Lecture 2 Aquatic Physiotherapy

Question 1

What is aquatic physio?

Answer 1

• commonly known as hydrotherapy

- defines physiotherapy in the water; seperate from hydroptherapy

Question 2

What are the benefits of hydrotherapy?

Answer 2

1. Reduced swelling (better for LL swelling since pressure at feet is 10% greater than in UL; neck deep water same as medical grade compression!)
2. Buoyancy
3. Heat - pain relief/relaxation
4. Stimulating environment

Question 3

Effect of hydrotherapy on CVS?

Answer 3

External force on BVs = increased venous return = increased SV = increased Q

Question 4

Effect of hydrotherapy on respiratory system?

Answer 4

More pressure on lungs = increased work of breathing (this can be good - but also bad if pt has a respiratory disorder)

Increased pressure on BV also improves circulation in chest cavity

Question 5

Archimedes principle

Answer 5

An object immersed in fluid will be buoyed up by a force equal to the weight of the fluid that the object displaces.

Question 6

What determines if someone will float?

Answer 6

Buoyancy interacts with centre of mass and relative density of the object to determine if someone will float

CoM - affected by body composition+position
Center of buoyancy - affected by body position

Question 7

What % of your bodyweight are you weight bearing if you’re immersed upto:

• C7
• xiphoid
• ASIS

Answer 7

• 10%
• 33%
• 50%

Question 8

What is the effect of depth of immersion on postural control?

Answer 8

S2 level or lower - normal postural control

T11 or deeper - more head/arm control of posture
- less feedback from gravity here which is why head and arms have to chime in to help

Question 9

What increases drag and turbulence?

Answer 9

1. increasign the SA of the limb
2. increasing the speed of the movement
   - increasing speed 2x = increased resistance 4x

Question 10

How does speed of movement in water affect the amount of mm used?

Answer 10

Moving SLOW (abd) at 30º/sec = reduced mm as compared to same speed on land

Moving FAST (abd) at 90º/sec = same mm activation as on land

*faster movements creates suction force behind the arm that tries to drag arm back to body

Question 11

What things should pt’s be screen for before entering pool? (6 things)

Answer 11

1. CV risks - bc hydrostatic pressure increases Q
2. Respiratory risks - bc of increased WOB
3. Seizure in water
4. Renal - hydrostatic pressure increases GFR 7x
5. Cognitive
6. Mobility

Question 12

Cautions for pregnancy

Answer 12

<35º is ok
- if exercising 30-32º - keep <35º for <30mins
- more overheating occurs on land than in pool (0.3º rise in 33º pool vs 0.5º rise in 30º land)
-

Question 13

What should you consider when prescribing ex in the pool?

Answer 13

1. Safety
2. Goals
3. Principles of immersion

Question 14

Hydrotherapy and CV exercise

Answer 14

• increased Q and reduced lung volumes (increased WOB)
• less loading on joints means that higher intensity
• use principles of drag/turbulence to increase load

Question 15

Hydrotherapy and strengthening exercise

Answer 15

• pool more unstable - more core control needed
• but more stability needed if trying to ISOLATE mm group

To progress strengthening:

1. Increase reps/sets
2. Decrease depth
3. Increase speed
4. Increase SA
5. Change effect of buoyancy

Question 16

What is the general progression of strengthening whilst using buoyancy?

Answer 16

1. Buoyancy assisted - using buoyancy to help with the movement
2. Buoyancy counter balanced - eg. moving parallel to water surface
3. Buoyancy resisted

*Use these to describe the exercises being rx’d

Question 17

Describe functional walking test in the pool

Answer 17

Measure speed of walking (width wise)

- record depth starting position, assistance devices