Week 9 Hydrotherapy/Compession Flashcards
Compression Reduces edema by:
Increasing extravascular hydrostatic pressure and circulation
Edema and venous stasis ulcers with intermittent compression pumps the inflation time is generally:
greater than deflation time
What temperature should the pool water be kept?
79-97 dgrees
Temp of the pool for the elderly deconditioned patients or patients with arthritis
93-97 degrees at low intensity
79-82 degrees in the pool should be used for:
vigorous/high intensity exercise
Anything below 65 degrees of water would cause
impairment of the muscle to contract
Buoyancy
An upward force on an object immersed in a flude that is equal to the weight of the fluid it displaces, enabling it to float or to appear lighter
Hydrostatic Pressure
The process exerted by a fluid on a body immersed in the fluid. The pressure increases with increased depth of immersion
Resistance
A force counter to the direction of movement. Resistance to a body’s movement in water is proportional to the relative speed of body and water motion and to the frontal areas of body parts in contact with the water
When a person exercises in water what is their heart rate response?
HR is blunted
Cleansing effects of Hydrotherapy
-Softens materials
- exerts pressure
- debriding agent for exudate or necrotic tissue
Antimicrobial or surfactant additives may be
Venous blood is displaced (blank) from the extremities
Proximally
renal effects of Hydrotherapy
- Increased urine production
Increased renal flow
Increased central blood volume
Decreased ADH and aldosterone
Uses of hydrotherapy
Superficial heating/cooling
Water exercise
Pain Control
Edema Control
Wound Care
Edema Reduction is due to (blank) when in the pool
Hydrostatic Pressure
Wound care hydrotherapy
- Hydrotherapy accelerates wound healing
- facilitates rehydration, softening, debridement
- May improve circulation
Contraindications for LOCAL Immersion Hydrotherapy
- Maceration around a wound
- Bleeding
Contraindications for FULL BODY immersion hydrotherapy
- Cardiac instability
- Infectious conditions that may be spread by water
-Bowel incontinence
-Severe epilepsy
-Suicidality
Contraindications for Negative pressure wound therapy
- necrotic tissue
- untreated osteomyelitis
- malignancy in the wound
- Untreated malnutrition
- exposed vessels, nerves, or organs
- nonenteric and unexplored fistulas
- exposed anastomotic sites
Precautions for LOCAL Immersion
- impaired thermal sensation in immersed area
- Infection in immersed area
-Confusion or impaired cognition
-Recent skin graft
Precautions for FULL BODY in hot/very warm water
- pregnancy
- multiple sclerosis
- poor thermal regulation
Precautions for FULL BODY immersion for ANY temperature
- Confusion/disorientation
- Alcohol ingestion
- limited strength, endurance, balance, ROM
- Medications
- Urinary Incontinence
- Fear of water
- respiratory problems
Precautions for nonimmersion Hydrotherapy
- maceration
- May be ineffective
Precautions for Negative pressure wound therapy
- anticoagulant therapy
- Difficult hemostasis
- Confusion
Adverse Effects of Hydrotherapy
Drowning
Asthma
Burns, Fainting, bleeding
Hyponatremia
Infection
Aggravation of edema
Asthma exacerbation
Compression
A mechanical force that increases external pressure on the body or a body part
- To improve fluid balance/circulation
- May increase activity of temperature sensitive collagenase to control scar formation
Effects of External Compression
- Improves Venous and lymphatic circulation
- Limits the shape and size of tissue
- Increases Tissue temperature
- Edema reduction
-prevention of deep vein thrombosis
Intermittent compression may be (blank) effective than static by milking fluids from proximal to distal vessels
More
Clinical indications for the use of external compression
- Edema Control
Prevention of DVT - venous stasis ulcers
- Residual limb shaping after amputation
- Control of hypertrophic scarring
How does compression reduce edmea?
Increases extravascular hydrostatic pressure= circulation promotion
- May move fluid proximally through vessels
Venous Stasis Ulcers what can compression do to help?
- Improve venous circulation
Improve rate of healing of venous stasis ulcers - multilayered compression more effective than lower pressure
- Compression therapy is the cornerstone of venous ulcer treatment
Contraindications to Compression
- ABI less than 0.8
Contraindication for Intermittent or sequential compression pumps
- Heart failure or pulmonary edema
- Recent or acute DVT thrombophlebitis or PE
- Obstructed lymphatic or venous return
- Severe PAD
- Acute local skin infection
- Significant hypoproteinemia
- Acute trauma/ fracture
- Arterial revascularization
Precautions for compression
- Impaired sensation or mentation
- Uncontrolled hypertension
- Cancer
- Stroke/significant cerebrovascular insufficiency
- Superficial peripheral nerves
Compression garments: DVT Prevention compression range
16-18 mmHg
- worn 24 hours a day
Compression garments: Custom or off the shelf Scar tissue control
20-30 mmHg
- Scar tissue control
Compression garments: Custom or of the shelf edema control
30-40 mmHg
