Hydrotherapy Flashcards
1
Q
Buoyancy (definition)
A
Force experienced as an upward thrust on the body in the opposite direction to the force of gravity
2
Q
Buoyancy (properties)
A
- support
- off loading
- assistance
- resistance
3
Q
Buoyancy (clinical applications)
A
- decreases stress and compression on weight bearing joints, muscles, and connective tissue
- resistance
- helps raise the body parts against gravity
- helps the therapist support the patients weight
- can be used for relaxation
4
Q
Hydrostatic pressure
A
- pressure exerted by a fluid on a body immersed in fluid
- pressure increases with the depth of the water
- redistribution of fluid volume
- decreased fluid capacity
5
Q
Hydrostatic pressure (clinical applications)
A
- decreases lower extremity edema
- breathing exercises
- brace unstable joints or week muscles
- motion progressively more difficult as water depth increases
- balance training
6
Q
Effects of hydrotherapy
A
-heat transfer, depending on whether the person is resting or moving and the amount of the body is immersed in the water
7
Q
Physiological effects of hydrotherapy
A
- hemodynamics: local
- systemic: immersion of most of the body
8
Q
Cardiovascular effects during immersion
A
- changes in cardiac output
- increase in venous return
- increased cardiac volume leads to an increased stroke volume
- decreased heart rate
- increased cardiac output
9
Q
Cardiovascular effects
A
- exercise in water as compared to exercise on land of the same metabolic rate will, decrease heart rate, decrease systolic blood pressure, and decreased oxygen consumption
- metabolic rate and energy expenditure is 3 times more in water then on dry land
10
Q
Musculoskeletal effects
A
- decreased weight bearing
- strengthening
- ROM
- increased relaxation
- slowed bone density loss
- less fat loss than other forms of exercise
11
Q
Respiratory effects
A
- increase resistance to lung expansion
- decreased vital capacity
- increased work of breathing
12
Q
Renal effects
A
- diuresis
- increased sodium and potassium secretion
13
Q
Mechanical effects of hydrotherapy
A
-wound healing: debridement, phagocytosis, pgitated whirlpool
14
Q
Indications for hydrotherapy
A
- superficial heating or cooling
- edema
- water exercise: facilitates movement and functional activity training
- muscle relaxation
- decreased spasticity
- physiological benefits
- neurological rehabilitation
15
Q
Contraindications
A
- cardiac instability
- infectious diseases
- bowel or bladder incontinence
- fever
- severe or uncontrolled epilepsy
- suicidal patients
- acute RA
16
Q
Precautions
A
- respiratory problems
- alcohol ingestion by the patient
- limited strength, endurance, balance or ROM
- medications
- fear of water
- thermal regulation problems
- severe PVD
- metastatic disease
- severely deconditioned
- pregnancy
- multiple sclerosis
17
Q
Adverse effects
A
- drowning
- burns
- fainting
- bleeding
- infection
- hyponatremia
- aggravation of edema
- asthma exacerbation
18
Q
Minimizing risk (immersion therapy)
A
- identify hazardous conditions
- know how to aid a drowning person
- check water temperature
- only immerse necessary body parts
- add salt to water if patient has extensive open wounds
- infection control
- nonslip surfaces around the pool
- appropriate entry/exit points
- water depth should be marked
- evacuate during power outages
- have appropriate emergency equipment
- chemicals appropriately stored
19
Q
Minimizing risk (local immersion)
A
- tank should be grounded
- motors securely fastened to outside of the tank
- turbine should not be run without water
- treatment room warm and ventilated
- infection control
- check water temperature
20
Q
Application of hydrotherapy
A
- temperature: based on the patient’s medical condition and treatment objectives (cold, neutral or heat)
- heating modality: 15 minutes
- cold modality: 10 to 15 minutes
- exercising: 10 to 20 minutes depending on patient status
- aquatic exercises in a pool environment maybe 30 to 60 minutes
- contrast bath: alternating very hot and very cold water
21
Q
Immersion therapy
A
- Hubbard tank, use for wound care, ROM, therapeutic exercise
- Pool therapy
22
Q
Goals of immersion therapy
A
- improved general mobility
- increase circulation
- promote relaxation
- increase muscle strength
- increase ROM
- improve GAIT/coordination/balance
- increase endurance
- promote emotional and physiological well-being
23
Q
Patient populations
A
- arthritis
- osteoporosis
- neurological problems
- orthopedic problems
- General deconditioning
24
Q
Guidelines for aquatic exercise
A
- exercise is more difficult as speed of movement increases
- exercise is more difficult as the size of the movement increases
25
Q
General program
A
- consists of warm-up, exercise, cooldown
- need to think about intensity, duration, and frequency
26
Q
Environmental concerns
A
- outside air temperature and humidity must be maintained at a level that is comfortable and will not interfere with bodies physiological processes
- if too hot or humid: the body will not be able to dissipate heat adequately
- if too cool and or dry: too much heat is lost
- room should be well ventilated
- pool should be tested for pH, chlorination, temperature
- appropriate stairways and railings, hydraulic lifts
- someone should no special emergency procedures and CPR
27
Q
Whirlpools
A
- fixed or portable
- extremity: large or small
- high boy
- low boy
28
Q
Whirlpool application
A
- fill tank with water to appropriate temperature
- allow patient to undress
- remove wound dressings
- inspect skin, test for thermal sensitivity
- check vital signs
- position patient comfortably
- turn on the turbine
- stay with the patient in full body immersion
- patient may exercise
- duration is generally 10 to 30 minutes
- after treatment, remove limb from whirlpool and drive
- replace dressings as necessary
- assess patient response
- document
29
Q
Advantages to whirlpool
A
- can be used for heat transfer, cleansing and debriding, and exercise
- patient can be position securely and comfortably
- when your muscles can move more freely than on dry land
- allows movement while heat is being applied
30
Q
Disadvantages to whirlpool
A
- size of tanks limit the amount of exercise and size of the area to be treated
- large quantity of water used
- costs for cleaning and heating water
- time-consuming to fill and clean
- time helping patient to dress and undress
31
Q
Hubbard tank
A
- Applied similarly to Whirlpool
- temperature between 97 and 100°F
- duration is generally 20 minutes
32
Q
Advantages to the Hubbard tank
A
- can treat large areas or multiple areas of the body
- can be used for heat transfer, for cleansing and debriding, open wounds, water exercise
33
Q
Disadvantages to the Hubbard tank
A
- costly to provide treatment
- costly equipment and space requirements
- uses large amounts of warm water
- time-consuming to fill, move patient, clean
- extra precaution in regards to systemic effects of overheating
34
Q
Contrast bath
A
- alternately immersing distal extremity in warm/hot then cool/cold water
- causes fluctuation in blood flow
- warm: 110°F to 111°F
- cold: 50°F to 64°F
- warm water for 3 to 4 minutes and then immersed in cold water for 1 minute
- repeat 5 to 6 times, total treatment time of 25 to 30 minutes
35
Q
Indications for a contrast bath
A
- when heating is desired there is increased risk of edema
- chronic edema
- subacute trauma
- inflammatory conditions
- hyperalgesia or hypersensitivity
36
Q
Advantages of a contrast bath
A
- may promote a more vigorous circulatory effect then he or cold alone
- provides good contact with distal extremities
- may help provide pain control without aggravating edema
- allows movement water
37
Q
Disadvantages of a contrast bath
A
- limbs in a dependent position
- some patients don’t tolerate cold immersion
- lack of research
