Download Chapter 13 - ESHE 365

13
Aquatic
Therapeutic
Exercise
Benefits and Purpose
of Aquatic Therex
Exercise sometimes possible sooner
in water than on dry land
Non weight bearing
Offers total exercise program:
cardiovascular conditioning,
flexibility, strength, muscular
endurance
Specific Gravity
Also called relative density
Ratio of an object’s weight to the
weight of an equal volume of water
Specific gravity of water = 1
For human body, depends on lean
and fat mass and distribution
of body fat
Average specific gravity for body =
0.95-0.97
Archimedes principle: A body partially
or fully immersed in a fluid will
experience an upward thrust of that
fluid that is equal to the weight of the
fluid the body displaces.
Buoyancy
Archimedes principle
A body with a specific gravity of less
than 1 will float because weight of
water displaced is less than weight of
body
If body has specific gravity of 0.95,
95% of body will be submerged and
5% will float
Center of Buoyancy
The center of gravity of the displaced
fluid and the point at which the
buoyant force acts on the body
When in equilibrium, the center of
buoyancy and the center of gravity
are in vertical alignment with each
other and the body is balanced
Hydrodynamics
Viscosity
The resistance to movement within a
fluid that is caused by the friction of
the fluid’s molecules
Influenced by cohesion, adhesion,
surface tension
(continued)
Hydrodynamics
Drag: the water’s resistance to a body
that is moving through it
Form drag
Wave drag
Frictional drag
Hydrostatic Pressure
Pascal’s law: Pressure from a fluid is
exerted equally on all surfaces of an
immersed object at any given depth
The more deeply the object is
immersed, the greater the pressure
For every foot of submersion, water
pressure increases by 0.43 psi
Positive impact on edema
Pascal’s Law
Reprinted from Bates and Hanson 1996.
Weight Bearing in Water
The more deeply the body is
submerged, the less weight is borne
by the lower extremities.
Females’ center of gravity is lower
than males’: affects percentage of
body weight borne at different
depths.
The faster a person walks in the
water, the higher the weight-bearing
percentages.
Weight Bearing in Water
Reprinted from Harrison, Hillman, and Bulstrode 1992.
Aquatic Equipment
Safety equipment
Assistive devices: help stabilize
body, maintain buoyancy, assist in
motion
Resistive devices: used to increase
muscle strength/endurance; increase
surface area, require speed, add
buoyancy or weight
Cardiovascular devices
Indications
for Aquatic Therex
Pain, edema, muscle spasm, loss of
motion, weakness, limited endurance
Restricted weight-bearing status
Maintaining cardiovascular
conditioning or normal status of
uninvolved extremities
Advantages
Can be performed even if weight
bearing is restricted
Warmth of water can relax muscles,
relieve pain
Buoyancy reduces joint compressive
forces
Reduces weight bearing while
allowing muscles to continue to
function properly in the gait
sequence
Advantages
Can promote body awareness and
balance
Can relieve or reduce pain due to
immobilization or edema
Can be used early in rehabilitation
program, helping to prevent
deconditioning
Precautions
for Aquatic Therex
Fear of the water
Medications
Ear infections
Conditions such as diabetes,
cardiovascular disease, seizure
disorders
Never allow patient in pool
unattended
Contraindications
for Aquatic Therex
Contagious infection
Severe cold or flu
Urinary tract infection
Temperature of 100° F or more
Open wounds
Application
of Aquatic Principles
Hydrostatic pressure: more
advantageous to exercise swollen
extremity in deep water
Greater resistance achieved through
longer lever arm, straighter
extremity
increased speed
moving object at surface of water or
with increased surface area
Aquatic Exercise
Progression
Early
Use buoyancy equipment for
increased range of motion.
Do gait training in deep water.
Use resistance exercises without
equipment.
(continued)
Aquatic Exercise
Progression
Mid
Emphasize restoration of muscle
strength and endurance.
Use drag to increase resistance.
Add resistive equipment.
Increase reps and sets.
(continued)
Aquatic Exercise
Progression
Advanced
Focus on restoration of ABCs of
proprioception
Gait training more intense and
varied
Hopping, jumping, etc.
Eyes open, closed.
Increased intensity for strength
(continued)
Aquatic Exercise
Progression
End phase
Mimicking skills and demands of
sport
Aggressive coordination, agility,
speed activities
Plyometrics
Benefits
of Deep-Water Exercise
No weight bearing and no impact
forces
Can help maintain cardiovascular
fitness and strength
Forces of gravity on a submersed
body are minimal
Exercises essentially concentric
Correct Vertical Alignment
Correct Position
for Deep-Water Running
Refraction of Light
Determining Depth
of Water
Patient’s confidence in the water
Patient’s weight-bearing status
Goals of the exercise