Multiple Sclerosis (MS)
and Aquatic Therapy
Tiffany Dean
Temple University
Therapeutic Recreation Major
Tiffany.dean@temple.edu
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Learning Outcomes
S Define Multiple Sclerosis (MS) and describe the effects it
causes.
S Explain ways in which Aquatic Therapy is beneficial for
individuals with Multiple Sclerosis
S Identify Precautions that should be considered before an
individual with MS participates in Aquatic Therapy.
Overview of Multiple Sclerosis
S Multiple sclerosis (MS) is a chronic autoimmune
disorder affecting movement, sensation, and bodily
functions. It is caused by destruction of the myelin
insulation covering nerve fibers (neurons) in the central
nervous system (brain and spinal cord).
S “Most common cause of neurological disability in young
& middle aged adults affecting an estimated 400,000
people in the U.S.” (Salem, et al, 2011).
Types & Symptoms of MS
Types
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RelapsingRemitting Pattern
Primary Progressive
Pattern
Secondary
Progressive Pattern
ProgressiveRelapsing Pattern
Symptoms
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visual disturbances
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sensation in extremities
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weakness or clumsiness in leg
or hand
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Spasticity
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Difficulty with bladder
control
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Vertigo
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Gait disturbances
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Stiffness
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Fatigue of limbs
Overview of Aquatic Therapy
S Aquatic therapy is a form of physical
therapy that is performed in a pool.
S The goal of this particular form of
therapy is to assist in restoring the
person's strength and movement
through the use of buoyancy, resistance,
and heat.
S It aims to rehabilitate patients after
injury or those with chronic illness.
http://www.youtube.com/watch?v
=bZQUYaG0Zqc
Types of Aquatic Activity
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Balance exercises
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Relaxation and stretching
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Ai Chi (Water Tai Chi)
Halliwick techniques
Stretching
Ai chi
Aquatic body work: Watsu,
Jahara, or Healing Dance
Strengthening exercises
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S
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Deep or shallow water techniques
Bad Ragaz Ring Method
Use of drag or resistance equipment
Sample Aquatic Exercises
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Marching—stand with your side to the pool wall. Hold onto the wall if needed for
balance. Lift one leg up and down, then the other. Repeat 5 to 8 times.
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Side leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if
needed for balance. Lift leg out to the side 5 to 8 times. Do the other leg.
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Back leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if
needed for balance. Lift leg straight back 5 to 8 times. DO NOT arch the back. Do the
other leg.
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Runner's stretch—stand facing the side of the pool. Hold the edge of pool for balance.
Step one leg back. Both feet flat on floor. Keep the heel of the back leg on the floor.
Bend the knee of the forward leg. Lean forward from the ankles. You should feel a
stretch in the lower leg or calf muscles. Hold for 20-30 seconds. Do 1 to 2 times. Switch
legs.
Equipment for Aquatic Therapy
S Flotation devices
S Ankle weights
S Water barbells
S Kickboards
S Water shoes
S Therapy bars
Benefits for Individuals with MS
Water Quality
Benefit
Buoyancy: The feeling of being lighter in the
water; of floating.
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Provides support for weak limbs.
Movement takes less effort. A greater range
of motion can be achieved.
Promotes muscle relaxation.
Viscosity: The sensation that there is resistance to
your movements; that you move slower through
the water.
• The resistance of water can be used to improve
muscle strength.
• Slower movement in water provides an
opportunity to work on skills such as balance
and coordination which may be harder to do
on land.
Hydrostatic pressure: The sensation of
compression while the body is in the water.
Pressure increases with depth.
•
Compression can provide support for
standing activities, such as walking, with less
effort than on land.
Temperature Control
•
Cooler water can help maintain lower core
body temperature even during vigorous
activity. This is especially helpful for people
with heat sensitivity issues.
Other Benefits…
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Decreases stress
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Pain relief
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Improved flexibility
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Ease depression
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Boost self-esteem
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Improved posture
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Increased circulation
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Increased cardiovascular functioning
Research Study
S Conducted by Physical Therapy Departments of Long Island
University & Hunter College in 2011
S Purpose: to examine the effects of group aquatic exercise in
individuals with MS.
S Methods: 11 participants, 5-week program, 2/wk for 1hr
S Results: Improved gait speed, grip strength, muscle strength,
walking speed, balance, & mobility
S Conclusion: Aquatic Therapy is beneficial in improvement in
motor functioning of individuals with MS.
Precautions
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Bowel incontinence with firm stools
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Communicable diseases (cold flu,
Hepatitis)
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Autonomic dysreflexia
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Sensitivity to disinfection chemicals
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Sensitivity to heat/ humidity
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Rashes, skin conditions with flaking or
open areas
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Hydrophobia
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Controlled seizures,
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Open wounds
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Compromised immune system
Interested in Aquatic Therapy
Certification?
S Aquatic Therapy & Rehab
Institute (ATRI)
S How to get started
http://www.atri.org/How%20to%20Get
%20Started12.pdf
S ATRI Certification
S Membership $45
Resources
Butler, C. (2002). Walking in Water. Inside MS, 20(3), 66.
Chamberlayne, N. (2006). Come on in, the water's fine!. Inside MS, 24(4), 34-35.
Merck Manual Staff (2013). Overview of Multiple Sclerosis. Accessed via
www.merckmanuals.com/professional/neurologic_disorders/demyelinating_disorders/mult
iple_sclerosis_ms.html?qt=muliple%20sclerosis&alt=sh
Salem, Y., Scott, A., Karpatkin, H., Concert, G., Haller, L., Kaminsky, E., & ... Spatz, E.
(2011). Community-based group aquatic programme for individuals with multiple sclerosis:
a pilot study. Disability & Rehabilitation, 33(9), 720-728. doi:10.3109/09638288.2010.507855
Weiss, Thomas C. (2010). Aquatic Therapy- Facts and Information. Accessed via
http://www.disabled-world.com/medical/rehabilitation/therapy/aquatic-therapy.php
Using Aquatic Therapy to treat individuals with
Multiple Sclerosis
“If I could live in the water, I would.” –Mary Ann Lee.
Tiffany Dean
Temple University
tiffany.dean@temple.edu
Overview of Aquatic
Therapy
•Aquatic therapy is a form of
physical therapy that is
performed in a pool.
Benefits of
Aquatic Therapy
•The goal of this particular
form of therapy is to assist in
restoring the person's strength
and movement through the
use of buoyancy, resistance,
and heat.
Improved muscle
strength
•
Improved walking
speed
•
Enhanced balance
& coordination
•
Decreases stress
•
Pain relief
•
Improved motion
•
Improved
flexibility
•
Promotes muscle
relaxation
•
Ease depression
•
Boost self esteem
•Types of Aquatic Therapy
include: Ai Chi, Halliwick
Method, Watsu, Bad Ragaz
Ring Method, etc.
•
Resources:
Americans w/ Disabilities Act
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www.ada.gov
The National MS Society
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www.nationalmssociety.org/index.aspx
Moss Rehab www.mossrehab.com
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ATI Physical Therapy
www.atipt.com
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Oxford Rehab Center
www.oxfordrehab.com
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ATRI Certification www.atri.org
ATRA's Aquatic Therapy Treatment
Network www.atra-tr.org
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Aquatic Resources Network
www.aquaticnet.com
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http://recreationtherapy.com/article
s/aquaticstherapy.htm
Just so you
know…
• Aquatic Therapy
Certification will look
great on your resume!
• Aquatic Therapy
has the power to
change someone’s
life!