Hydrotherapy and contrast baths Flashcards
buoyancy
The tendency to remain afloat in a liquid
- contributes to water being used as an anti-gravity enviroment
Archimedes’ prinicple
- an object that is immersed in water experiences an upward thrust equal to the weight of the water displaced
- Water therefore can be a supportive medium
- upward movements assisted
- downward resisted
Specific gravity
- the measure of an objects density in grams per cubic cm
- the specific gravity of pure water at 4 degrees Celsius is 100 g/cm^3
- object with specific gravity of <1.00g/cm^3 will float
- greater than 1 will sink
- The human body with inflated lungs has specific gravity of 0.974 g/cm^3
Center of buoyancy
- Reference point
- pertains only to that segment of the body immersed in water
- used to analyze effect of buoyancy on movement
Rotary components of gravity and buoyancy
- at 90 degrees (arm out) gravity straight down, buoyancy straight up
- 45 degrees both hitting move obliquely on arm
Changes to center of buoyancy
- 90 degrees arm out CB close to body
- 90 degrees arm out holding ball CB moves farther awa
Hydrostatic pressure
pressure exerted by the water on the immersed part
Pascal’s law
- When an object immersed in fluid is at rest, the fluid will exert equal pressure on all surfaces of the object
- compression on lungs in respiratory pts
Viscosity
The degree to which fluid resists flow
-due to cohesive forces present between molecules
The viscosity of water tends to resist movement in all directions
-more rapid movements encounter greater resistance than slower movements
Physiological effects of hydrotherapy: Cleansing effect
- Tx of open wounds
- pressure-soften and remove debris
- force exerted is proportional to rate of flow
- Debriding agent> remove endogenous agents
- cleansing agent> remove exogenous waste
- Can add products to water to improve cleansing power
- antimicrobial
- surfactants
Cleansing effects: immersion
- Hydrostatic pressure, heat
- inc circulation
- inc nutrients and inc removal of waste products
- inc wound healing
Cleansing effects: nonimmersion
- Cleansing
- softens necrotic tissue removes wound debris
- dec bacterial load, dec barrier to epithelization
- inc wound healing
Physiological effects of hydrotherapy: musculoskeletal effects
- Decreased WBing
- Strengthening
- Slowed bone density loss
- less fat loss than with other forms of exercise
Physiological effects of hydrotherapy: cardiovascular effects
Increased venous circulation
- increased cardiac volume
- increased cardiac output
- decreased heart rate, systolic BP, and VO2 response to exercise
Cardiovascular effects
hydrostatic pressure displaces venous blood proximally, which increases cardiac volume, which increases stroke volume and increases cardiac output
Physiological effects of hydrotherapy: Respiratory effects
- Decreased vital capacity
- increased work of breathing
- decreased exercise-induced asthma
Respiratory effects
- hydrostatic pressure increases compression of chest wall which decreases vital capacity which increases work of breathing
- hydrostatic pressure also increases circulation in chest cavity which increases work of breathing
- high humidity of air decreases exercise induced asthma
Physiological effects of hydrotherapy: renal effects
- Diuresis
- induced sodium and potassium excretion
Renal effects
- hydrostatic presssure increases renal blood flow which increases urinated K+ and Na+ which decreases edema
- hydrostatic pressure also increases central blood volume which decreases ADH and aldosterone which increases urinated K+ and Na+ which decreases edema
Physiological effects of hydrotherapy: psychological effects
- Relaxation
- invigoration
Indications for hydrotherapy: Subacute/chronic soft tissue injuries
Effect
- dec swelling (pressure)
- Hastens healing (thermal)
- decreases pain/spasm (thermal)
- increases ROM (buoyancy and thermal)
- increases strength (buoyancy and pressure)
Physiological effects of hydrotherapy: shortened tissues, contractures, scars
Effects
- causes relaxation ( thermal and psychological)
- increases extensibility of non elastic tissues (thermal)
- softens scar tissue ( fluidity and thermal)
Physiological effects of hydrotherapy: arthritis
- Increased joint mobility
- decreased pain
- increased ROM
- all b/c of thermal and buoyancy properties of water
Physiological effects of hydrotherapy: open wounds
- Cleanses, debrides ( fluidity and pressure)
- increases circulation ( thermal and pressure)
Physiological effects of hydrotherapy: Muscle weakness
- Increased ROM
- increased strength
( buoyancy and antibouyancy pressure)
Contraindications for hydrotherapy: cardiac dysfunction
Heart cannot adapt to changes needed for thermal homeostasis adjustment
Contraindications for hydrotherapy: Respiratory dysfunction
Inability to resist hydrostatic pressure, tolerate heat, or both
Contraindications for hydrotherapy: decreased thermal sensation
Inability to report overheating or overcooling. Avoid hot or cold water. Recommend cool through warm range (80° to 98°F)
Contraindications for hydrotherapy: severe PVD diabetic, arterial sclerosis
Contraindication for heat. Avoid temp. ↑ 95°F
Contraindications for hydrotherapy: surface infections
Infections may spread to other areas or cross contaminate via water
Contraindications for hydrotherapy:
Contraindication for heat
Contrast bath classification
A form of infared modality emitting electromagnetic radiation
-wavelengths & frequencies are dependent upon specific temp of the baths
Thermal modality used for superficial heating and cooling of tissues
-maximum depth of penetration of heating or cooling is approx 1 cm
-usually utilizes the conduction method of heat transfer
Contrast bath description
Immersion of part of body into baths in which the temp of the water alternates between warm and cold
Contrast bath purpose and goals
Primarily vascular exercise
- alternate dilation and constriction of local blood vessels
- peripheral circulation is stimulated which may stimulate the healing process in damaged tissues
- may promote pain relief and desensitization
Contrast bath physiologic responses
- Vasoconstriction/ dilation of superficial BVs
- edema decreased
Contrast bath indications
- impaired venous circulation
- subacute or chronic traumatic and inflammatory conditions
- may be used during the transition period between acute and sub acute
- chronic edema
- sinus or congestive headaches (apply to feet or hands and feet)
- hypersensitivity due to reflex sympathetic dystrophy (RSD) or complex regional Pain Syndrome (CRPS)
Whirlpool classification
- infared modality emitting electromagnetic radiation
- wavelength and frequency are dependent upon specific temp of water
- thermal modality used for superficial heating of tissue
- depth penetration 1cm
- usually uses conduction and convection method of heat transfer
- A mechanical modality for debriding open wounds
Whirlpool description
- tub of water which is agitated by an electric turbine
- generally made of stainless steel or acrylic material
- made in many shapes and sizes
- may be used for either heating and cooling
Whirlpool types
- Extremity tank- immerse distal extremity
- high-boy & low-boy tanks used for immersion of larger body parts of extremities and immersion up to waist
Whirlpool therapeutic purposes/goals
- Debride open wound
- same as those for other superficial heating and cooling
- to provide medium for ther ex
- reduce pain
Hubbard tank
- Classification same and whirpool
- butterfly shaped whirlpool designed so that a pt may be immersed in recumbent position
- to deliver heat or cold to large portion of body
- to allow unweighted exercise
