Hydrotherapy

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HYDROTHERAPY

ELECTROTHERAPY
HYDRO THERAPY

• HYDROTHERAPY ALSO KNOWN AQUATIC THERAPY

• USED AS AN MODALITY FOR REHABILITATION

• HYDRO THERAPY USE AS OF WATER IN ANY OF ITS THREE


FORMS TO TREAT DISEASES AND TRAUMA & PAIN
MANAGEMENT.
HYDRODYNAMICAL PRINCIPLES

1. RELATIVE DENSITY.
2. METACENTER.
3. TURBULENCE.
4. HYDRO STATIC PRESSURE.
RELATIVE DENSITY.
• DENSITY OF A SUBSTANCE IS THE MASS PER UNIT VOLUME OF A
GIVEN SUBSTANCE.

• RELATIVE DENSITY OF A SUBSTANCE IS THE RATIO OF THE


DENSITY OF SUBSTANCE TO THE DENSITY OF WATER.
.
IF A SUBSTANCE'S RELATIVE DENSITY IS LESS THAN ONE
THEN IT IS LESS DENSE THAN THE REFERENCE
AND WILL FLOAT IN WATER.
(AN ICE CUBE, WITH A RELATIVE DENSITY OF ABOUT 0.91, WILL
FLOAT)

IF GREATER THAN 1
THEN IT IS DENSER THAN THE REFERENCE
AND WILL SINK.
.

YOUNG CHILD HAVE TOTAL RELATIVE DENSITY APPROX. 0.86


IN ADOLESCENCE AND EARLY ADULTHOOD IT INCREASES UP TO 0.97
LATER IN LIFE BODY TENDS TO ACQUIRE MORE ADIPOSE TISSUE AND THE RELATIVE
DENSITY TENDS TOWARDS 0.86

• INDIVIDUALLY EVERY PART AND EVERY TISSUE HAS ITS OWN RELATIVE DENSITY.

• UPPER LIMBS ARE LESS DENSE THAN LOWER LIMBS.

• SO, THE UPPER LIMB FLOATS MORE EASILY.


• IN PARAPLEGIA AND GBS. ADVANTAGES CAN BE TAKEN.
METACENTRE
• METACENTER CONCERNED WITH BALANCE IN WATER.

• TWO FORCES BUOYANCY AND GRAVITY ARE RESPONSIBLE FOR BALANCE.


• METACENTRE IS THE POINT WHERE LINE OF GRAVITY AND LINE OF BUOYANCY
MEET.

• ANY MOVEMENT OF THE LIMBS, TRUNK AND HEAD WHICH ALTERS THE BODY
SHAPE WHETHER ABOVE OR BELOW THE SURFACE PRODUCE ROTATIONAL EFFECT.

• OFFLOAD PRESSURE ON THE JOINTS


• IMMERSION TO NECK LEVEL, 7KG COMPRESSIVE FORCE ON SPINE, HIPS AND KNEES
• BUOYANCY COUNTERBALANCES THE EFFECT OF GRAVITY FORCE DURING
FLOATING
.
HYDROSTATIC PRESSURE
• PASCAL’S LAW STATES THAT FLUID PRESSURE IS EXERTED EQUALLY AT ANY LEVEL
IN A HORIZONTAL DIRECTION.

• THAT PRESSURE IS EQUAL AT A CONSTANT DEPTH.

• AN IMMERSED BODY HAS FLUID PRESSURE EXERTED ON ALL SURFACES WHEN AT


REST AT A GIVEN DEPTH.

• PRESSURE INCREASES WITH DEPTH AND WITH THE DENSITY OF THE FLUID.

• INCREASED PRESSURE AT GREATER DEPTHS MAY BE USED TO REDUCE SWELLING


EFFECTIVELY, IF THE PART TREATED IN AS DEEP AS POSSIBLE.

• IT IS DIRECTLY PROPORTIONAL TO BOTH LIQUID DENSITY AND DEPTH OF


IMMERSION.
TURBULENCE

• TURBULENCE IS THE TERM WHICH DENOTES THE EDDIES THAT FOLLOW IN THE
WAVE OF AN OBJECT MOVING THROUGH A FLUID.
• SINCE ANY MOVEMENT CREATES TURBULENCE MAY BE USED IN
HYDROTHERAPY TO ASSIST AND RESIST MOVEMENT.

• TOTAL ENERGY OF A PARTICLE OF WATER AT ANY MOMENT IS THE SUM OF ITS


ENERGIES.
I) PRESSURE ENERGY.
II) POTENTIAL ENERGY.
III) KINETIC ENERGY.
.
METHODS OF APPLICATION

NON-IMMERSION IMMERSION
TECHNIQUE TECHNIQUE
• HOT PACKS • SITZ BATH
• MOIST HEAT/AIR CABINET • CONTRAST BATH
• CRYO-THERAPY • WHIRL POOL BATH
• SUANA AND JACUZZI • POOL THERAPY
SITZ BATH
SITZ BATH

HOT SITZ COLD SITZ


• 40.5 – 46°C (2-10 MINS)
• 1.7 - 24 °C (2-10 MINS)
• REDUCE PAIN
• INC TONE OF MUSCLES
• INCREASE CIRCULATION IN (IN ATONIC CONSTIPATION)
PELVIC AREA

• ENHANCE TISSUE HEALING • REDUCE UTERINE


IN POST PREGNANCY/
BLEEDING
HYSTERECTOMY
CONTRAST BATH

• HOT BATH – 38-40 DEG C


• COLD BATH – 10-16 DEG C

• HOT FOR 10 MINS. COLD 1 MIN

• HOT FOR 4 MINS. COLD 1 MIN

• HOT FOR 4 MINS. COLD 1 MIN

• HOT FOR 4 MINS. COLD 1 MIN

• FINISH WITH 5 MINUTES IN HOT WATER


WHIRL POOL BATHS
36.5 – 40.5 DEG CELSIUS
• EXTREMITY (ANKLE/FOOT/HAND)
POOL THERAPY

• POOL THERAPY COMBINES PHYSICAL FORCES OF WATER WITH THERAPEUTIC


EXERCISES

1. PROMOTE RELAXATION
2. IMPROVE CIRCULATION
3. RESTORE MOBILITY
4. STRENGTHEN MUSCLES
5. PROVIDE GAIT TRAINING WITH LESS STRESS ON WEIGHT-BEARING JOINTS
6. IMPROVE PSYCHOLOGICAL AND EMOTIONAL OUTLOOK
7. REDUCE PAIN AND MUSCLE SPASMS AND INCREASE RANGE OF MOTION
INDICATION FOR POOL
THERAPY
• PROBLEMS ARISING FROM MUSCLE WEAKNESS
• LOSS OF JOINT MOBILITY
• POOR COORDINATION OR BALANCE
• PAIN AND LACK OF CONFIDENCE
• GAIT TRAINING
MUSCULOSKELETAL
CONDITIONS
• ANKYLOSING SPONDYLITIS
• OSTEOARTHRITIS
• RHEUMATOID ARTHRITIS
• CHRONIC JUVENILE POLY ARTHRITIS
• SPONDYLOSIS
• CAPSULITIS.
• MECHANICAL SPINAL DISORDERS
• FIBRO MYALGIA.
• POST FRACTURE STIFFNESS
• ORTHOPEDIC SURGERY
NEUROLOGICAL CONDITIONS

• HEMIPLEGIA
• PARAPLEGIA
• TETRAPLEGIA
• POLY NEUROPATHY
• PARKINSON
• G B S ( GUILAIN BARRE SYNDROME)
CONTRAINDICATION

• PYOGENIC (INFECTED) WOUNDS • RADIOTHERAPY IN PREVIOUS 3


• PYREXIA( TEMP. MUST BE NORMAL MONTHS
2-3 DAYS BEFORE THERAPY)
• UN CONTROLLED OR
• INCONTINENCE
SYMPTOMATIC DIABETES
• DVT • AIDS (PATIENTS OF THIS
• RECENT PULMONARY EMBOLUS CATEGORY MAY NOT BE
TREATED WITH SKIN CUTS)
• UN-STABLE ANGINA
• HYDROPHOBIA
• C V A (NOT WITHIN 3 WEEKS) • HEPATITIS B & C
• GASTROINTESTINAL DISORDERS • CONTACT LENSES
• TRACHEOTOMY • ALLERGY TO CHLORINE
• UNCONTROLLED HYPO AND • SEVERE MENTAL
HYPERTENSION RETARDATION
PHYSIOLOGICAL EFFECTS OF
WATER
EFFECTS OF WATER ON THE RESPIRATORY SYSTEM
 HYDROSTATIC PRESSURE AGAINST THE CHEST WILL TEND TO INHIBIT LUNG
EXPANSION. ALSO, INCREASED CIRCULATION TO THE CENTER OF THE BODY
DURING IMMERSION WILL INCREASE CIRCULATION IN THE CHEST CAVITY,
FURTHER INHIBITING LUNG EXPANSION.

EFFECTS OF WATER ON RENAL FUNCTION


 WATER IMMERSION CAN AFFECT RENAL FUNCTION, RESULTING IN
INCREASED URINE OUTPUT (DIURESIS), INCREASED SODIUM EXCRETION,
AND INCREASED POTASSIUM EXCRETION.
PHYSIOLOGICAL EFFECTS

EFFECTS OF WATER ON THE NEUROLOGICAL SYSTEM


 EFFECTS OF WATER IMMERSION ON THE NEUROLOGICAL SYSTEM ARE PRIMARILY
TEMPERATURE DEPENDENT.
 WARM WATER TENDS TO BE RELAXING, WHEREAS COLD WATER TENDS TO BE INVIGORATING
OR STIMULATING.

EFFECTS OF WATER ON THE MUSCULAR SYSTEM


 DIRECT EFFECTS ON THE MUSCULAR SYSTEM ARE PROBABLY SECONDARY TO TEMPERATURE
EFFECTS, SUCH AS INCREASED MUSCULAR BLOOD FLOW SECONDARY TO IMMERSION OF A
MUSCLE IN WARM WATER.
 CLINICAL USE OF HYDROTHERAPY FOR RELAXATION OF MUSCLE SPASM MAY IN PART BE A
RESULT OF INCREASED BLOOD FLOW BY IMMERSION IN WARM WATER.
MECHANICAL EFFECTS OF
WATER
• THE FORCE OF THE WATER CAN HELP DEBRIDE LOOSE
NECROTIC TISSUE IN A WOUND AND CLEANSE THE WOUND
OF DIRT AND OTHER CONTAMINANTS.
• WATER HAS A SOFTENING EFFECT ON TISSUE, WHICH MAY
FACILITATE DEBRIDEMENT OF NECROTIC TISSUE.
• HOWEVER, WATER APPLIED TO WOUNDS MAY DAMAGE
NEW GRANULATION TISSUE, AND PROLONGED SOAKING
MAY CAUSE MACERATION OF INTACT SKIN.
TECHNIQUES OF EXERCISE IN
WATER
• BUOYANCY ASSISTED, RESISTED, SUPPORTED XS.
• BAD RAGAZ PATTERNS.
• HOLD RELAX TECHNIQUES.
BUOYANCY ASSIST MOVEMENTS IN REQUIRED RANGE
• STABILIZATION.
i. PRODUCE CO CONTRACTION OF JOINT.
ii. BALANCE AND COORDINATION.
iii. IMPROVING CIRCULATION AND MUSCLE STRENGTH.

• REPEATED CONTRACTIONS (ISOMETRIC AND ISOTONIC)


• BREATHING XS.
SAFETY PRECAUTIONS

• WATER TEMPERATURE SHOULD BE 34-37 CELSIUS


• CHLORINE LEVEL SHOULD BE 1.5-3.00 PARTS/MILLION
• WATER PH LEVEL SHOULD BE 7.2=7.8
• CHLORINE AND PH LEVEL SHOULD BE MONITORED AT THE START OF
EACH SESSION
• NON-SLIPPERY FLOOR OF THE POOL
• HAND RAILS MUST ON THE BOTH SIDES OF STEPS IN AND OUT OF THE
POOL
• EMERGENCY BELL MUST BE INSTALLED OVER THE POOL
SAFETY PRECAUTIONS

• A FOOT BATH NECESSARYAT THE ENTRY POINT IN THE POOL


• AIR TEMPERATURE SHOULD BE 25 CELSIUS
• HUMIDITY LEVEL SHOULD BE 55 %
• P.T AND SUPPORTING STAFF MUST BE TRAINED IN
EMERGENCY AND RESUSCITATION PROCEDURE
• RECOMMENDED TIME FOR PHYSIOTHERAPIST IN WATER IS
NO MORE THAN 1.5 HOUR IN WATER WITHOUT A BREAK

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