DR. SHAHABUDDIN
BS.PT(JPMC), PP.DPT(IIRS), MPPTA LECTURER
COLLEGE OF PHYSIOTHERAPY
JINNAH POSTGRADUATE MEDICAL CENTRE KARACHI
•Hydrotherapy
INTRODUCTION:
 Hydrotherapy is a method of treating disease
by using water at different temperatures and
in different ways.

Any activity performed in water to assist
in rehabilitation and recovery from hard
training or serious injury.

It is a part of medicine, Specially in
physiotherapy, that involves the use of water
for pain relief and treatment.

The term (Hydrotherapy)encompasses a
broad range of approaches and therapeutic
methods that take advantage of the physical
properties of water, such as temperature and
pressure, for therapeutic purposes, to
stimulate blood circulation and treat the
symptoms of certain diseases.


Hydrotherapy is the union between water and
physical therapy. It is being used widely
throughout the world as a form of physical
therapy.
By working in a hydrotherapy department of a
physical therapy clinic, one may see how
patients use hydrotherapy for treating their
conditions.

Patients are instructed through a specific
program designed to help their physical
conditions.

Hydrotherapy is a great way to
exercise the body.
Facilitate range of motion (ROM) exercise
 Initiate resistance training
 Facilitate weight-bearing activities
 Enhance delivery of manual techniques
 Provide three-dimensional access to the patient
 Facilitate cardiovascular exercise
 Initiate functional activity replication
 Minimize risk of injury or re-injury during
rehabilitation
 Enhance patient relaxation

The four most important properties of water
from a treatment point are:

1. Water is non-irritating, non-allergic,
and totally compatible with human
physiology both inside and outside of the
body.

2. Water is a good heat conductor and at
the same time greatly heat storing in capacity
so that it is the ideal agent for manipulating
body temperature.
3.Water is totally conformable to the body
surfaces. This means that it makes an
intimate interface with whatever it comes in
contact, which greatly facilitates its ability to
affect the temperature the object it contacts.

4.Water is inexpensive in spite of all its
marvelous properties.



In common with other forms of matter, water
has certain physical properties which include
weight, density, buoyancy, Hydrostatic
pressure, and surface tension.
The most important physical laws of water
that physiotherapist should understand and
apply when giving hydrotherapy, are buoyancy
and hydrostatic pressure.
Buoyancy is the force experienced as an up
thrust which acts in the opposite direction to
the force of gravity.

A body in water is therefore subjected to
two opposing forces.



When the weight of the floating body equals
the weight of the liquid displaced, and the
centers of buoyancy and gravity are in the
same vertical line, the body is kept in stable
equilibrium.
If the centers are not in the same vertical line
the two forces acting on the body will cause it
to roll over until it reaches a position of
stable equilibrium.

Decrease stress and compression to body
tissues (weight-bearing surfaces)

Assist weak muscles.
Pressure exerted by fluid on body immersed
in fluid.
Pascal’s Law
 A fluid exerts equal pressure on all surfaces
of a body at rest, at a given depth…
 This pressure increases in proportion to
depth of fluid.





Water can have similar effect as compression
bandages.
Helpful in decreasing edema
Greatest effects of hydrostatic pressure occur
in vertical position.
NO hydrostatic pressure effects with nonimmersion hydrotherapy.
CLEANSING EFFECTS:
 Water can be used as a cleanser.
 Water is most commonly used as cleansing
agent for skin.
 Hydrating effects and friction of water used
to soften and remove the Debris.
 Water is used clinically both as wound
exudate or necrotic tissue, and as a cleanser
to remove exogenous waste.

MUSCULOSKELETAL EFFECTS:
 The Buoyancy of water unload the weightbearing of anatomical structures and allow
patients to perform exercise with less trauma and
pain.
 Buoyancy effect can help patients with;
 Decrease weight bearing (Arthritis)
 Increase blood flow to muscles
 Muscle Strengthening
 Ligamentous instability
 And other degenerative or traumatic conditions.

CARDIOVASCULAR EFFECTS:
 The Cardiovascular benefits of hydrotherapy
are primarily due to the effects of hydrostatic
Pressure.
 Increased Venous circulation
 Increase Cardiac Volume
 Increase Cardiac Output.

RESPIRATORY EFFECTS:
 Immersion of the whole body in water
increases the Work of Breathing.
 Hydrostatic Pressure on the chest wall
increases the resistance to lungs expansion.
 Water based exercise is also often
recommended for patients with EXERCISEINDUCED ASTHMA because it appears that
High Humidity of the air inspired during water
exercise, which prevents drying and/or
cooling of the Respiratory mucosa.

RENAL EFFECTS:
 Increase Sodium and Potassium excretion
 Increase Urine Production
 May be used to treat the patient with
hypertension and peripheral edema.

PSYCHOLOGICAL EFFECTS:
Water immersion can be invigorating and/or
Relaxing.
The Variation in the Psychological effects
depends primarily on the temperature of water
SUPERFICIAL HEATING AND COOLING:
 Warm or cold water can be used clinically to
heat or cool the superficial tissues
 Advantages
 Even contact with skin
 Does not need to be fastened
 Allows movement of heat/cold
 Disadvantages
 Extremity often in dependent position

WOUND CARE:
 Cleansing properties facilitate
 Rehydration
 Softening and debridement of necrotic tissue
 Removal of wound debris
 Hydrostatic pressure and heat increase
circulation
 Provides moist environment to optimize
healing

PAIN CONTROL:
 Increased sensory stimulation to peripheral
mechanoreceptors
 Cold water decreases inflammation
 Decreases weight-bearing, increases “ease of
movement”.

EDEMA CONTROL:
 Water immersion has shown to reduce
peripheral edema.
 This effect is due to Hydrostatic pressure
 Contrast Baths are frequently used to control
edema


Miscellaneous conditions;
a.Control
b.Acute
of Pain & swelling – Cold whirlpools
Sprains & strains - Cold whirlpools
c.Facilitate
motion & ex’s for Sub acute & chronic stages of
sprains & strains - Warm whirlpools
d.Facilitation
of stretching of contracture (simultaneous or
immediate pre application of Warm whirlpools)
e.Postsurgical
repair of joints (after post surgical wounds are
healed fully – to help soften scar tissue, ↓ pain & promote
restoration of motion )
f. Healing fractures of bones – after clinical union has been achieved.
g.Assist in ↑ of mobility – thermal & buoyancy of warm whirlpools
h.OA & RA – Buoyancy effects of warm whirlpools – off loading of the
affected joints – leading to decrease in pain & ↑ in mobility.
i. Help to ↓ post operative peripheral edema – Hydrostatic pressure.
j. Psychological effect – Relaxation & ↓ of anxiety
k. Wound care – Mechanical debriding by removing necrotic material &
cleansing.

CONTRAINDICATION (LOCAL IMMERSION):
 Maceration
Increased maceration, increased size of wound

Bleeding
In or near the area
(Maceration is defined as the softening and
breaking down of skin resulting from prolonged
exposure to moisture).









CONTRAINDICATION (FULL BODY IMMERSION):
Cardiac instability
Uncontrolled hypertension or heart failure
Infectious conditions that spread with water
like UTI’s, plantar warts, tinea pedis (pool)
Severe epilepsy
Increased risk of drowning
Suicidal patients
Increased risk of drowning

Acute inflammatory conditions - ↑ intravascular pressure -
↑ in oedema.

Hyperpyrexia - ↑ tissue temperature

Malignancies – Spreading - ↑ blood flow

Active bleeding – Prolonging arterial blood flow

Cardiac dysfunction – Not able to adapt to thermal homeostasis

Respiratory dysfunction – Not able to resist hydrostatic
pressure, tolerate heat or both

↓ thermal sensation – Inability to sense too much heat / cold

PVD – Not able to meet ↑ metabolic demand

X-ray therapy – Not able to meet ↑ metabolic demand

Venous ulcers – May promote venous congestion

Surface infections – Cross contamination

Uncontrolled bowels – Contaminate water

Dermatological conditions(Atopic eczema) – Exacerbate

Severe epilepsy – Risk of drowning (Full body immersion)
PRECAUTION (LOCAL IMMERSION):
 Impaired thermal sensation
Check temperature of water with thermometer
first
 Infection
 Universal Precautions
 Clean WP
 Confusion, impaired cognition
 Use constant, direct supervision
 Temperature of water near body temperature
 Recent Skin Grafts
 Neutral or mild warmth (96 - 98 F)

PRECAUTION (FULL BODY IMMERSION):

Confusion, Disorientation Keep head above water
Constant supervision
Low temperature

Patients with limited strength, endurance, balance,
ROM Hands-on approach required
 Patients on medications
Physician clearance sometimes required Patients with fear
of water
Patients with respiratory problems
 Watch for signs of respiratory distress, especially in hot
or very warm water


Impaired thermal sensation in area to be immersed – Burns

Infection in area to be treated – Need additional infection control
measures

Impaired cognition – Not able to report problems or discomfort

Recent skin grafts – May not able to tolerate agitation or not able to
compensate for extreme of heat or cold

After ingestion of alcohol– Impaired judgment – risk of drowning.

Limited strength, endurance, balance or ROM (full body immersion) –
Safety hazard – risk of drowning

Medications – May alter CVS

Urinary incontinence (full body immersion) – Risk of UTI

Fear of water (full body immersion) – May refuse to participate

Respiratory problems – ↑ respiratory distress

Multiple sclerosis (full body immersion) – ↑ fatigue & weakness

Poor thermal regulation (full body immersion) – Risk of
thermal shock

Previously existing edema (full body immersion) – ↑ edema

Sea sickness – Cause anxiety
GENERAL RULES OF APPLICATION:
 Assess problem and set goals of treatment
 Determine if most appropriate treatment
 Make sure no contraindications

Select appropriate form of
hydrotherapy Whirlpool
Hubbard Tank
Contrast bath
Non-immersion device Pool
 Explain the procedure, purpose, sensations
 Apply appropriate form of hydrotherapy
 Assess outcome
 Document

SELECTION OF HYDROTHERAPY MEANS:
 Select the appropriate form of hydrotherapy
according to the
condition to be treated
desired treatment effects
Size of area to be treated
Allowance for safety,
control of infection
Cost-effectiveness


Whirlpool bath

Hubbard tank

Pool/Aquatic Therapy
Low Boy Whirlpool
High Boy Whirlpool
Extremity Whirlpool
Chair for Whirlpool

These are stainless steel tanks of various sizes.

It has an attached motor called – TURBINE.

The turbine – AGITATES the water in the tank to
create the whirlpool effect.

These WP are intended to used as single-patient
treatments & must be drained & cleaned after
each use.

Agitator/ Turbine ejector/ Aerator
 Hot
and cold water mixing valve

Temperature gauge

Gravity drain

Seat / Chair
On / Off switch
Motor Pump/Turbine Motor
Thermometer
Steel Tank
Wheels
 stimulation
 promotion
of circulation
of muscle relaxation
and pain relief
 debridement
 facilitation
of exercise

It is designed for ease of transfer in & out of
the tank by virtue of low walls & length.

Patients in a low boy are usually in a long
sitting position.

Dimensions
width: 24 inches
length: 52 – 66 inches
depth: 18 inches

It’s also referred as “HIP” tanks.

It requires a chair or lift to transfer the patient in
& out of the tank.

Patients in a high boy tank usually sit on a
removable seat attached to rungs on the side of
the tank or may sit on a chair outside the tank
with their lower extremity dangling in the tank.

Dimensions
width: 20 -24 inches
length: 36 -48 inches
depth: 28 inches
 The
WP tank is smaller in size, designed
especially to treat distal extremities.
(Ankle/foot/hand)
 It
is often portable with attached wheels
for ease of movement.

Dimensions
width: 15 inches
length: 28 – 32 inches
depth: 18 – 25 inches





These are large whirlpools designed for full body
(Head out) immersion & for patients who are
unable to stand.
Mainly designed for under water ex’s.
The wide top & bottom & narrow middle allow
room for ex’s for the extremities & PT access to
the patient for assistance with ex’s.
Pt’s are typically lowered into tank on a stretcher
by an over head hydraulic hoist.
It is equipped with 2 turbines, that can be moved
around the perimeter of the tank to direct &
control the agitation pattern.

Dimensions
length: 7 feet 2
inches
upper wing
width: 6 feet
middle wing
width: 35 inches
lower wing
width: 4 feet 2
inches
depth: 22 inches
 Walk trough
 Adjustable seat
 Motorized
 Hydro
chair lift
stretcher with hydraulic lift
Pressured water
irrigation system:
 It is mainly used for wounds,
where it is impossible or not
required to immerse the body
part treated.
• It should range between 4 to
15 pounds /square inch (psi).
• Used to treat one patient at a
time.
• Reusable.

WP is recommended for
◦ Delayed primary wound – Wounds that are
surgically closed after 5 days.
◦ Secondary intention – Wounds are allowed to close
by granulation, marginal or budding
epithelialization & wound margin contracture.

WP application – facilitates;
◦ Cleansing
◦ Softening and debridement of necrotic tissue
◦ Removal of wound debris
◦ Antibacterial action
◦ Circulation enhancement
The WP could be carried out until the wound closes.

1. THE RELIEF OF PAIN & MUSCLE SPASM
2. MAINTANANCE OR INCREASE IN RANGE OF
MOTION OF JOINTS

3. THE STRENGTHENING OF WEAK MUSCLES & AN
INCREASE IN THEIR TOLERANCE TO EXERCISE


4. THE RE-EDUCATION PARALYSED MUSCLES

5. THE IMPROVEMENT OF CIRCULATION

6. THE ENCOURAGEMENT OF FUNCTIONAL ACTIVITIES
7. THE MAINTANANCE & IMPROVEMENT OF BALANCE,
CO-ORDINATION & POSTURE


8. WOUND HEALING IS ENHANCED

9. SEDATIVE EFFECT & RELAXATION

10. FACILITATES CARDIOVASCULAR EXERCISES

11. FACILITATES THE WEIGHBEARING ACTIVITIES
Assess problem and set goals of treatment
 Determine if most appropriate treatment
 Make sure no contraindications
 Select appropriate form of hydrotherapy

◦
◦
◦
◦
◦




Whirlpool
Hubbard Tank
Contrast bath
Non-immersion device
Pool
Explain the procedure, purpose, sensations
Apply appropriate form of hydrotherapy
Assess outcome
Document

Base decision on
◦ Desired effects
◦ Size of area to be treated
◦ Allowance for safety, control of infection
◦ Cost-effectiveness

Cold (32-790 F)
 Acute

inflammation
Tepid (79-920 F)

Exercise

Acute inflammation if cold not tolerated

Neutral warmth (92-960 F)

Open wound

Medically compromised patients

Decrease tone

Mild warmth (96-980)
◦ Increase mobility
◦ Burn

Hot (99-1040)
◦ Pain,
◦ Increase ROM
◦ Increase soft tissue extensibility

Very Hot (104-1100)
◦ Limited body area
◦ Chronic conditions

DO NOT use WP at temperatures > 1100 F !!
 Prevention
of falls
 Precautions
for prevention
of drowning
 Electrical
safety

20 min when strictly used as a heating modality
– skin muscle & joint temperature.

5 – 20 min when used for debridement –
depending on amount of necrotic tissue.

10 – 20 min for ex’s – depending on pt’s medical
status.

High boy tank:- it requires the pt’s to flex their hip &
knee & limits the amount of ROM ex’s. But its depth
allows a greater body surface area to be submerged
safely & comfortably to as high as the mid thorax
region.

Low boy tank:- Not deep but allows the pt’s to fully
extend their lower extremity & perform full ROM ex’s.

Extremity tank:- When only distal portion of the lower
extremity has to be immersed, then extremity tank with
use of chair will be appropriate.

The patient should be seated comfortably next to
the extremity tank, with a towel or other form of
padding on the tank edge to avoid compression
of axillary area.

E.g.

1. Pt’s with arthritis & is unable to negotiate
transfers.

2. Pt’s with neurologically involved – paralysis,
who can actively move the limbs in water with
the help of water & unable to do the same in air.

3. A burn pt,

4. An elderly patient with an open wound.
Pt’s skin thermal sensory discrimination testing
 Skin status
 Health & mental status
 Hydro equipment
 Accessories
 Water temperature
 Water Additives (When applicable) – Name &
concentration of solution.
 Body part treated
 Treating method – non immersion or
immersion
 If immersion – level – partial or full
 If immersion - Duration

History
Carlos Andreson 1943

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
Definition
 Hydrotherapy may
be defined as the use of
water, in any of its forms, for the
maintenance of health or the treatment of
disease.
 hydrotherapy has been used to treat disease
and injury by many different peoples.
 Also called( Hydrothermal therapy)
additionally uses its temperature effects, as
in hot baths, saunas, wraps, etc.
Benefits of hydrotherapy
The goal of hydrotherapy is to improve the circulation and
quality of blood.
This is important, since blood deliveries nutrient to and remove
the waste products from the tissues and organs.
 If circulation is poor or slow, healing nutrients could not
be delivered and toxins could not be removed, which
causes degeneration of tissues and organs.

By improving the quality of blood, more nutrients are
available for cells to use and toxins are managed more
efficiently
Physiological Effects

Thermal effects: are produced by the application
of water at temperatures above or below that of
the body.
 The mechanical: effects are produced by the
impact of water upon the surface of the body in
the form of sprays, douches, frictions, whirlpools,
etc.
 The chemical: effects are produced when it is
taken by mouth or used to irrigate a body cavity,
such as the large colon.
Common techniques
 baths and showers, neutral baths, sitz baths,
contrast sitz baths, foot baths, cold mitten friction
rub, steam inhalation, hot compresses, cold
compresses, alternating hot and cold
compresses, heating compresses, body wrap,
wet sheet pack, and salt glow.
Therapeutic properties
of
water
Physical
properties
chemical
prosperities
Physical properties of water
(Aquatic Physics )
These properties include
 High
specific heat and thermal conductivity
 Bouncy
 Resistance
 and hydrostatic pressure
Physical properties
1-Specific heat and 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.
 It is effective for this application because of its high
specific heat and thermal conductivity
Specific heat. Cont.,
 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 shortduration exercises
Specific heat. Cont.,
 The
specific heat of water is approximately
four times that of air and its thermal
conductivity is approximately 25 times that
of air.
 Thus it transfers the thermal energy 25
times more rapidly than air at the same
temperature.
Clinical benefits

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.
Physical properties
2-Bouncy

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
Specific gravity

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
Center of Buoyancy
 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
Physical properties
Clinical benefits

Buoyancy
Help exercise when weight
bearing is contraindication
(decrease stress and compression
on weight bearing
joints,muscles and connective
tissues).
Can be used as assistive or
resistive force
Raise weakened body parts
against gravity.
Combination of Buoyancy
and Hydrostatic pressure help
in balance exercises

Torque = F x L
Center of Buoyancy (CB)
of a body segment
immersed in water + Center
of Gravity (COG) of a body
segment out of water used
to analyze torque

Buoyancy & Gravity
counteracting forces
Body stable: COG&CB
vertical
Body rotates: COG&CB not
vertical
Physical properties
3-Resistance

Water at rest
Density: mass per unit
volume
ρ = m/V
m= mass; V=volume
Physical properties
3) Resistance

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.
Clinical benefits

-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.
Hydromechanics of water
 Term
used to refer to movement through
water
 The faster the movement, the greater the
resistance
Physical properties
4-Hydrostatic
pressure

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
Clinical benefits

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 nonimmersion hydrotherapy techniques are used.
Physical properties
 Hydrostatic pressure
Patients with respiratory problems:
– exercises to improve lung expansion
– Difficulty breathing
Pressure  with density: more pressure in deeper
water (patients with circulatory problems)
Physical properties

Other properties
Surface tension: water molecules
on the surface have greater
tendency to hold together
Adhesion: the tendency of water
molecule to adhere to other
substances
Cohesion: the tendency of water
molecules to adhere to each other
Physical properties
Water in motion
Flow motion

Laminar

Turbulent
Physical properties

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
Physical properties

Bow wave: positive pressure in front of the moving
object – caused by the displaced water (stop moving
forward)
 Wake (drag effect): forms behind moving object
caused by water flowing into the area immediately to
the rear – negative pressure (hold object back)
Exercise in water
 Adjust
resistance
Speed
Size and shape
– Change limb position – lever length
– Increase surface area – add apparatus
What is Hydrotherapy
Hydrotherapy
Hydrothermal
incorporates water as a treatments include
healing tool
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
Multiple Ways to Use
Hydrotherapy
Hydrotherapy
uses
Immersion
full body or partial
stretches and exercises
Topical
apply cool/warm water
wraps or packs
ingestion/inhalation
drink enough water
for hydration
Benefits of Water for Healing
• Physical Therapy
– increase range of motion
– strengthen muscles
– Reduces pressure on painful/weak
joints/muscles
– Useful especially for people with chronic pain
and decreased bone density where land based
exercises would cause pain or injury
Why Exercise in Water?
• Physical Properties of Water allow it to be a valuable tool
in Physical Therapy
– Buoyancy; water counteracts gravity and helps to
support the weight of the patient in a controlled
fashion as the patient is immersed
– Viscosity: resists movement by means of friction,
allowing strengthening and conditioning of an
injury, while reducing the risk of further injury due
to loss of balance
– Hydrostatic pressure: produces forces
perpendicular to body surfaces at every point,
increasing kinesthetic (body motion or position)
and proprioceptive (posture self-regulating)
awareness in some patients
• Buoyancy reduces the effects of gravity upon a
patient which is especially helpful in aiding
movement to improve natural range of motion for
those with chronic pain, arthritis and neck/back
injuries.
• Pain can also be relieved by sensory alterations
that can be caused by relaxation of muscles due to
water temperature and pressure.
• Increased strength and movement can thus be
obtained through exercise in an aquatic setting
Types of Exercises
• Exercises include
– Use of stretches
– Resistive training for
strength
– And even cardiovascular activities such
as
• Swimming
• Pool walking
• Running on a treadmill
Topical hydro treatments
• Use warm or cold compresses
• Warm compresses help to eliminate
dull aches and pains as well as stiffness
• Cold compresses help with sharp pain
Both treatments should be used for 10-15
minutes every four hours and to comfort
levels of patient
Drink Your Water
• Remember to drink water
throughout your day in
order to stay properly
hydrated.
• Water is the main
component ion both blood
and cells of the body
• General recommendations
are to drink at least eight
glasses of water a day as
that is the amount the
body loses in a single day
General Cautions
• While hydro therapy is an important aspect in physical health, prior to any
exercise or treatment a professional should be consulted to avoid injury
• For more info and sources used visit the following links
Sources of Info
• www.spinehealth.com
•
•
http://www.holisticonline.com, Holisticonline.com is developed and maintained by ICBS, Inc.
© 1998-2003
Golanty, Eric. Health and Wellness, 5th Ed.. Jones d Brtlet Publ. Inc.1998
Pictures
•
•
www.csp.org.uk/physiotherapy/ az_conditions/w.cfm
www.findershealth.com/Hydrofloat/
Hydrotherapy Research By Jasmine Vanderwiel
Hydrotherapy
B.Nelson
What is hydrotherapy ?
• The treatment of physical disability ,injury
or illness by immersion , of all or part of the
body in water to facilitate movement
,promote wound healing, relieve pain and
maintain health
Physical properties of water
•
•
•
•
Buoyancy
Resistance
Hydrostatic pressure
Specific heat and thermal conductivity
Specific heat & thermal conductivity
• The ability of water to transfer heat rapidly
and efficiently is one of the advantages of
performing exercises in a swimming pool
that is colder than the patient’s temperature
Buoyancy
• Force experienced as an upward thrust on
the body in the opposite direction to the
force of gravity
• Submersion of the body decresaes stress
and compression on the weight bearing
joints ,muscles and connective tissue
Buoyancy cont’d
• Used to assist the therapist in supporting the
weight of the patient’s body part during
therapeutic activities
• Used to help raise a weakened part against
gravity
Resistance
• The viscosity of water provides resistance to
the motion of a body in the water
• Resistance occurs against the the direction of
movement
• Resistance increases with the speed of the
body’s movement and the frontal area of the
body part.
Hydrostatic pressure
• Pressure exerted by a fluid on the body
immersed in the fluid.
• According to Pascal’s Law a fluid exerts
equal pressure on all surfaces of a body at
rest at a given depth and the pressure
increases in proportion to the depth of the
fluid
Hydrostatic Pressure cont’d
• Immersion in water can assist in promoting
circulation and alleviating peripheral
oedema
• Greatest effect with the vertical position
Physiological effects
•
•
•
•
•
•
•
Are due to the physical properties of water
The effects are:
Cleansing
Musculoskeletal effects
Cardiovascular effects
Respiratory effects
Psychological effects
Uses of hydrotherapy
•
•
•
•
•
Superficial heating or cooling
Water exercise
Pain control
Oedema control
Wound care
Water exercise- types
•
•
•
•
•
Swimming
walking
Running
Cycle ergometry
Underwater treadmill
Uses of water exercise
•
•
•
•
•
Increase circulation
Increase muscle strength
Joint flexibility and range of movement
Improve ambulation and coordination
Improve cardiovascular and respiratory
conditioning
Specific uses of water exercise
• Orthopaedic rehabilation
• Neurological rehabilitation
• Cardiorespiratory fitness
• Exercise in water during pregnancy
Specific uses of water exercise
• Exercise induced asthma
• Age-related deficits
Uses of Hydrotherapy cont’d
• Pain control
• Oedema control
• Wound care
Adverse effects of hydrotherapy
•
•
•
•
Drowning
Infection
Hyponatremia
Aggravation of edema