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Practice Topics/PID Exam 7 > Aquatic Therapy 3 > Flashcards

Aquatic Therapy 3 Flashcards

1
Q

Ai Chi

A

Flowing aquatic energy
Creator = Jun Konno (1993)
Molded after Tai Chi, Qi gong, and yogic breathing
Consists of 19 movements with increasing difficulty

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2
Q

Key elements to Ai Chi

A

Listening to inward feeling
Breath modulation
Relax (increase chi)

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3
Q

Ai Chi - progression

A

WBOS to narrow
Symmetrical to asymmetrical UE mvmnt
Small hand to large hang mvmnt
Visual control to non visual (fixate on something outside of water - progress to moving gaze)
Symmetrical trunk to rotatory trunk mvmnt
Static to dynamic COG

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4
Q

Ai Chi progression - positions

A

19 of them

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5
Q

Ai Chi - populations of patients

A

Balance or prop deficits (CVA, head injury)
Cardiorespiratory disorders (COPD, asthma)
MSK stiffness/Dec ROM (RA, OA, Fibro)
Pain (back, HA, chronic fatigue)
Stress related disorders (anxiety, depression)

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6
Q

Ai Chi - populations of patients - with cardiprespiratory disorders -

A

Need to be at mid chest level with Ai Chi

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7
Q

AquaStretch

A 
Assisted stretching and myofascial release technique 
Performed in 3 to 5 ft of water 
Uses properties of water 
10 step process from toe to head
May use weights
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8
Q

AquaStretch - basic procedure (ex shoulder pain and restriction)

A

PLAY - in water just moving shoulder around until find painful place - then freeze!
FREEZE - they do not move! have them explain where the pain is - they direct you to the spot
PRESSURE - you apply pressure to this point that acts as the fulcrum
MOVE - you want them to move freely - not directed by PT on how to move

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9
Q

AquaStretch - appropriate patient populations

A 
Fibromyalgia
Joint of mm pain (arthritis, HA, fibro)
Post injury/accident
Post surgical patients (TKA)
Psychological 
Spinal deformities, degenerative or herniated discs
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10
Q

Bad Ragaz Ring Method

A

Modeled after principles of PNF
Developed in Switzerland in 1950s
Horizontal tx technique - pt must be comfortable in supine position
Neck and hips supported by rings
Resistance from PT hands and drag due to mvmnt through water

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11
Q

Bad Ragaz ring method - explain

A

Slow mvmnts OR rapid mvmnts - streamline and turbulent flow are used
Unilateral and B mvmnts
Sym and Asym mvmnts
With unilateral - one limb is often isometric and the other is isotonically working

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12
Q

Bad Ragaz - PT position

A

You do not want to be too deep

Probably to about T9 area

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13
Q

Bad Ragaz progression

A 
Inc ROM
Hand holds proximal to distal 
Inc speed
Lengthen lever
Use combination of techniques 
Inc resistance 
Dec air in flotation devices 
Change SA
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14
Q

Pt populations for Bad Ragaz

A

Chronic spine problems/poor spinal stabilization
General weakness or motor control deficit
Peripheral joint problems
post surgery
Relaxation or tone reduction

Good for CHF and COPD too because get good effects but they are in supine and not have to be vertical in water

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15
Q

Halliwick concept

A

Mostly concentrated on neurological facilitation; can be task oriented
Developed by James McMillan in the 50s
Techniques based on fluid mechanics
Teaches how to maintain balance control in water
4 phases
10 stages

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16
Q

Halliwick concept - phases

A

Phase 1 = adjustment to water
Phase 2 = rotation control
Phase 3 = control of movement
Phase 4 = movement in water

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17
Q

Halliwick concept - phase 1

A

Adjustment to water
Mental adjustment - pt feel comfortable in water
Breath control

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18
Q

Halliwick concept - phase 2

A

Rotation control
Ability to maintain a position
Ability to change a position in a controlled way

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19
Q

Halliwick concept - phase 3

A

Control of movement

Balance and control

20
Q

Halliwick concept - phase 4

A

Movement in water

Effective, efficient and directed skilled activity

21
Q

Halliwick concept - patient populations

A 
Balance deficits 
Gait pattern dysfunctions
Dec control of voluntary mvmnt
Dec mm endurance
Developmental disorders (CP)
mm tone dysfunctions
Stabilization deficits
22
Q

Watsu

A

Developed by harold dull in 1980s
Based on Zen shiatsu, stretching body’s meridians (energy pathways)
Very beneficial when promoting relaxation and tone reduction
Pt is cradled by the PT throughout movements

23
Q

Watsu - provides what

A 
Soft tissue stretch
Vestibular stimulation 
Relaxation
Deep tissue massage 
Decrease in SNS and increase in PNS
24
Q

People who get watsu tx have better

A

Sleep
Immune system function
Digestive motility

25
Q

Pt population - watsu

A

Restricted ROM of spine/extremities
High tone or spasticity
Pain
Stress or difficulty relaxing

NOT WITH OP patients - rotation and flexion motion = contra

26
Q

Chronic LBP

A

Watsu - need to be careful since 100% passive
Ai Chi - can work on inc ROM and breathing
Bad Ragaz - stabilization

27
Q

CVA

A

Ai Chi - start with unilateral
Bad Ragaz - if poor trunk control
Halliwick - can work on rotation
Spastic CVA - could do Watsu

28
Q

Incomplete spinal cord

A

Halliick - work on trunk stability

Bad Ragaz

29
Q

Mild heart failure and general weakness

A

Bad Ragaz - help with weakness

Ai Chi

30
Q

TKA 6 months post op

A

Ai Chi
Halliwick
AquaStretch

31
Q

OP

A

Bad Ragaz

NOT WATSU

32
Q

Neuro population - general guidelines - Deep vs. Shallow

A

Deep if working on weakness deficit
Spasticity - would want to deep to get relaxation and warmth properties
Balance - progress from deeper to more shallow

33
Q

Neuro population - general guidelines - Unilateral vs. B

A

Coordination - B
Balance - Unilateral is easier with UE support - then progress to B

Coordination B then U
Balance U then B

34
Q

Neuro population - general guidelines - Distal stabilization

A

Have them stabilize on something that is connected and then progress to less support

35
Q

Neuro population - general guidelines - Speed and excursion

A

Small excursions first and then progress to bigger

Start slow and progress to fast

36
Q

Neuro population - considerations

A

Access - to the pool (stairs, zero access)
Varying depths
Temp
Pt position (cube, triangle, stick)

37
Q

Neuro population - things to work on

A 
Inc or dec tone (rotational will dec = watsu will help with dec tone)
Trunk control
Balance restrictions
Incoordination
Weakness
Deconditioned
Dec ROM
Gait dysfunction
38
Q

MSK population - Acute injury

A

Phase 1 - acute
Phase 2 - recovery
Phase 3 - functional phase (plyometrics)

39
Q

MSK population - Post operative

A

Phase 1 - acute or early rehab
Phase 2 - Intermediate rehab
Phase 3 - Advanced rehab
Phase 4 - Return to sport participation

40
Q

MSK considerations

A

Need to follow protocol if indicated by surgeon/need to follow the phase of healing
Try to add in new activities often in the supportive and controlled environment of water

41
Q

MSK precautions

A

Monitor exertion, symptoms, pain

Can easily underestimate the effects of buoyancy, turbulence, and work

42
Q

MSK - spine population

A 
Postural alignment 
Core stabilization 
Pelvic stabilization 
Water walking 
Traction 
Aerobics
43
Q

CP population - target HR zone…etc

A

12 to 17 beats below 220-age
Use Borg scale (13 is highest)
Low vital capacity
Be aware of body heat build up (esp with obese)
Encourage breaks
Check vitals
Swimming (hardest CV exercise you could have pt do)

44
Q

CV population - benefits

A

Inc cardiac efficiency and myocardial perfusion
Improve preload, SV, CO during execise
Strengthen resp mm
Promote clearing of excretions
Promote complete exhalation and larger inhalation
Reduce LE edema

45
Q

Obese population

A

Protective effects against heavy joint loading
Aerobic exercise sufficient for conditioning effect
Aids circulation
Dec possibility of stress fractures or overuse injuries
High risk for heat exhaustion

46
Q

Pediatric population

A

Tend to be more chest breathers so requires more energy to breathe
Not good at determining if they are overworked
Won’t notice signs of intolerance
Need to keep things functional

Practice Topics/PID Exam 7 (9 decks)

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