Hydrotherapy and contrast baths

Question 1

buoyancy

Answer 1

The tendency to remain afloat in a liquid

- contributes to water being used as an anti-gravity enviroment

Question 2

Archimedes’ prinicple

Answer 2

• 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

Question 3

Specific gravity

Answer 3

• 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

Question 4

Center of buoyancy

Answer 4

• Reference point
• pertains only to that segment of the body immersed in water
• used to analyze effect of buoyancy on movement

Question 5

Rotary components of gravity and buoyancy

Answer 5

• at 90 degrees (arm out) gravity straight down, buoyancy straight up
• 45 degrees both hitting move obliquely on arm

Question 6

Changes to center of buoyancy

Answer 6

• 90 degrees arm out CB close to body

- 90 degrees arm out holding ball CB moves farther awa

Question 7

Hydrostatic pressure

Answer 7

pressure exerted by the water on the immersed part

Question 8

Pascal’s law

Answer 8

• 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

Question 9

Viscosity

Answer 9

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

Question 10

Physiological effects of hydrotherapy: Cleansing effect

Answer 10

• 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

Question 11

Cleansing effects: immersion

Answer 11

• Hydrostatic pressure, heat
• inc circulation
• inc nutrients and inc removal of waste products
• inc wound healing

Question 12

Cleansing effects: nonimmersion

Answer 12

• Cleansing
• softens necrotic tissue removes wound debris
• dec bacterial load, dec barrier to epithelization
• inc wound healing

Question 13

Physiological effects of hydrotherapy: musculoskeletal effects

Answer 13

• Decreased WBing
• Strengthening
• Slowed bone density loss
• less fat loss than with other forms of exercise

Question 14

Physiological effects of hydrotherapy: cardiovascular effects

Answer 14

Increased venous circulation

• increased cardiac volume
• increased cardiac output
• decreased heart rate, systolic BP, and VO2 response to exercise

Question 15

Cardiovascular effects

Answer 15

hydrostatic pressure displaces venous blood proximally, which increases cardiac volume, which increases stroke volume and increases cardiac output

Question 16

Physiological effects of hydrotherapy: Respiratory effects

Answer 16

• Decreased vital capacity
• increased work of breathing
• decreased exercise-induced asthma

Question 17

Respiratory effects

Answer 17

• 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

Question 18

Physiological effects of hydrotherapy: renal effects

Answer 18

• Diuresis

- induced sodium and potassium excretion

Question 19

Renal effects

Answer 19

• 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

Question 20

Physiological effects of hydrotherapy: psychological effects

Answer 20

• Relaxation

- invigoration

Question 21

Indications for hydrotherapy: Subacute/chronic soft tissue injuries

Answer 21

Effect

• dec swelling (pressure)
• Hastens healing (thermal)
• decreases pain/spasm (thermal)
• increases ROM (buoyancy and thermal)
• increases strength (buoyancy and pressure)

Question 22

Physiological effects of hydrotherapy: shortened tissues, contractures, scars

Answer 22

Effects

• causes relaxation ( thermal and psychological)
• increases extensibility of non elastic tissues (thermal)
• softens scar tissue ( fluidity and thermal)

Question 23

Physiological effects of hydrotherapy: arthritis

Answer 23

• Increased joint mobility
• decreased pain
• increased ROM
• • all b/c of thermal and buoyancy properties of water

Question 24

Physiological effects of hydrotherapy: open wounds

Answer 24

• Cleanses, debrides ( fluidity and pressure)

- increases circulation ( thermal and pressure)

Question 25

Physiological effects of hydrotherapy: Muscle weakness

Answer 25

- Increased ROM - increased strength ( buoyancy and antibouyancy pressure)

Question 26

Contraindications for hydrotherapy: cardiac dysfunction

Answer 26

Heart cannot adapt to changes needed for thermal homeostasis adjustment

Question 27

Contraindications for hydrotherapy: Respiratory dysfunction

Answer 27

Inability to resist hydrostatic pressure, tolerate heat, or both

Question 28

Contraindications for hydrotherapy: decreased thermal sensation

Answer 28

Inability to report overheating or overcooling. Avoid hot or cold water. Recommend cool through warm range (80° to 98°F)

Question 29

Contraindications for hydrotherapy: severe PVD diabetic, arterial sclerosis

Answer 29

Contraindication for heat. Avoid temp. ↑ 95°F

Question 30

Contraindications for hydrotherapy: surface infections

Answer 30

Infections may spread to other areas or cross contaminate via water

Question 31

Contraindications for hydrotherapy:

Answer 31

Contraindication for heat

Question 32

Contrast bath classification

Answer 32

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

Question 33

Contrast bath description

Answer 33

Immersion of part of body into baths in which the temp of the water alternates between warm and cold

Question 34

Contrast bath purpose and goals

Answer 34

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

Question 35

Contrast bath physiologic responses

Answer 35

- Vasoconstriction/ dilation of superficial BVs | - edema decreased

Question 36

Contrast bath indications

Answer 36

- 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)

Question 37

Whirlpool classification

Answer 37

- 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

Question 38

Whirlpool description

Answer 38

- 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

Question 39

Whirlpool types

Answer 39

- Extremity tank- immerse distal extremity | - high-boy & low-boy tanks used for immersion of larger body parts of extremities and immersion up to waist

Question 40

Whirlpool therapeutic purposes/goals

Answer 40

- Debride open wound - same as those for other superficial heating and cooling - to provide medium for ther ex - reduce pain

Question 41

Hubbard tank

Answer 41

- 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