Other Systems Flashcards

1
Q

Aquatic Therapy Principles

A
  • Hydrostatic pressure
  • Buoyancy
  • Drag
  • Depth
  • Temperature
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2
Q

What is Hydrostatic Pressure?

A

• Pressure that is exerted by a

fluid on an object immersed in

water.

Greater Depth=Greater Hydrostatic Pressure

Hydrostatic pressure “is kinda

like” TED hose

What conditions have LE swelling that

we want to get back to the heart? Chronic Insufficiency, Lymphedema, CHF

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3
Q

What is Buoyancy?

A

• Up-thrust, is an upward force

exerted by water that opposes

the weight of an immersed

object.

Increase depth=Increase buoyancy

Buoyancy is a force the unweighs

the body.

• What type of patient do we want

to unweigh? OA, Post-surgery, joint pain, stress fx

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4
Q

What is Hydrodynamic Drag?

A

the resistance force caused by

the motion of a body through a

fluid.

Greater the speed and cross sectional area, the greater the drag.

The greater the drag the more

resistance the patient is getting

How would we convert and aerobic aquatic therapy

exercise into a resistance/strength building exercise? Increase the drag, a resistance tool

*To improve POWER, resist vertically because you are fighting drag and buoyancy

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5
Q

Water Temperature Classifications…?

A
  • Very cold, Cold or Cool Water (<80*)
  • Vasoconstriction, analgesia, possible

anesthesia

  • Tepid or Thermoneutral (81-96*)
  • Minimal impact
  • Warm, hot, very hot (97-110*)
  • Vasodilation, analgesia, relaxation,

overheating and rapid fatigue

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6
Q

• Who should be treated in cold water?

A

Multiple Sclerosis, Hyperthyroidism (80-84*)

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7
Q

• Who should be treated in warm water/hot water?

A

Joint pain, Fibromyalgia

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8
Q

What is the Diving Reflex?

A

• Immersion in water up to the head or

immersion in cool, cold, or very cold

water

Causes:

  • Bradycardia
  • Peripheral vasoconstriction
  • Peripheral shunting of blood to vital

organs

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9
Q

What is the Physiologic Response of Warm of Hot water?

A
  • Warm or Hot Water (97oF +)
  • Increased HR
  • Increased SV
  • Increased CO
  • Decreased BP
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10
Q

What is the Physiologic Response of Cold water?

A
  • Decreased HR
  • Decreased SV
  • Decreased CO
  • Increased BP
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11
Q

Respiratory Rate Response?

A

• Hydrostatic pressure against the chest

wall limits chest expansion.

• Increased work of breathing because of

lower maximal oxygen uptake

(VO2Max)

• Xiphoid process is the landmark for

decreasing chest wall expansion.

Increase in depth=increase hydrostatic pressure=increase in RR

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12
Q

What is the effect of hydrostatic pressure on Renal System?

A

• Hydrostatic pressure increases the fluid that

returns back to the abdomen, kidneys, and

heart

• Immersion increases diuresis, including

sodium and potassium excretion

• What should a PT be concerned about in

regards to the renal system and the aquatic

environment? Contraindicated for ESRD

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13
Q

List Aquatic Therapy Indications…

A

-Reduce Swelling

  • Lymphedema
  • Venous Insufficiency

-Reduce Spasm or Tone

  • Lumbar muscle spasm post fusion
  • Spasticity/Rigidity

-Reduce Pain

  • Inflammatory conditions/joint pain
  • Fibromyalgia

-Improve Coordination

  • Hyperkinetic Movement
  • Gait Ataxia

-Perform Functional Activities With Reduced Risk For Falls

  • Parkinson’s Disease
  • Pregnancy
  • TBI
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14
Q

Aquatic Therapy Precautions…

A
  • Aspiration Risk
  • Open Wound
  • Cognitive Impairment
  • Dry Skin or Scales
  • Tetraplegia or high paraplegia

(Difficulty with thermoregulation)

  • Catheters
  • Indwelling catheters must be clamped
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15
Q

Contraindications…

A
  • Uncontrolled Bowel or Bladder Incontinence
  • Tracheostomy
  • Infectious Diseases
  • Cardiovascular Problems
  • Uncontrolled BP
  • Decompensated CHF (Right CHF)
  • Uncontrolled Seizures
  • Respiratory Failure/Compromise
  • Vital Capacity < 1 L
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16
Q

Special NPTE considerations…

A

Pregnancy-

• Pool water 80 -84oF or cooler

Multiple Sclerosis/Hyperthyroidism-

  • Heat intolerance
  • Pool water 80 -84oF

Congestive Heart Failure-

• If compensated can be in pool with

monitoring

• If right sided CHF contraindicated

Renal Failure-

• Contraindicated on the NPTE

Epilepsy-

• Can perform aquatic therapy with

proper supervision

17
Q

What is High Altitude?

A

• High altitude = 1,500–3,500 meters

(4,900–11,500 ft)

• At sea level, atmospheric pressure is

high and PaO2 is high

• At high altitudes, atmospheric

pressure is low and PaO2 is low

• Therefore high altitudes create

acute hypoxia

18
Q
A
19
Q

What are the Initial Reactions of High Altitude?

A

• Decreased O2 in air

⚬ Hyperpnea or increased

ventilation

■Respiratory Alkalosis

⚬ Increased heart rate

(tachycardia)

⚬ Stroke volume decreased

⚬ Cardiac Output Increased

⚬ Blood Pressure Increased

• Signs & Symptoms

⚬ Decreased exercise performance

⚬ Muscle weakness/fatigue

⚬ Diminished concentration

⚬ Dizziness

⚬ Headaches

⚬ Blurred vision

20
Q

Acclimization period of High Altitude?

A

Adjustment To Environment (1-2 weeks)

⚬ Blood pressure falls

⚬ Cardiac output falls

⚬ Ventilatory Acclimatization*

⚬ pH stabilization

■Renal Excretion of bicarbonate

21
Q

Exercise at Higher Altitudes

A

Resting & submax heart rates are

greater at high altitudes

• The maximal heart rate that can be

achieved at high altitude is reduced

compared to sea level

• Rate of myocardial ischemia/infarct is

higher due to acute response to hypoxia

Can get altitude sickness which is composed of:

  • Headache
  • Peripheral edema
  • Lethargy
  • Epitaxis
  • Insomnia
  • Anorexia
  • Dyspnea
  • Nausea & vomiting
  • Altitude cerebral/pulmonary edema