Hydrotherapy Flashcards
Hydrotherapy
the use of water in any of its three forms: liquid, solid or vapor, internally or externally, in the prevention, treatment or healing of any ailment or disease
Know and understand all the indications of your treatments
Yes
Know and understand all the contraindications and precautions of your treatments
Yes
Maintain detailed records of your patients treatment and review these records before…
Every treatment
When should you take the time to fully explain the hydrotherapy procedure to your patient
Before the treatment starts
Clarity =
Safety
Monitor your patient closely and comfort at all times
Yes
Your patient must be thoroughly and evenly warm before any treatment begins. Never…
Cold on cold patient
What should you do if your patient is chilled by the treatment (i.e goose flesh, feels chilly)
Stop treatment immediately and warm your patient
After warm/hot treatments, it’s should be followed by
A rest period
After cool/cold treatments, it should be followed by
Light, monitored exercise
Circadian rhythm heating phase
3am - 3pm
Circadian rhythm cooling phase
3pm - 3am
Intense treatments are best done in
The morning
Medium treatments are best done in
The afternoon
Light treatments are best done in
The evening
The heat application should be bigger and longer than
The cold
Always end with
Cold
In contrast treatments there should be a minimum of ______ in temperature
10 degree difference
Uses
• Relieve pain and discomfort (ie. analgesic)
• First aid (PRICE in sports or acute injuries)
• Pre-heat for massage or exercise
• Promote relaxation and reduction of stress
• Increase circulation to skin, extremities and joints
• Stimulate immune system
• An exercise environment (pool exercises assist in increasing joint ROM)
• Increase joint ROM (eg. using paraffin wax in the treatment of non
acute arthritis)
Indications
• Pain and inflammation
• Sports injuries, overuse injuries, repetitive strain injuries
• Stress
• Insomnia
• Decreased ROM
• Patients that are weak, bedridden or unable to support their weight (eg.
wheelchair, rehab)
• Hypertoned muscles
• Arthritis (not in acute/flared up stage, no extremes of temperature)
• Decreased circulation, poor or sluggish circulation
Physiological Effects of water
• Thermal
• Mechanical
• Chemical
Thermal
Using temperatures above or below the normal human body temperature
Mechanical
Friction to the skin (ex. Salt glow)
Strike to the skin (ex. Jets in a hot tub)
Chemical
- Dissolve substance in water
applied to skin (ex. Compress or poultice)
-absorbed (ex. Epsom salt bath)
-Inhaled (ex. Steam with eucalyptus***)
Classification of hydrotherapy
Constitutional
Regional
Local
Constitutional
treats whole person/body (eg. Fullbath, steam, IRS)
Regional
treats a section/part of body (eg. CAB, CFB, abdominal wash)
Local
treats a small area/part of body (eg. ice massage, heat pack)
Precautions to hydrotherapy
Cold
Heat
Hydrostatic pressure
Cold precaution
avoid further injury, such as returning to vigorous activity after ice or cryotherapy, avoid application of ice over bony areas and superficial nerves
Heat precaution
Monitor your patient’s reactions, the medical condition of the patient (ie. Multiple Sclerosis) to tolerate heat, and the ability to generate sweat must be considered
Hydrostatic pressure precaution
This pressure is exerted to the venous system from immersion of the body in water. Hydrostatic pressure increases with water depth. Monitor patient reactions and the medical condition of the patient. (eg. patients with a cardiovascular condition, pregnancy, arteriosclerosis)
Cold contraindications
• Very high/low blood pressure
• Pleurisy (inflammation of pleura, tissue around lungs, tissue is fragile)
• Raynaud’s disease in flared up stage (impaired ability for blood vessels to
constrict & relax)
• Hypersensitivity to cold (a negative reaction is hives, or increased pain)
• Peripheral neuropathy (lack of or diminished sensation in the extremities, caution
with diabetes)
• Previous history of frostbite to the area
• Sinusitis (tissues are already constricted due to nasal congestion)
• NEVER cold on a chilled/cold patient
Heat contraindications
•Very high/low blood pressure
•Circulatory dysfunction (hemophilia, varicose veins, numbness, severe diabetes, kidney disease)
•Infections (open wounds, burns, sores)
•Cancer (unless palliative care and/or MD approved)
•Tuberculosis (fragile lung tissue)
•Acute inflammation, high fever
•Medications (any medication that impairs sensation, pain relievers, blood thinners, corticosteroids)
General negative reactions to heat and cold
the result is unexpected, unusual and abnormal
Negative reactions to heat and cold may appear in the following situations
• Too cold, too long
• Too hot, too long
• Extreme contrast treatments
• Patient cold before treatment started
• Weak or fatigued patient
• Too intense of a treatment
• Low blood sugar
Negative reactions to heat and cold signs and symptoms
• Dizziness
• Headaches
• Heart palpitations
• Nausea
• Light headed
• Fainting
• Shivering
• Skin sensitivity
• Insomnia
__ mins hot
__secs cold
X __
3
30
3
Treatment protocol in case of a negative reaction
- Stop the treatment
- If the patient is pale – have patient lie down, recovery position, raise feet
- If the patient is stuffy – have patient sit upright, try using semi-fowlers
- Reassure and stay with the patient, have patient take slow deep breaths
- If in clinic, inform the clinic instructor
- Document results
4 main types of negative reactions to heat or cold
- Arterial
- Venous
- Paradox
- Combined
Arterial
appears after exposure to extended cold, after abrupt contrast, or intense heat
Arterial signs
Red-white spotting of the skin
Patient’s arm will hurt
Arterial causes
• Extended intense cold (too cold, too long)
• Intense heat
• Abrupt contrasts (ie) kamikaze contrasts
Arterial treatment
• Stop the treatment
• Gently dry off affected area
• A carefully dosed warm application (increasing temperature foot or arm bath).
• Rest patient, stay with the patient
• If in clinic inform clinic instructor
• Document reaction
Venous
Appear after exposure to extended heat
Venous signs
Blue-red spotting of the skin
Venous causes
extended heat (too hot, too long)
Venous treatment
• Stop the treatment
• Dry off
• Active exercises
• Raise the affected area (get blood back to heart) stay with the patient
• If in clinic inform clinic Instructor
• Document reaction
Paradox reaction
Response opposite of what should occur
Combined reaction
Two extremes of temperature variations
Combined reaction signs
Red-blue skin discoloration
Combined reaction causes
• Due to extreme temperature in alternating applications
• Can also occur when the patient is exhausted
Combined reaction treatment
treatment for the corresponding conditions should be used
Properties of water
Buoyancy
Hydrostatic pressure
Water resistance
Specific heat
Latent heat of fusion
Heat conductivity
Chemical properties
Electrical properties
Portability
Buoyancy
Helps to make us float
Hydrostatic pressure
Pressure that is caused by a mass of fluid that is exerted on body when immersed in water
Specific heat
The capacity of a substance to store heat
Latent heat of fusion
Heat liberated or absorbed by substance as it changes phase
Heat conductivity
Heat is the total kinetic energy of an object. Heat can be transferred to other materials through convection, conduction, evaporation, radiation
Chemical properties
Properties that change the characteristics of water
Normal body temp is
37 degrees
Methods of heat transfer
Conduction
Convection
Conversion/radiation
Evaporation
Conduction
The exchange of thermal energy between two bodies where there is direct physical contact
Convection
The transfer of heat by moving currents, in a liquid or a gas
Conversion/radiation
Conversion of heat into electromagnetic waves
Evaporation
Convection of liquid into vapour
The local effect of heat on the body is determined by the following
Frequency
Intensity
Duration
Surface area
Frequency
The rate at which the energy is being added to the tissue
Intensity
The extent of the temperature rise
Duration
The length of time of exposure
Surface area
The volume of tissue exposed
Physiological local changes that occur as the result of the application of heat
Vasodilation of vessels
Increase in local blood flow
Increased collagen extensibility
Increased local tissue metabolism
Nerve simulation
Affects muscle spindles
Disadvantages of heat
May cause swelling
Can burn tissues if not carefully monitored
Local effect of cold upon the body is determined by
Frequency
Intensity
Duration
Surface area
Physiological local changes that result in the application of cold
Local vasoconstriction of vessels
Counterirritant effects
Metabolic changes
Analgesic
Control of inflammatory process
Decrease muscle spasm
Disadvantages of cold
• May increase stiffness and decrease tissue extensibility
• Patient may develop hives
• May cause burns if not properly monitored
Reflex effects of heat and cold
effects that occur elsewhere in the body via the nervous system when a sufficient or intense heat or cold stimulus is applied to a local area
Vasomotor or circulatory
Circulatory changes from contraction of smooth muscle in walls or blood vessels
Visceromotor or muscular
Changes in the smooth muscles of organs causes movement in a organ
Secretory or glandular
Glandular stimulation increased eliminated mucous, hormones, enzymes
Acute inflammation timeline
0 - 4 days
Acute inflammation should always be treated with
Cold
Sub-acute inflammation timeline
3 days - 6 weeks
Sub-acute inflammation should be treated with
Contrast
Chronic inflammation timeline
6 weeks - years
Chronic inflammation should be treated with
Heat
