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Upper Test 2 > Lecture 1 - Hydrotherapy (modalities) > Flashcards

Lecture 1 - Hydrotherapy (modalities) Flashcards

1
Q

The use of water to faciltate healing and movement and to enable patients to achieve therapy goals

A

Hydrotherapy

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2
Q

What are the 4 kinds of hydrotherapy

A

1) Aquatic therapy
2) Whirlpool
3) Contrast Bath (going from hot to colrd)
4) Pulsed lavage

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3
Q

Unweighting force from water on an object immersed in water

A

Buoyancy

the amount of water thats displaced relates to the amount of unweighting force you have

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4
Q

Will a pt weight bear more or less through their LE the deeper they are in the water?

A

Less

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5
Q

KNOW: Resistance exercises can be used using principles of buoyancy

A
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6
Q

Buoyancy of an object depends on its _____

A

Density
* less dense items dont sink as much as more dense items

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7
Q

Will adipose tissue float more or less easily than bone? Why?

A

More easily because it has decreased density

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8
Q

Thickness of liquid is known as its _______

A

Viscosity

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9
Q

KNOW: w/ an object that has increased viscosity the liquid will have more cohesive forces between molecules (they want to stick together more)

If we try to move an object through a thicker liquid it will have more internal friction (trying to break those very stuck together molecules creates increased firction)

Another motion that resists that movement through the very thick liquid is drag force. The more viscis the lquid the more drag forces are going to be present (drag = resists the movement of an an object in liquid)

A
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10
Q

What resists the movement of an object (or body part) in water?

A

Drag forces

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11
Q

Will drag forces increase or decrease w/ increased viscosity?

A

Increase

Think throwing something trhough honey - it won’t work as well as throwing it through water aka its movement was resisted more

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12
Q

What force increases when the speed of movement underwater increases. This force occurs in the opposite direction of movement

A

Drag force

Essentially saying that w/ faster movement underwater this force works against you even more

In doing the action below the faster they move their leg the increased drag force (which will resist the movement of their leg in the water)

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13
Q

Will a deeply submerged object have more or less pressure on it? Why?

A

More

Because the water itself is exerting that pressure on it

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14
Q

Pressure water exerts on the immersed body or body part?

A

Hydrostatic pressure

The deeper you are the more water is pressing down = more hydrostatic pressure

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15
Q

Will the hydrostatic pressure be more on a surfer who has just fallen off a surfboard or someone 10m down in the ocean

A

10m down

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16
Q

Is there genreally more hydrostatic pressure on LE or UE? Why?

A

LE

because they’re deeper down

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17
Q

The ability of water to transfer heat

A

Theramodynamics

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18
Q

What will transfer heat better - sitting water or turbulent water. Which force is used?

A

Turbulent water via convextion

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19
Q

Properties of water in motion is known as:

A

Hydrodynamics

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20
Q

What two things can hydrodyanmics be (water in motion be)

A

Stream lined
Turbulent

21
Q

Water in motion can be streamlined or turbulent

Explain both
* which one has a higher viscosity?
* Which one will transfer heat more affectively?

A

Streamlined: think of water in a stream - its all moving in one direction - no churning

Turbulent water: Its constantly churning - think white water rapids
* higher viscosity
* Transfers heat more effectively via convection (making all those tiny water bubbles)

22
Q

Between what temperatures do we have cooling affects?

A

33-65

23
Q

Between what timeratures do we have heating effects?

A

97-104

24
Q

What temps do we want to do aquatic therapy at?

A

81-96 (no heating or cooling effects here - this is neutral water)

25
Q

What are hemodynamic effects?

A

Changes in bloodflow

26
Q

Submerging someone in cold water will do what do HR?

A

Brady

27
Q

Submerging someone in warm water will do what to HR?

A

Tachy

28
Q

Hydrostatic pressure does what to venous return?

A

Increases it (lots of these effects negated by gravity_

29
Q

What does hydrostatic pressure do to breathing?

A

Makes it harder because the water is exerting that force back on your chest

KNOW: If someone is immersed up to the neck in water it can be 60% more work to breathe

Would want to watch out for this for a pt w/ COPD
* would not want to immerse their chest (may just below level of lungs to not increase the amount of work needed to breathe)

30
Q

KNOW: Cold water can sitmulate urge or urination

A
31
Q

What happens to neural conduction in cold water?

A

it decreases

32
Q

What kind of water increases BF to the muscles the most

A

Moving hot water

33
Q

KNOW: muscle strength will increases w/ exercise against turbulent water

A
34
Q

KNOW: Aquatic therapy safety concerns:

Contraindications:
* Bowel/bladder incontinece
* Tracheostomy (dont want water into lungs)
* Infectious diseases
* Progressively worsening congestive heart failure
* Uncontrolled seizures
* Respiratory compromise (especially when vital capacity < 1L) - any kind of water on them will make breathing harder (hydrostatic pressure)

Precautions:
* Aspiration risk
* Catheters
* Cognitive impairments
* Tetraplegia/high level paraplegia
* Open wounds
* Skin condition/dryness

A
35
Q

Aquatic therapy = PT in the water

A
36
Q

KNOW: Whirlpools are passive and have little effect on function
* No longer utlize for wound debridement

A
37
Q

What are whirlpools normally used for

A

Subacute/chronic sprains or strains (cold)

KNOW: Are also used ofr RA/OA to reduce pain if the water is warm

38
Q

Are whirlpools used for edema? Why

A

Effects on edema not strong

Because limbs are in that gravity depend position - meaning even though its cold gravity will pull the edema back down

39
Q

KNOW: Whirlpool clinical procedure

Initital set up:
* Choose appropriate whirlpool size
* Inspect tank for cleanliness, electrical safety
* Close drain in tank and fill w/ water at appropriate temperature
* Prior to appointment, ensure patient is in appropriate clothing to expose body part or submerge body (swimsuit)
* Inform patient of precatuions, clear of condtraindications
* Edurcate pt on purpose of whirlpool use
* Take appropriate measures prior to reatment (girth, ROM, pain etc.)
* Skin inspection
* Patient to end whirlpool (assist if needed - provide pt w/ a way to contact you [supervision if necessary])
* Adjust turbine assembly and turn on - can direct the current toward the treatment area or indirect (if to sensitive use indirect)
* Treatment time 10-30 minutes

A
40
Q

KNOW: Following treatment
* Inspect skin
* Re-test
* Provide patient w/ towel and assist w/ exiting the whirlpool
* Document details of treatment and response
* Drain tank and disinfect

A
41
Q

Whirlpool Precaustions:
* Malignancies (especiialy w/ heat)
* Sensory Impairments
* Hypersensitivity to cold
* Pulmonary disease
* Cardiac insufficiency (were putting body in an environment thats going to alter BF so dont want this)
* Unstable BP
* Impaired circulation
* Edema (we don’t want to put a swollen limb into a warm whirlpool)
* Acute fibril Episode (if someone has a very)
Acute inflammation
* Theraml regulation impairment
* RA
* MS
* Impaired cognitiion
* Fear of water

NOTE: Whirlpools can be hot or cold

A
42
Q

Whirlpool Contraindications:
* Bowel / Bladder Incontince
* Intoxication
* Uncontrolled Epilespy
* Danger of hemorrhaging (again were changing that BF)
* Recent post-op surgical incision (want it to be fully closed)
* Skin Ulcers (venous insufficiecy, edema, lymphedema) - already areas of body w/ lots of fluid - wont help
* Skin conditions / infection
* Tissue Flaps
* Skin graphs (want them to heal)
DVT or other thrombosis (BF/Pressure chaging = bad here - dont want them getting knocked lose)

A
43
Q

Cyclic immersion of body or body part into hot then cold water

A

Contrast bath

44
Q

What is a typical cycle patttern for contrast bath

repeated how many times?

How long is one of these cyclles (hot+cold)

How long does treatment last

A

3:1 or 4:1 (hot:cold)

1-5 minutes cycles

Repeated 5-7 times

total time = 20-30 minutes

45
Q

Biggest indication for contrast bath. Why?

A

Edema

Theroy is that this creates a vascular pumping because you’re altearning between warming (vasodilation = increased BF) and then cold (vasoconsitrction = decreased BF) creating a pumping effect

HOWEVER - theres not a lot of strong evidence that this helps edema
* theres a superficial BF change but it doesnt really get to the heart of edema
* this is priamrily because you’re still in that independent position so its not doing much
* Force of gravity is much graeter than that pumping effect (negates it)

46
Q

Contrast bath clinical procedure
* Obtain 2 containers of appropriate size
(Hot = 100-111 [slightly lower than theraputic level] cold = 50-66)

Prepare pt:
* educate on purpose / contraindications
* Take pre- measures
* Skin inspection

Position patient and containers in appropriate position
* Quickly move body or limb between containers

Instruction pt and set timer approperly
* 3-4 min hot 1 min cold
* 5-7 cycles or total time = 20-30 mintes

Place body/limb in hot container and begin treatment

End treatment
* Provide towel
Assess patient response
* Skin check, post measure

A
47
Q

Documentation:

Aquatic therapy:
* Water temp
* SOAP note information
* Means of entry/exit (how were they able to get in and out of the pool - qualifies the nesesity for this) - goal for aquatic therapy is to get these people on land and to fucntion on land - if they need a lift to get in and out then this is good for them and they wouldnt be able to do dry land

Whirlpool
* Type of whirlpool - was it just a limb or body
* Treatment area
* Agitation (mild, moderate, full)
* Duration - how long
* Active/Passive - was the person exercising in pool?
* Pt response - skin checks / post measurements etc… how did the pt respond

A
48
Q

Who benefits from aquatic therapy:
* RA
* Chronic Low back pain
* Fibromyalgia
* Postoperative orthopedics
* OA
* Children w/ cerebral palsy

A

Upper Test 2 (5 decks)

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