Hydrotherapy Flashcards
What is hydrotherapy?
The application of water in any form - including liquid solid or gas - to produce therapeutic effects on the body.
Physiological effects of hydrotherapy
They occur as the body attempts to return to homeostasis. For instance, heat hydrotherapy produces the physiological effect increasing blood flow to the area on which it is applied; cold therapy produces initial vasoconstriction to the area; contrast hydrotherapy produces increased local circulation.
Reflexive effects of hydrotherapy
They occur away from the application site by influence of the nervous system. For example, heat hydrotherapy applied to one limb will increase blood flow to the distal part of the same limb in the arterial trunk reflex.
5 Principles of Hydrotherapy
1) The greater the temperature difference between the application and the body, the more pronounced the effects of the hydrotherapy.
2) The greater the area an application covers, the more pronounced the effects of the hydrotherapy.
3) The effects of an application vary depending on the length of time it is applied.
4) The weight of the application should be considered so that painful compression is avoided.
5) Following any full-body application, the client should rest at least the same amount of time as the application was applied.
Hydrotherapy Cautions
- Never leave a client unattended when a hydrotherapy application is on him or her.
- Never allow a client to lie on top of a hydrotherapy application, as the effects of the application may be multiplied beyond a manageable level.
- Never use less than four layers of toweling (or an industry approved barrier) with the application of a hydrocollator pack.
- Always note any changes in the client’s tissue that indicate a dangerous response to a hydrotherapy application (for example, changes in vascular supply, subcutaneous fat or muscle mass).
- Always monitor the client visually and verbally for any adverse reactions to the hydrotherapy application
Heat and Cold Allergy Reactions
welting, rashes, headaches, lethargy, delirium, and/or nausea
Heat-Specific Systemic Reactions
profuse sweating away from the area of application, obvious changes in respiratory rate
Cold-Specific Systemic Reactions
body-wide piloerections (goose bumps) and uncontrollable shivering or chills
Stage of Injury when Heat Hydrotherapy is Applied
Chronic (4 weeks to 2 years post injury)
Duration of Heat Hydrotherapy Application
5 minutes to 30 minutes (10 minutes is common)
Heat application considered warm
96.8 to 100.4 (36 to 38) degrees
Heat application considered hot
> 102.2 (39) degrees
Types of Heat Hydrotherapy Applications
- Hydrocollator Pack
- Thermophore
- Arm and Foot Baths
- Wax (paraffin) Baths
- Warm Compresses
- Self-Care
Hydrocollator Pack
A gel-filled cloth pack placed in a temperature controlled water tank (160 degrees); four layers of toweling separate the pack from the skin; generally applied for 10 minutes
Thermophore
An electric moist-heat pad that is temperature-controlled and ranges in size; generally applied for 10 minutes
Arm and Foot Baths
small water receptacles that allow for the local immersion of an arm or foot followed by thorough drying; generally applied for 30 minutes
Wax (paraffin) Baths
melted paraffin applied to the skin; after application, the body region is covered in plastic film and a towel to conserve heat; generally applied for 20 minutes
Warm Compresses
towels that are immersed in warm water, wrung out and applied to the skin; warm compresses are replaced before cooling
Self-Care
full-body baths often using Epsom salts and herbals extracts; also steam inhalation in which steam is inhaled from a bowl of boiling water; generally applied for 15 minutes
Contraindications for Heat Hydrotherapy
- Acute Injury (up to 48 hours after injury)
- Circulatory Pathologies (prolonged or full-body applications)
- Sensory Changes
- Acutely Inflamed Joints
- Acute Infections
- Existing Burns
- Decreased Tissue Health
- Hypersensitivity to Heat (allergic or systemic response)
- Multiple Sclerosis
Effects of Heat Hydrotherapy
- Increased Surface Temperature
- Increased Local Vasodilation and Blood Flow
- Increased Local Metabolism
- Increased Oxygen and Nutrients
- Increased Capillary Permeability
- Increased Local Perspiration
- Increased Collagen Extensibility
- Increased ROM
- Increased Blood Flow to Contralateral Limb
- Increased Relaxation/Sedation
- Decreased Pain Perception
- Decreased Muscle Spasms
- Decreased GI Motility and Gastric Acid Production
General Protocol for Heat Hydrotherapy
- Communications
- Resting Position
- Initial Warming (stroking, compressions)
- Fascial Techniques
- Joint Mobilization
- Apply Hydrocollator to Low Back for 10 Min; Work Upper Back
- Clearing
- Deeper Warming (Swedish)
- Trigger Point Therapy
- Smooth and Stretch Muscles Treated w/ Trigger Point Therapy
- Address Referral Zone
- Work from Specific to General
- Close
Injury Stage when Cold Hydrotherapy is Applied
Acute (48 to 72 Hours After Injury)
Duration for which Cold Hydrotherapy is Applied
5 to 30 Minutes (or until numbness occurs)
Temperature of Cool Cold Hydrotherapy
55.4 to 64.4 (13 to 18) Degrees
Temperature of Cold Cold Hydrotherapy
32 to 53.6 (0 to 12) Degrees
Types of Cold Hydrotherapy Applications
- Ice Pack
- Ice Massage
- Arm and Foot Baths
- Cold Compresses
Ice Pack
a gel-filled plastic pack kept in a freezer separated from skin by a towel); generally applied for 25 to 30 minutes
Ice Massage
a paper or Styrofoam cup of ice, peeled back and rubbed on the skin in a circular manner; used until area goes numb
Arm and Foot Bath
small water receptacles that allow for the local immersion of an arm or foot followed by thorough drying; generally applied for 1 minute
Cold Compresses
towels that are immersed in cold water, wrung out and applied to the skin; cold compresses are replaced before warming
Contraindications for Cold Hydrotherapy
- Raynaud’s Disease
- Circulatory Insufficiency
- Sensory Changes
- Cold Sensitivity (allergy)
- Debility (weakness)
- Hypersensitivity to Cold (systemic reaction)
Effects of Cold Hydrotherapy
- Increased Local Vasoconstriction
- Increased Blood Viscosity
- Stimulation (w/ brief applications)
- Decreased Local Temperature
- Decreased Local Blood Flow
- Decreased Bleeding
- Decreased Inflammation
- Decreased Edema
- Decreased Pain
- Decreased Muscle Spasms
- Decreased Collagen Extensibility
Stages of Cold Hydrotherapy
- Cold
- Tingling
- Burning
- Numbness
(C)lean (t)he (B)aby’s (N)ose
Stage When Contrast Hydrotherapy is Used
Early (2 days to 3 Weeks) and Late (2 Weeks to 6 Weeks) Subacute
Temperatures Used in Contrast Hydrotherapy During Early Subacute Stage
Warm and Cool
Temperatures Used in Contrast Hydrotherapy During Late Subacute Stage
Hot and Cold
Hydrotherapy in which therapist uses warm/hot application followed by a cool/cold application to create a flushing effect
Contrast Hydrotherapy
Temperature Contrast Hydrotherapy Should Always End On
Cool/Cold (to prevent tissue congestion)
How to Increase the Effects of Contrast Hydrotherapy
- Increase Temperature Differential
- Increase Number of Temperature Alterations
Common Ration for Using Contrast Hydrotherapy
3:1 (3 min warm/hot; 1 min cool/cold)
vasoconstriction occurs more rapidly
Types of Contrast Hydrotherapy
- Hydrocollator Pack and Ice Pack
- Arm and Foot Baths
- Warm and Cool Compresses
Contraindications for Contrast Hydrotherapy
- Acute Injuries/Conditions
- Decreased Skin Sensitivity
- Vascular Pathologies
- Congestive Heart Failure
- Untreated Hypertension
- Hypersensitivity to Cold or Heat
