Other Systems Flashcards
Aquatic Therapy Principles
- Hydrostatic pressure
- Buoyancy
- Drag
- Depth
- Temperature
What is Hydrostatic Pressure?
• 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
What is Buoyancy?
• 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
What is Hydrodynamic Drag?
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
Water Temperature Classifications…?
- 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
• Who should be treated in cold water?
Multiple Sclerosis, Hyperthyroidism (80-84*)
• Who should be treated in warm water/hot water?
Joint pain, Fibromyalgia
What is the Diving Reflex?
• 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
What is the Physiologic Response of Warm of Hot water?
- Warm or Hot Water (97oF +)
- Increased HR
- Increased SV
- Increased CO
- Decreased BP
What is the Physiologic Response of Cold water?
- Decreased HR
- Decreased SV
- Decreased CO
- Increased BP
Respiratory Rate Response?
• 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
What is the effect of hydrostatic pressure on Renal System?
• 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
List Aquatic Therapy Indications…
-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
Aquatic Therapy Precautions…
- Aspiration Risk
- Open Wound
- Cognitive Impairment
- Dry Skin or Scales
- Tetraplegia or high paraplegia
(Difficulty with thermoregulation)
- Catheters
- Indwelling catheters must be clamped
Contraindications…
- 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
Special NPTE considerations…
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
What is High Altitude?
• 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
What are the Initial Reactions of High Altitude?
• 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
Acclimization period of High Altitude?
Adjustment To Environment (1-2 weeks)
⚬ Blood pressure falls
⚬ Cardiac output falls
⚬ Ventilatory Acclimatization*
⚬ pH stabilization
￭Renal Excretion of bicarbonate
Exercise at Higher Altitudes
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
