Hydrotherapy

Question 1

Hydrostatic pressure

Answer 1

Increases with depth due to the weight of water pressing down. When standing in water= more pressure in the ankles than the chest.

Question 2

Relative density

Answer 2

Relative density is defined as the density of an object or substance relative to the same volume of pure water. The average density of water is 1Kg/m3, the average body with air in the lungs= 0.975, and without air =1.2. The body’s density increases with increased muscle and bone mass.

Question 3

Buoyancy

Answer 3

Is the result of the pressure gradient creating an upward force (upthrust) exerted on an object in water.

Question 4

Depth of water

Answer 4

Water depth= ASIS= 50% WB
Xiphisternum or T11- 25-30%
C6/7 or sternal notch- 8-10%

Question 5

Stability in water

Answer 5

A body immersed in water is subject to 2 opposing forces. Gravity acts downwards and Buoyancy acts upwards. The shape, distribution of mass and density of a body determine stability. 2 forces acting= COG and COB.

Question 6

Metacentric effect

Answer 6

the restoring or stabilising rotation on an immersed body when forces of gravity and buoyancy are not acting in the same vertical plane.

Question 7

Resistance to movement- drag

Answer 7

3 elements that contribute to 90% of drag= negative pressure of the turbulence behind a moving object, skin friction, size of th ecolumn of fluid adhering to each other. Other 10%= bow waves (positive pressure from weight of water in front of moving object), viscositiy, cohesion and surface tension

Question 8

drag resistance is increased by

Answer 8

increased speed, decreased streamline, increased lever length, changed direction quickly

Question 9

refraction

Answer 9

its what happens when light rays pass through a material of different densities. Meaning light can bend as they pass through water.

Question 10

use of buoyancy

Answer 10

to strengthen muscle action
assist joint movement
assist prolonged muscle stretches
to provide weight relief
to assit relaxation

Question 11

use of drag

Answer 11

to assist movement, to resist isometric and isotonic muscle action, to maintain/displace/restore balance, to assist/resistance walking

Question 12

use of meacentric effect

Answer 12

to assist/ initiate movement o.e rolling
recruit trunk stability muscles
promote balance/stability

Question 13

Muscle actions during immersion- concentric

Answer 13

BA-movement towards the surface of the water (grade I muscle power), BC- movement parallel to waters surface, DA- a movement created by either moving the body part to create a drag effect in the direction of movement to assist, DR- patient initiated movement in any direction at a speed that creates negative pressure from turbulent water- increased speed= increased resistance

Question 14

Muscle actions during immersion- eccentric

Answer 14

Moving towards the water surface slower than the speed of buoyancy progressed with additional floats,

Question 15

Muscle actions during immersion- Isometric

Answer 15

hold a position against the buoyancy force, increased by using a float. Metacentre- hold a posture against the metacentric rotational force, turbulence- hold posture against applied turbulence, drag effect- hold a posture against the drag effect created by the therapist moving the patient through the water or patient moving themselves through water

Question 16

Physiological effects of immersion- CV changes

Answer 16

30% increase in cardiac volume improves the myocardial efficiency by the stretch enhancing actin-myosin filament relationship. Increase in CO, SV, HR, PR, BP

Question 17

Physiological effects of immersion- pulmonary

Answer 17

hydro affects pulmonary function due to direct hydrostatic pressure on the thorax, venous engorgement from increased CBV reducing the diffusion capacity. Immersion increases WOB by 60% due to pressure on rib cage

Question 18

Physiological effects of immersion- pulmonary changes

Answer 18

TV remains unchanged or slightly diminshed, Reduced- expiratory reserve volume, VC, TLC, FRC,
increased= airway resistance

Question 19

Physiological effects of immersion- central and peripheral NS changes

Answer 19

skin sensory nerve endings including temp, touch and pressure receptors are affected by immersion. the sympathetic nervous system can develop and sustain neurogenic pain with the release of noradrenaline. Warm water suppresses SNS. Increased CBV stimulates baroreceptors- causing vasomotor centre to inhibit noradrenaline release

Question 20

Physiological effects of immersion- suppression of SNS and release of noradrenaline may….

Answer 20

Reduce ischaemic pain by reducing arterial tone= increased vasodilation and blood flow, interrupts pain cycle, reduce inflammatory response

Question 21

Physiological effects of immersion- MSK changes

Answer 21

increase in cardiac output, decrease in joint pain

Question 22

Benefit of aquatic physiotherapy- Pain

Answer 22

pain relief and reduction of muscle spasms. Due to the warmth of the water, suppression of the SNS, stimulation of skin sensory nerve endings, reduced effect of gravity

Question 23

Benefit of aquatic physiotherapy- joints

Answer 23

ease of movement, joint range and flexibility. Due to: support of buoyancy, reduced effect of gravity

Question 24

Benefit of aquatic physiotherapy- reduction of oedema and improved circulation

Answer 24

hydrostatic pressure, ability to move freely

Question 25

Benefit of aquatic physiotherapy- strength

Answer 25

viscosity of water, drag effect, negative pressure from turbulence, weight and density of water, force of buoyancy

Question 26

Benefit of aquatic physiotherapy- Re-education of functional activities

Answer 26

metacentric effect, support of buoyancy and variation in weight-bearing, assistance or resistance to movement

Question 27

Benefit of aquatic physiotherapy- improved CV fitness

Answer 27

hydrostatic pressure, resistance to movement, opportunity for exercise

Question 28

Benefit of aquatic physiotherapy- enhanced relaxation

Answer 28

reduced effect of gravity, support buoyancy, reduction in pain, hypnotic effect of water

Question 29

Benefit of aquatic physiotherapy- enhanced feeling of well being

Answer 29

ability vs disability, social interaction, enjoyment, independence

Question 30

progression of buoyancy resisted exercise

Answer 30

Increase the size of the flotation aid, slower movement, longer lever if possible, starting position

Question 31

to progress a drag resisted exercise

Answer 31

increase speed of movement, increase in SA, longer lever