

Evaluation -

A

Land based eval first
Give pt tour of clinic and pool
Perform eval with shoes off to analyze gait

31
Q

Common pitfalls for denials

A

Did not demonstrate skilled intervention
Billed for 2 eval codes for same diagnosis
Duration of therapy exceeded reasonable time frame
Repetitive nature of tx
Failure to document why land alone was not adequate
Failure to demonstrate carry over

Practice Topics/PID Exam 7 (9 decks)

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