Hydrotherapy

Chapter 5

Buoyancy

Is a force that works in the opposite direction to gravity Gravity pulls downward, buoyancy pushes upward from the bottom A relative weightlessness occurs when a body is immersed in water (Amount depends on % of body below surface)

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

Hydrostatic pressure

Is pressure exerted by water on an object immersed in the water Because hydrostatic pressure is proportional to the depth of immersion, exercises are easier to perform closer to the surface of the water where the pressure is less Assists in venous return, heart rate reduction, & centralization of peripheral blood flow

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

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 shortduration exercises

Hydromechanics of water

Term used to refer to movement through water The faster the movement, the greater the resistance

Water temperature

Chart pg 141 Therapeutic warmth is considered to be 94 F, which is appropriate for performing therapeutic exercises

Equipment

Extremity tanks

Smallest tanks which holds up to 25 gallons of water

Full-body tanks; resemble a bathtub resting on the floor with enough room for pt to long-sit Hold as much as 200 gallons of water Tanks that were created to accommodate a pt in supine position, and allow range of movement in both upper & lower extremities Has lifting devices to get pt in and out of whirlpool

Low boys:

Hubbard tank:

Equipment cont.

Turbines:

Mix air & water to provide agitation & turbulence to the water Stimulation from the agitation to the skin receptors may promote an analgesic effect Turbines have adjustable; height, direction of flow, & strength of flow

Hydrotherapy treatment techniques

Additives to prevent infection

Tanks & turbines must be thoroughly cleaned in between pts Most common agents used to prevent or reduce chances of infection are providone-iodine, chloramines-T, & bleach Important to run turbine with disinfectant agent in water

Aquatic pools & infection control

Water not emptied from pool following every patient Recommendations

Pts shower before entering pool to remove excess soil Have filtration system that is chlorinated Do not use with pts who are incontinent Do not use with pts with open wounds

Deep water exercises

Open chain exercises are performed here Buoyancy-assistive devices can be worn to help pt maintain an upright posture in water

Middle-level to shallow-level exercises

Promotes some weight bearing Considered closed-chain exercises Pain with exercises can be minimized

Bad Ragaz techniques

Uses a buoyant ring to assist the patient in floating in the water Ring may be placed around the trunk, under the extremities, or may support the head and neck

Debridement

Is the rapid removal of necrotic & devitalized tissue to allow reepithelialization & granulation Necrotic & devitalized tissue impedes granulation & prevents or slows migration of epithelial cells across the wound This tissue delays healing & provides potential for bacterial growth Hydrotherapy can be utilized to debride, soften, & loosen adherent tissue

Hydrotherapy for wound care

Cleansing

Removes dirt, foreign bodies, exudates, or residue from topical agents & bacteria Provides a moist wound bed that will proceed more rapidly through the phases of healing Increased circulation obtained with hydrotherapy is the result of thermal effects

Hydration

Circulatory stimulation

Hydrotherapy for wound care cont.

Analgesia & sedation

Mechanical stimulation of skin receptors can assist in decreasing pain Thermal effects also assist Assess for: color, edema, temp, areas of pain or sensory changes, & pulses
Document & describe: location, size, shape, margins, exudates Most frequently used bactericidal additives are betadine, salt, and chlorazine

Condition of surrounding tissues

Description of wound:

Additives to whirlpool: