Week 9 - Exercise in water Flashcards

1
Q

What is hydrotherapy?

A

Exercise in warm water

OR

exercise in water

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2
Q

Origins of hydrotherapy?

A

→ Origins stem from ancient practices of immersion and hot and cold therapy

→ Western medieval revival late 1700’s in Europe, and the UK in the late 1840s (Victorian era)

→ Understanding and application has developed, but essential principles remain largely unchanged

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3
Q

4 principles of water as a physical material?

A
  • Density and buoyancy
  • Hydrostatic pressure
  • Viscosity
  • Thermodynamics (ability to hold/transfer heat)
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4
Q

What is density?

A

The relationship between the mass of an object (KG) and the amount of space that object occupies.
(m3).

→different materials have different density ratios
→ water at 4C has a density of 1000kg/m3 - 1000x more dense than air
→ salty water more dense as its more compressed - molecules are a lot closer together

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5
Q

What is archimedes principle?

A

When an object is immersed in water it displaces the same volume of water as the volume it occupies and receives an opposite force accordingly.

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6
Q

How is density applied to humans?

A

Density determines whether we float or sink.

Human beings are roughly 970kg/m3.

Very lean and muscly individuals = more dense (sink)
Individuals w/more adipose tissue = float

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7
Q

How can human density be manipulated?

A

Taking a deep breath

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8
Q

What is buoyancy?

A

Buoyancy is the relative force of displacing water and is in direct opposition to mass and gravity (it points upwards)

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9
Q

How does buoyancy change depending on how much of an object is submerged?

A

The more of an object that is submerged, the more buoyancy force is created and the less that object is subjected to the downwards force of gravity and mass.

  • The more submerged in water we become, the less we seem to weigh.
  • Immersed up to C7 = 10% bodyweight on land
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10
Q

Key points about buoyancy?

A

→ Buoyancy can either resist or assist depending on the direction of movement
→ Muscle contraction in a positively buoyant
environment is opposite to what is expected on land

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11
Q

How can buoyancy be applied to hydrotherapy?

A

→ Minimising weight-bearing and forces - increasing depth leads to reductions in load of body weight.
→ Reduction of loads through arthritic joints and fracture sites
→ Individuals who are wheelchair dependent may be able to ambulate when immersed in water.

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12
Q

What is hydrostatic pressure?

A

Density creates pressure - pressure = the force exerted by one substance on another

Hydrostatic pressure increases w/depth (about 1mmHg per 1.4cm) - deeper you submerge an object, the more pressure it is subjected to.

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13
Q

Therapeutic application of hydrostatic pressure?

A

Immersion in water acts to compress the human being. Deeper water causes more compression.
Systems relying on pressure see changes in function.

→ Fluids driven from extremities towards centre of body ↳ muscle blood supply increases followed by central CV system

→Kidney filtration increase and urine output increases
↳ dehydrate more quickly in pool.

→Thorax compressed creating increased work of breathing (+60% at neck immersion).

→Possible improvements in sensory information, proprioception etc. due to compression of our nervous system e.g. peripheral nerves.

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14
Q

What is water’s relationship with viscosity?

A

→It is inherently hydrophilic and possess a high degree of internal friction.

→Water molecules resist being separated from other molecules of water

→ Moving through water creates separation of water molecules - requires effort and produces a force known as drag

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15
Q

What is drag?

A

The force created by an object moving through a fluid.

→ Depends on the shape of the object and the speed at which that object is moving through the fluid
→ The bigger the object, the faster the object, the more drag.
→ There is also drag created by friction between the skin of the object and the water

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16
Q

Viscosity and drag therapeutic application?

A

The water acts as a velocity-dependent resistor

  • the faster you try to move through water, the more resistance you will generate (too easy = speed up, too hard = slow down)
  • water resistance also reduces to zero immediately upon ceasing movement so painful activities can be stopped immediately
17
Q

How can drag be manipulated to challenge or assist?

A

→ Increase SA or friction of an object can make activities more challenging
→ Turbulence to assist or resist - it creates low pressure and tends to pull objects towards it.

18
Q

Thermodynamics key points?

A
  • Water is denser than air so it is much better at storing and transferring thermal energy
  • The molecules of water are closer together and bump into each other more often, maintaining the energy of the substance
  • It holds heat roughly 1000 times better than air and transmits it 25x faster
19
Q

Therapeutic application of thermodynamics?

A

Temperature of pool can be altered to suit rehabilitation purposes:

→ Cryotherapy (post-athletic recovery) - 10-15C ↳ manage inflammation, muscle soreness and oedema associated with high intensity effort

→ Most competitive swimming pools/athletic rehab pools - 27-29C (performance)

→ Hydrotherapy pool - 33.5-35.5 (increased blood flow, competitive stimulus for pain, reduced stiffness/spasticity and improved ROM, relaxation)

20
Q

Why does hydrotherapy make it difficult to effectively shed heat during high intensity exercise?

A

Due to water’s high heat capacity.

Especially as a human being’s main method of heat loss is through evaporative cooling.

21
Q

Absolute contraindications to exercise in water?

A
  • Acute systemic illness/pyrexia
  • Acute vomiting or diarrhoea
  • Medical instability following an acute episode
  • Resting angina
  • Open infected wounds
  • Shortness of breath at rest
  • Proven chlorine/bromine allergy
  • Known HIV-positive and Hepatitis C patients must not enter the pool; during menstruation.
22
Q

Relative contraindications to exercise in water?

A
  • Irradiated skin during course of radiotherapy
  • Known aneurysm
  • Open wounds
  • Poorly controlled epilepsy → plan in place if seizure occurs
  • Unstable diabetes
  • Thyroid deficiency
  • Neutropaenia
  • Oxygen dependency
  • Weight in excess of evacuation equipment limit
23
Q

Challenges of hydrotherapy?

A

Challenges of access can be overcome at a pool level.

Challenges of finding locations and accessing services can be difficult:
→ expensive: to heat, staff numbers
(water, chlorine + electricity) - break down/need servicing