aquatic therapy

Getting You Back in the Swim

By Michael Vogel, PT, MPT, Therapy Services, Advocate BroMenn Medical Center

ften after an injury or surgery, a persons sensitivity to pain is increased, while weight bearing is limited. This may restrict the persons level of land-based activity. The inability to tolerate landbased activity may also be true for someone recovering from a serious illness or chronic condition. Aquatic therapy therapeutic exercises performed in water is a good option in these situations, or even for someone just starting an exercise program. Aquatic therapy is administered in a specially designed pool. Aquatic physical and occupational therapy complements traditional, land-based therapy programs. Treatment is provided by a licensed physical therapist or occupational therapist. In water, the effects of gravity are reduced, but functional activity and motion can still occur. The properties of water allow for the patient to exercise in a relatively low or no impact environment that provides more comfortable movement and enhanced range of motion. Water supports the body, reduces joint stress, and provides resistance and assistance to movement in a truly unique manner. Patients can rapidly improve mobility, strength, and function during the healing process. Water possesses unique properties such as buoyancy, viscosity, and hydrostatic pressure. These properties are used to extend the range of motion for people who may have physical injuries or illnesses. By taking advantage of the buoyant force of water, an aquatic therapy pool will eliminate up to 90 percent of an individuals body weight. For example, in collarbone-deep water, a 200-pound patient will bear only 20 pounds of weight while in the aquatic therapy pool. As a result, the patient may be able to move in ways not possible on land. Viscosity refers to the internal friction specific to fluid. This friction provides resistance with water exercise. Water resistance is often imporPage 32 Healthy Cells Magazine Bloomington September 2013

tant during strengthening exercises. Since no weights or machines are involved, this form of resistance is uniquely safe and effective. Water exerts pressure on an object that is immersed in the water. Pressure is greater at deeper depths. This pressure benefits patients who may have swelling in the legs and ankles. It also reduces the perception of pain, which allows the patient to move willingly and correctly. This, in conjunction with therapeutic warm water, allows for substantially decreased joint compression and pain. Once in warm, soothing water: Range of motion increases Water resistance helps to strengthen muscles and reinforce balance  Water resistance automatically creates an easy or hard workout based on energy exertion Muscle spasms decrease Pain sensitivity decreases Exercises are more enjoyable Patients exercise at their own comfort level

The following conditions are ideal for treatment in the aquatic therapy environment: Arthritis Fibromyalgia Neck, shoulder, back, knee, or ankle injuries Rehabilitation following surgery Chronic pain Sports and work-related injuries Benefits of aquatic physical or occupational therapy: Accelerated rehabilitation Protects joints during exercise Reduces stress Decreased swelling Trunk stabilization Improved gait or postural deviations Increased circulation Increased strength and endurance Increased range of motion and flexibility Increased balance and coordination Increased muscle tone  Improved body mechanics with work and daily activities to avoid re-injury The best aquatic therapy pools have the following features:  R esistive swim jets. These jets are essential for rehabilitation, resistance exercises, physical training, and swimming-in-place.

Harnessing the force of the water jet into a focused stream creates a deep, wide band of pressure for therapeutic massage. This increases flexibility, decreases recovery times, and strengthens and heals injured tissue through improved circulation. A controllable water current provides the proper amount of resistance or assistance for each individual patients needs. Underwater treadmill that is integrated seamlessly into the pool floor Full handicapped accessibility, including chair lift Easy access stairs (no ladder) in/out of pool 92 degree water temperature Locker rooms with showers A physicians referral is required to participate in aquatic physical or occupational therapy. Each aquatic therapy session is individually designed to meet the patients needs and uses different equipment depending on the nature of the condition. A pool session may last from 30 to 60 minutes, and patients do not have to know how to swim to participate. Patients work one-on-one with their therapist and are never left unattended while in the pool. Patients of all ages may participate in aquatic physical or occupational therapy. Aquatic therapy is available at the Advocate BroMenn Outpatient Center, 3024 E. Empire Street, Bloomington. For more information, contact Advocate BroMenn Therapy Services, 309-556-7900, or visit www.advocatehealth.com/bromenn/aquatic-therapy.

September 2013 Bloomington Healthy Cells Magazine Page 33