Hydrotherapy Flashcards
Water has what unique properties that allow weakened pts to perform a wide range of therapeutic activities?
buoyancy & resistance & hydrostatic pressure
Water has a low, high or indifferent specific heat?
high
Thermal conductivity relates to?
rate at which a material transfers heat by conduction
This property of water provides resistance to the motion of a body in water
viscosity
viscosity occurs against the direction of the motion of the body and increases in proportion to?
the relative speed of the body’s motion & the frontal area of body part (s) in contact with the h20
Water can transfer heat via?
conduction & convection
What is hydrostatic pressure?
pressure exerted by a fluid on a body immersed in the fluid
What is Pascal’s law?
states that fluid exerts equal pressure on all surfaces of the body at rest at a given depth, and this pressure increases in proportion to the depth of the fluid
What can immersion in water assist in promoting or alleviating?
peripheral edema caused by venous or lymphatic insufficiency
This type of pressure may also facilitate cardiovascular function.
increasing external hydrostatic pressure on the limbs
What are the musculoskeletal effects of hydrotherapy?
Decreased weight bearing
Strengthening
Effects on bone density loss
Less fat loss than w/ other forms of exercise
Name the cleansing effects of hydrotherapy?
pressure to remove debris
dissolved surfactants and anitmicrobials to assist w/ cleaning
What are the cardiovascular effects of hydrotherapy?
Increased venous circulation, cardiac output, and cardiac volume
Decreased heart rate, systolic blood pressure, and rate of oxygen uptake response to exercise
List the effects of hydrotherapy on the respiratory system?
Decreased vital capacity and exercise induced asthma
Increase work of breathing
What are the renal effects of hydrotherapy?
Diuresis
Increased sodium and potassium excretion
What psychological effects can come from hydrotherapy?
Relaxing or invigorating
What should be used to guide exercise intensity in water?
Perceived exertion
What should be noted when a land based exercise is performed in water?
changes in biomechanics
What are the benefits of water exercise for musculoskeletal problems?
Decreased weight bearing on joints Velocity dependent resistance Closed or open chain exercises Effects on bone density loss Fibromyalgia
What are the benefits of water exercise for neurological problems?
Proprioceptive input & improved balance
Increased safety
What are the benefits of water exercise for patients w/ reduced cardiac fitness?
cardiac conditioning in patients w/ poor tolerance for land based exercise
What are the benefits of water exercise for pregnant patients?
Decreased weight bearing and risk of maternal hyperthermia
Less elevation of HR w/ exercise
What are the benefits of water exercise for patients w/ exercise induced asthma?
Less exercise induced asthma than w/ other forms of exercise
What are the benefits of water exercise for age related deficits?
Improved balance, strength, cardiorespiratory fitness, & functional mobility
Water rehab programs are designed so that ____________ _________ by the patient do not cause problems in other areas
compensatory motions
How many psi should a nonimmersion irrigation device deliver fluid to remove debris w/o causing tissue damage?
4 to 15 psi
What are contraindications for local immersion forms of hydrotherapy?
Maceration around a wound
Bleeding
What are precautions for local immersion forms of hydrotherapy?
Impaired thermal sensations
Infection to area
Impaired cognition
Recent skin grafts
When should hydrotherapy be discontinued?
When the wound base is fully covered w/ granulation tissue
What are precautions for FULL body immersion in HOT water?
Pregnancy
MS
Poor thermal regulation
What are contraindications for FULL body immersion hydrotherapy?
Cardiac instability Infectious conditions Bowel incontinence Severe epilepsy Suicidal patients
What are precautions for FULL body immersion hydrotherapy?
Confusion or disorientation Alcohol ingestion by the patient Limited strength, endurance, balance, ROM Medications Urinary incontinence Fear of water Respiratory problems
What are closed chain exercises?
Exercises where the distal extremity is stationary on a stable support
When performed in the pool the distal extremity is supported on the bottom of the pool
What is dead tissue or a scab that forms on a wound?
Eschar
What are open chain exercises?
Exercises where the distal extremity is free to move
Open chain exercises can be performed in the pool if the distal extremity is not touching the side or bottom of the pool
What is the softening of tissues from excessive soaking in liquid?
maceration
What is the name of wound fluid composed of serum, fibrin, and WBCs.
exudate
What is necrotic tissue in the process of separating from viable, living tissue?
slough
Describe negative pressure wound therapy?
The application of continuous or intermittent subatmospheric pressure vacuum suction to an open wound to promote healing
AKA - vacuum assisted wound closure
This substance contains pus, is an opaque wound fluid that is thicker than exudate and contains WBCs, tissue debris, and microorganisms?
Purulence
What is nonimmersion hydrotherapy used for?
Cleansing wounds to reduce bacterial load and removing debris during wound care
What is used to apply immersion therapy?
whirlpool, Hubbard tank, or an exercise pool
Negative wound therapy is often used in conjunction with ___________ __________
nonimmersion therapy
Specific gravity of a person ______ when there is greater amounts of adipose tissue
decreases
Specific gravity less than 1 will ____ and greater than 1 will ____.
less than floats
greater than sinks
What is the specific gravity of the body?
.87-.97
The resistance is ______ the direction of movement and ________ in proportion to speed of body’s motion and the frontal area of body part in contact with water.
opposite increases
What is specific heat?
Amount of heat, in calories required to raise the temperature of 1 gram of a substance by 1 degree C
Specific heat of water and air is?
Water = 4.19 J/gm/CAir = 1.01 J/gm/C
Arthritis benefits from ____ water.
warmer
What is product of several forces acting on an object immersed in water?
Turbulence
What is horizontal flow of water passing over a body part in motion that creates drag?
Laminar flow
What inhibits movement by resisting forward motion?
Drag
What is encountered initially as a body moves through the water, creating a positive pressure?
Frontal resistance
How does hydrotherapy control pain?
Studies show decreased pain in patients with OA and fibromyalgia.
Thought to stimulate peripheral mechanoreceptors to gate transmission of pain signals to spinal cordMore stim=less pain (e.g. higher temp w/ increase H2O agitation)
Cold water for reducing acute inflammation
How does hydrotherapy control edema?
Used with lymphatic insufficiency, renal dysfunction, and post-op inflammation Uses cold water to cause vasodilation in conjuction with effect of hydrostatic pressure Contrast baths (switching between warm and cold water) to create pumping action thru alternating vasodilation and vasoconstriction.
Whirlpool for wound care?
Has decreased in use over the last 5-10 years.Was used to cleanse wound, assist with debridement of necrotic tissue and to increase circulation in area via warm water to assist with healing.
Concerns: potential for wound infection from bacteria, cytotoxic effect of cleansing additives, and soft tissue damage due to inability to control fluid pressures.
What do turbines do?
Mix air and water to provide agitation and turbulence to the water in tank
Mechanical stimulation from agitation to skin receptors may promote analgesic effectMore air that is mixed with water, more turbulence
Why would you use a hubbard tank?
Hubbard tanks are whirpool tanks to accommodate supine position and allow ROM in both UE and LE with support from the water
Hubbards are used for patients who cannot be transferred into a low boy or who have too large a surface area for treatment
Hubbards have lifting devices to transfer-usually hydraulically controlled
Contrast bath
Alternately immersing extremity in warm/hot and then in cool/cold water.
For: 1/edema; 2/pain control; 3/desensitization.20-25 min tx duration; 3-4 min warm; 30sec-1min cold; for a total of 5 to 6 repetitions.
COLD whirlpool treatment temp. & application
Temp- 32-79F (0-26C)
Used for acute inflammation
TEPID whirlpool treatment temp. & application
Temp- 79-92F (26-33C)
Use for medium exercise & acute inflammation (if colder temps are not tolerated)
NEUTRAL WARMTH whirlpool treatment temp. & application
Temp- 92-96F (33-35.5C)
Used for Open wounds
Medically compromised patients w/ circulatory, sensory, or cardiac disorders
Decreased tone
MILD WARMTH whirlpool treatment temp. & application
Temp- 96-98F (35.5-37C)
Used to increase mobility in burn patients
HOT whirlpool treatment temp. & application
Temp- 99-104F (37-40C)
Used to control pain
VERY HOT whirlpool treatment temp. & application
Temp- 104-110F (40-43)
Used to increase soft tissue extensibility
In chronic conditions
On limited body areas only
ABOVE 110 degrees, whirlpool treatment temp. & application
Should not be used