INTRODUCTION TO HYDROTHERAPY
Loganathan Chandrasekar
PHT 328 – 1435 -1436H – 1st Semester
Lecture Outline
2

Introduction – Hydrotherapy

Chemical & Physical properties of water

Physiological effects of water

Therapeutic benefits of Hydrotherapy

Indications, Contraindications & adverse effects of
Hydrotherapy
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Learning Objectives
3

At the end of this lecture, the students will be able to
Define Hydrotherapy, Recall the benefits of
water, List down some chemical & physical
properties of water & mention the physiological
effects of water.
 Describe & rationale the therapeutic effects,
indications, contraindications & adverse effects
of hydrotherapy.

PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Introduction - What is Hydrotherapy
Hydrotherapy incorporates
water as a healing tool
Hydrothermal treatments
include water temperature to
aid the healing process
Water allows movements
and exercises to be done
while limiting the effects of
gravity and pressure on
weak areas of the body
4
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Introduction - History
5
Carlos Andreson 1943

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Using thermal water for therapeutic purposes: balneotherapy, spa
therapy, hydrotherapy
Hippocrates (460-375BC) used hot and cold water immersion to
treat many diseases
Romans used baths for hygiene
19th-20th century: therapeutic & pleasure
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Introduction
6
Hydrotherapy inventor
Vinzenz Priessnitz
VINZENZ PRIESSNITZ 1799–1851
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Definition
7

Hydrotherapy, or water therapy, is
the use of water (hot, cold, steam, or
ice) to relieve discomfort and
promote physical well-being.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Benefits of water / Hydrotherapy
8

Soothe sore or inflamed muscles and joints,

Rehabilitate injured limbs,

Lower fevers,

Soothe headaches,

Promote relaxation,

Treat burns and frostbite,

Ease labor pains, and clear up skin problems.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Benefits of water / Hydrotherapy
9
The temperature of water used affects the therapeutic
properties of the treatment.

Hot water - Promote relaxation & thought to stimulate
the immune system

Tepid water - stress reduction

Cold water - reduce inflammation

Alternating hot and cold water - stimulate the
circulatory system and improve the immune system
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Primary Use of Hydrotherapy
10

Treatment of Wounds

Enhanced Environment for exercise

Pain

Edema

Health maintenance /disease prevention
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Common forms of hydrotherapy include
11
1. Whirlpools, Jacuzzis, and hot tubs.


These soaking tubs use jet streams to massage the
body.
To help injured patients regain muscle strength and
to soothe joint and muscle pain.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Common forms of hydrotherapy include
12
2. Pools and Hubbard tanks

Underwater pool exercises
are prescribed as a lowimpact method of
rebuilding muscle strength in
injured patients. Also helps
ease pain in such conditions
as arthritis.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Common forms of hydrotherapy include
13




Baths:
Tepid baths are prescribed to reduce a fever &
relaxation.
Showers:
Showers are often prescribed to stimulate the
circulation. Water jets from a shower head are also
used to massage sore muscles.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Common forms of hydrotherapy include
14

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Moist compresses:
Cold, moist compresses can reduce swelling and
inflammation of an injury.
Steam treatments and saunas:
Steam rooms and saunas are recommended to open
the skin pores and cleanse the body of toxins.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Chemical Properties of Water
15
Pure water is a
polar molecule
consisting of
2 molecules of
Hydrogen and
1 molecule of
Oxygen

PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Physical Properties of Water
16
CONSTANTS

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freezing point: 0 degree Celsius
boiling point: 100 degrees Celsius
density:
at 0 degree Celsius- .999868
at 4 degrees Celsius- 1.0000
pH: 7
specific heat: 1.00
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Physical Properties of Water
17
FORCES EXISTING IN WATER

Specific Gravity

Buoyancy

Hydrostatic pressure

Cohesion

Viscosity

Surface tension
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Specific gravity
18

Is the weight of a particular substance compared with the weight
of an equal volume of water

Specific gravity of a person increases when there is increased bone
mass and muscle mass and decreases when there are greater
amounts of adipose tissue

An object with low specific gravity (less than 1.0) will float

Objects with high specific gravity ( greater than 1.0) will sink

The human body has a specific gravity of 0.87 – 0.97
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Physical properties - Buoyancy

Buoyancy: upward force generated by
the volume of water displaced – force
opposing gravity

Archimede’s Principle: “the upward
thrust that a fully or partially
immersed body experiences is equal
to the weight of the water that it
displaces”
-The amount of the fluid it displaces
depends on the density of the
immersed body relative to the density
of the fluid.
Physical properties - Buoyancy


Water density change
with temperature and
atmospheric pressure
change
The density of salt water
is greater than fresh
water

Density is proportional
to its depth
Specific Gravity (SG):
pure water at 4oC is 1.0
SG>1.0 sink
SG<1.0 float


Body SG ~ 0.974
Center of Buoyancy
21

The COB is a point or location on the human
body that needs to be maintained within a base
of support to establish & maintain an upward &
stable posture
 Similar

to center of gravity
COB located in chest region – Mid chest level
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Clinical benefits - Buoyancy
22
Help exercise when weight
bearing is contraindication
(decrease stress and compression on
weight bearing joints, muscles and
connective tissues).




Torque = F x L

Can be used as assistive or
resistive force
Raise weakened body parts
against gravity.

Buoyancy & Gravity
counteracting forces


Combination of Buoyancy and
Hydrostatic pressure help in
balance exercises
Center of Buoyancy (COB)
of a body segment immersed
in water + Center of Gravity
(COG) of a body segment
out of water used to analyze
torque

Body stable: COG&COB
vertical
Body rotates: COG&COB
not vertical
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Hydrostatic pressure
23

Hydrostatic pressure:
pressure exerted by water on
the immersed body

Pascal’s law: “when a body part
immersed in fluid is at rest, the
fluid will exert equal pressure
on all surface areas at a given
depth”
P = F/A
F= Force; A=Surface area

PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Clinical Uses of Hydrostatic Pressure
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





Immersion in water can assist in promoting circulation or
alleviating peripheral edema due to venous or lymphatic
insufficiency.
Facilitate cardiovascular function
Support provided by hydrostatic pressure may help to brace
unstable joints or weak muscles.
The greatest effect will occur with vertical positioning.
The effect will be less pronounced if the patient is swimming in
more horizontal position close to the water surface.
There are also no hydrostatic pressure effects when non-immersion
hydrotherapy techniques are used.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Viscosity + Cohesion - Resistance
25


Viscosity (internal friction between the
molecules) and cohesion (attractive force exerted
by each molecule on those surrounding) of the
water provide resistance to the motion of a body
in water.
Resistance occurs in the against direction of the
motion of the body and increase in proportional
to the relative speed of the body's motion and the
frontal area of the body part(s) in contact with
water.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Viscosity + Cohesion - Resistance
26
Dependent on:
• speed/velocity of movement of liquid
• shape of the body

FLUIDITY
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Clinical benefits –
Viscosity + Cohesion - Resistance
27


-The velocity-dependant resistance provided by water
makes it a safe and effective strengthening medium
for many patients.
-Variable resistance and pressure provided by moving
water can be beneficial for debriding and cleansing
wounds.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Surface Tension
28


surface of liquid acts as a membrane under
tension
increased attractive forces on the surface
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
HYDROMECHANICS
29

Term used to refer to movement through water

The faster the movement, the greater the resistance
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
HYDROMECHANICS

laminar flow
 All

molecules are parallel
turbulent flow
 Molecules

are erratic/not parallel
drag
 Cumulative
30
effect of turbulence and fluid viscosity
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
HYDROMECHANICS
31
Water in motion
Flow motion

Laminar

Turbulent
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
HYDROMECHANICS
32

Movement of objects in
water cause water movement
(whirlpools or Eddy

Turbulence cause resistance

The faster the movement the
greater the turbulence

Underwater exercises vs
Land exercises
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Clinical Importance - Hydromechanics
33

Adjust resistance
 Speed
 Size
and shape
limb position – lever length
 Increase surface area – add apparatus
 Change
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Thermal Properties of Water
34

-Specific heat
Is the amount of heat, in calories, required to raise temp of 1 gram
of substance 1 degree C.



Specific heat of water = 1.0
Cool water temps are best for long exercise session, warm water is
indicated for short-duration exercises
Specific Heat 4 times that of air
 Water retains 4x as much thermal energy as an equivalent mass
of air
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Thermal Properties of Water
35



Thermal Conductivity:Water can transfer heat by conduction (stationary
water) and convection (moving water) and can
therefore be used as a superficial heating or cooling
agents.
Thermal Conductivity 25 x air
 Water
transfers thermal energy 25 x more rapidly than
air (at the same temperature)
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016
Clinical benefits - Thermal Properties
36

Clinically, during hydrotherapy, heat is generally
transferred from warm water to a patient by placing
the patient's limb in warm water.

Heat may also be transferred from the patient to cooler
water by immersion of a limb or part of it in cold or
ice water.
PHT 328 - HYDROTHERAPY - 1435 - 1436H - 1st Semester
7/1/2016