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What are the inherent physical properties of water?
- hydrostatic pressure
What is an upward thrust that acts in the opposite direction to the force of gravity?
What are the therapeutic benefits of buoyancy?
- decreases the effects of gravity
- decreased jt compression forces
- decreased weight bearing
With buoyancy, what % of weight bearing is the ASIS, xiphoid, and C7?
- ASIS= 50%
- xiphoid= 30%
- C7= 10%
When the water is helping with stretching, what type of buoyancy is it?
When pushing against the water, what type of buyoancy is it?
What occurs with supportive buoyancy?
- dereased pressure of jts
- makes the pt more comfortable, and decreases pain
With buoyancy supporting, and neurological reflexes, what tyoe of buoyancy is occuring?
What are some possible problems with bouyancy?
- may be difficult for the therapist to remain in a fixed position
- may be difficult to stabilize pt
- flaccid LE may float (may need weight)
What is hydrostatic pressure?
pressure exerted by the molecules of a fluid upon an immersed body
with increased depth, the amt of pressure on the body increases
stabilizing mm. have to work harder to hold the body still
Hydrostatic pressure is good for what?
edema and pain
What are some therapeutic benefits to hydrostatic pressure?
- decreases swelling with increased pressure
- offsets tendency of blood to pool in the LEs
- ehances proprioception
- eases pain thru constant support of the jts
- helps build up mm. of inspiration and assists with exhalation
What are some problems related to hydrostatic pressure?
- pts with vital capacity less than 1500ml may have difficulty breathing due to increased resistance to chest expansion
- pts may c/o or feel anxious about pressure on their chests
What is the type of resistance that occurs between the molecules of a liquid and how it may flow?
viscosity .. thickness
As temperature rises, what happens to the viscosity of the water?
water will have less viscosity
resistance is felt throughout the entire ROM
water has 790 times greater viscosity than air
What are some therapeutic benefits of viscosity?
- provides resistance to mvmt - resistance increases with speed of mvmt or wider surface areas in the water
- resistance drops to 0 the instance the force/effort stops
- allows increased time of response for pts equilibrium reactions
- safer for pts with decreased balance
What are the types of turbulence and hydrodynamic forces?
- streamlined flow- continous, steady mvmt of a fluid
- turbulent flow- irregular mvmt of a fluid with mvmt varying at any fixed point
- causes impedance and drag
- resistance is greater than streamline flow
What are some therapeutic benefits of turbulence?
- provides resistance to mvmt- increases when object is streamlined
- can use to treat balance problems
- can use it to provided more challenging trunk stabilization activities
What is the bending of light as it passes from a more dense to less dense medium?
causes objects and extremities to appear 25% larger and 25% closer to the surface than they are (leads to confusion about body position)
Why might reflection be a problem?
if pt is very sensitive to light, or prone to seizures
some pts may get motion sickness by watching the water
What are some physiological effects of the circulatory system from warm water?
- increased circulation
- increased stroke volume
- increased cardiac output (without increased HR)
*HR decreases in warm water, use 10bmp less resting HR than on land
What are some physiological effects of the pulmonary system from warm water?
- lung/breathing capacity
- vital capacity
- depth of ventilation
- efficiency of oxygen uptake
total work of breathing increases about 60% with submersion to the neck
*aquatics is good if you need to work on breathing, but bad if you cant handle it
What are some physiological effects of the musculoskeletal system in warm water?
- hydrostatic pressure decreases edema
- increased flexibility
- decreases abnormal tone, spasticity, muscle guarding (ish)
- decreased jt pressure
- increased muscular strength and stamina
- improved trunk/head stability and alignment
- blood supply to mm. significantly increased (improves oxygen delivery to mm. and improved removal of muscle lactate and other metabolic end products)
What type of water do neuro pts work best in?
What physiological effects does warm water have on the renal system?
- sodium excretion increases up to 10 times normal
- increase in central blood volume stimulates volume receptors which cases a decrease in ADH; this leads to diuresis
What are some things you should watch for while doing aquatics?
- increased body temp
- easy to over exert
- chlorine and bromine can cause skin and respiratory problems
- some ppl are sensitive to chemicals
What are absolute contraindications of aquatics?
- uncontrolled epileptic pts
- fever exceeding 100
- open wounds/skin infections
- severe cardiopulmonary conditions
What are some relative contraindications of aquatics?
- infectious diseases
- water phobia
- external fixator
- urinary infections
- severe weakness
- allergies to pool chemicals
What are some precautions to aquatics?
- difficulty maintaining BP
- selective cardiac pts
- acute CVA/TBI
- severe vestibular deficits
- absent cough reflex
What should the air temp and pH levels of the pool be?
pH= 7.2 and 7.5
What is the ideal water temp for the pool?
What are some types of equipment used in the pool?
resistance- gloves, paddles, dumbells, kickboards, ankle/foot cuffs
float- noodles., belts, aquajoggers, life jackets
increase ROM- noodles, cuffs, dumbells
Who may benefit from aquatics?
- orthopedic, neurological, circulatory problems, loss of ROM, strength, flexibility, endurance
- neuro, back, CP, fibromyalgia, jt pain, RSD
What are some ways to challange balance/trunk stabilization?
- put pt in deeper water (shoulder level)
- add upper/lower extremity involvement, progressing the amt of resistance
- increase amt of turbulence
- decrease amt of support in deeper end
- challanging their BOS (feet wider)
What would you like to do?
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