use of water that facilitates the application of established therapeutic interventions

Therapeutic interventions established in aquatic exercise

Goal of aquatic exercise is to enhance delivery of manual techniques

Goal of aquatic exercise is to provide four dimensional access to the patient

Goal of aquatic exercise is to initiate functional activity replication

Upward force that works opposite to gravity

Archimedes principle

Weightlessness

Resistance to movement against the force of bouyancy

Body composition and bone density

3D access to patient

Increased with fully inflated lungs, decreased with deflated lungs

C7 percentage of weight bearing immersion depths

Xiphoid process percentage of weight bearing immersion depths

ASIS percentage of weight bearing immersion depths

Pressure exerted by the water in immersed objects

Pascal’s law

An immersed body experiences upward thrust equal to the volume of liquid displaced

Pressure exerted by fluid on an immersed object is equal on all surfaces of the object

As the density of water and depth if immersion increase, so does hydrostatic pressure

Proportionality of depth and pressure allows patients to perform exercise more easily when closer to the surface

Hydrostatic pressure

Friction occuring between molecules of liquid resulting in the resistance to flow

Resistance from this is proportional to the velocity of movement through liquid

the higher the velocity of movement, the higher the resistance

the higher the surface area moving through water the higher the resistance

The surface of a liquid acts as a membrane under tension

Measured as force per unit length

The attraction of surface molecules is parallel to the surface

The resistive force changes proportionally to the size of the object moving through the fluid surface

An extremity that moves through the surface performs more work than if kept under water

Using equipment at the surface of the water increases the resistance

Comprise the physical properties and characteristics of fluid in motion

Laminar flow

Turbulent flow

DRAG

Molecules move parallel to each other

Slow

Molecules do not move parallel to each other

Faster

Cumulative effects of turbulence and fluid viscosity acting on an object in motion

As the speed of movement through water increases, resistance motion increases

Moving water past the patient requires the patient to work harder to maintain his or her position in pool

Application if equipment decreases drag

Rate of temperature change is dependent on the mass and the specific heat of the object

Water retains heat 1,000 times more than air

Differences in temperature between an immersed object and water equilibrate with minimal change in the temperature of the water

Amount of hear required to raise the temperature of 1 gram of substance by 1 celsius

Water conducts temperature 25 times faster than air

Specific heat

Temperature transfer

Heat transfer decreases with velocity. A patient moving through the water loses body temperature faster than an immersed patient at rest.

Reference point of an immersed objects on which bouyant (vertical) forces of fluid predictably act

Vertical forces that intersect the center of bouyancy create rotational motion

Center of bouyancy: in vertical position, the human center is located at the

In vertical position, posteriorly placed bouyancy devices cause the patient to lean _________; anterior buoyancy causes the patient to lean ________

During unilateral manual resistance exercises, the patient revolves around the practitioner in a ____________ motion

Patients bearing weight on the floor of the pool experience aspects of both the center of ______ and center of _______.

A patient with a unilateral lower extremity amputation leans toward the residual limb side when in a vertical position

Patient’s impairments and the intervention goals determine the temperature selection

Highter intensity exercises

Mobility, flexibility and muscle relaxations

Ambient temp should be ___ degrees celsius higher than the water temp

Water conducts heat 25x faster than the air

Small changes in air temp ate perceived more profoundly than small changes in water temp

Exercise at temps greater than 37 degrees celsius may be harmful if prolonged or maintained at high intensities

Pts are unable to maintain adequate core warmth during immersed exercise at temps less than 35 degrees celsius

At temperatures greater than or equal ti 27 deg c, cardiac output increases significantly at rest alone. In waist deep water exercise at 37 deg c, thermal stimulus to increase the heart rate overcomes the centralization of peripheral blood flow due to hydrostatic pressure

Temp range of performing aquatic exercises

Temp beneficial for patients with acute painful musculoskeletal injuries because of the effects of relaxation, elevated pain threshold, and decreased muscle spasm

Cardiovascular training and aerobic exercise water temp

Thus range maximizes exercise efficiency, increases stroke volume and does not elevate the heart rate to the extent that warmer water does

Intense aerobic training water temp to minimize risk of heat illness

100 ft in length and 25 ft in width. Depth usually begins at 3-4 feet with a sloping bottom, progressing to 9 or 10 feet

May be used for groups of patients and the therapists conducting the session

Entrance to larger therapeutic pools include ramps, stairs, ladders or mechanical overhead lifts

Have built in chlorination and filtration systems

Usually smaller, self contained units

Entered via a door or one to two steps on the side of the unit

Therapist provides instructions or cueing from outside the unit

In addition to built in filtration systems; these units may include treadmills, adjustable currents, and varying water depths

Equipment for swimming

Therapeutic pools require regular care and cleaning to avoid

Frequent use of pool increases the total organic carbon as well as ammonia and organic nitrogen found in the pool

Cleaning should be done at least

Chlorine and pH level tests should be done

Precautions

Tracheostomies

Ataxia

Multiple sclerosis (>33 deg)

Controlled epilepsy

Angina

Abnormal BP

Heart disease

Compromised pump mechanism

CHF & type 2 DM

Vital capacity of less than 1 liter

Cardiac failure

Tinea pedis

Ringworm