ORS AQUATIC

–ºcan limit the effectiveness of any immersed activity. â–ºFearful patients often experience increased symptoms during and after immersion because of muscle guarding, stress response, and improper form with exercise. â–ºOften patients require an orientation period designed to provide instruction regarding the effects of immersion on balance, control of the immersed body, and proper use of flotation devices.

–ºAtaxic patients may experience increased difficulty controlling purposeful movements. â–ºPatients with heat-intolerant multiple sclerosis may fatigue with immersion in temperatures greater than 33°C. â–ºPatients with controlled epilepsy require close monitoring during immersed treatment and must be compliant with medication prior to treatment.

–ºWater immersion may adversely affect the breathing of the patient with a respiratory disorder. â–ºLung expansion tends to be inhibited due to hydrostatic pressure against the chest wall. â–ºIncreased circulation in the chest cavity may further inhibit lung expansion due to increased circulation to the center of the body. â–ºMaximal oxygen uptake is lower during most forms of water exercise than during land exercise

–ºPatients with angina, abnormal blood pressure, heart disease, or compromised pump mechanisms also require close monitoring.

May be covered by waterproof dressings. â–ºPatients with intravenous lines, Hickman lines, and other open lines require proper clamping and fixation. â–ºPrecautions should also be exercised with patients having G-tubes and suprapubic appliances. â–ºObservation for adverse reactions to aquatic therapy is essential.

–ºis the upward force that works opposite to gravity.

Is the pressure exerted by the water on immersed objects.

is friction occurring between molecules of liquid resulting in resistance to flow.

The surface of a fluid acts as a membrane under tension. â–ºSurface tension is measured as force per unit length.

–ºStates that an immersed body experiences upward thrust equal to the volume of liquid displaced.

–ºstates that the pressure exerted by fluid on an immersed object is equal on all surfaces of the object. â–ºAs the density of water and depth of immersion increase, so does hydrostatic pressure.

Movement in which all molecules move parallel to each other, typically slow movement.

Movement in which molecules do not move parallel to each other, typically faster movements.

The cumulative effects of turbulence and fluid viscosity acting on an object in motion.

–ºAs the speed of movement through water increases, resistance to motion increases. 1. Moving water past the patient requires the patient to work harder to maintain his or her position in pool.

–ºWater temperature has an effect on the body and, therefore, on performance in an aquatic environment.

Is the amount of heat (calories) required to raise the temperature of 1 gram of substance by 1°C.

Water conducts temperature 25 times faster than air. 2. Heat transfer increases with velocity. A patient moving through the water loses body temperature faster than an immersed patient at rest.

Is the reference point of an immersed object on which buoyant (vertical) forces of fluid predictably act. Rather than center of gravity, affects the body in an aquatic environment.

–ºA patient’s impairments and the intervention goals determine the water temperature selection. â–ºIn general, utilize cooler temperatures for higher-intensity exercise and utilize warmer temperatures for mobility and flexibility exercise and for muscle relaxation. â–ºThe ambient air temperature should be 3°C higher than the water temperature for patient comfort. â–º Incorrect water or ambient air temperature selection may adversely affect a patient’s ability to tolerate or maintain immersed exercise.

During immersed exercise differs from that during land exercise because of alterations in temperature conduction and the body’s ability to dissipate heat. ► With immersion there is less skin exposed to air, resulting in less opportunity to dissipate heat through normal sweating mechanisms.

1.Aquatic exercises, including flexibility, strengthening, gait training, and relaxation, may be performed in temperatures between 26°C and 35°C. Therapeutic exercise performed in warm water (33°C) may be beneficial for patients with acute painful musculoskeletal injuries because of the effects of relaxation, elevated pain threshold, and decreased muscle spasm.

1.Aquatic exercises, including flexibility, strengthening, gait training, and relaxation, may be performed in temperatures

Should be performed in water temperatures between 26°C and 28°C. ► This range maximizes exercise efficiency, increases stroke volume, and decreases heart rate.

Cardiovascular training and aerobic exercise should be performed in water temperatures between

Intense aerobic training performed above 80% of a patient’s maximum heart rate should take place in temperatures between

Considered as high water temperature

Considered as low water temperature

–ºvary in shape and size. â–ºThe rooms in which pools are housed need to be adequately ventilated to avoid the accumulation of condensation on walls, windows, and floors. â–ºA dressing room should be provided for changing clothes and showering.

–ºmeasure at least 100 feet in length and 25 feet in width. â–ºDepth usually begins at 3 to 4 feet with a sloping bottom, progressing to 9 or 10 feet. â–  This larger type pool may be used for groups of patients and the therapists conducting the session while in the pool.

These self-contained pools are entered via a door or one to two steps on the side of the unit. â–  The therapist provides instructions or cueing from outside the unit. â–  In addition to built-in filtration systems, these units may include treadmills, adjustable currents, and varying water depths.

–ºEquipment designed to assist with patient positioning by providing buoyancy assistance can be applied to the neck, extremities, or trunk.

–ºBuoyant dumbbells are available in short and long lengths. â–ºThey are useful for supporting the upper body or trunk in upright positions and the lower extremities in the supine or prone positions

–ºThese devices are not buoyant and, therefore, only resist motion in the direction of movement.

Feet during lower extremity motions generates resistance by increasing the surface area moving through the water.

A versatile and effective aquatic tool for augmenting any exercise program. May be used to provide buoyancy in the prone or supine positions, create resistance to walking patterns in shallow water when held vertically, or used to challenge seated, kneeling, or standing balance in the deep water

Are used for the supine patient to support the neck and maintain the head out of the water

Come in various sizes and are used to support the extremities in any immersed position

Are used at the wrists and ankles during manual techniques to assist with patient positioning and relaxation.

Are used to position patients supine, prone, or vertically for shallow and deep water activities.

Describes the orientation of the practitioner to the patient.

Includes buoyancy-assisted (BA) seated or upright positioning and buoyancy-supported (BS) supine positioning.

Which stabilizes the patient, is typically the same (ipsilateral) hand as the patient’s affected extremity, and it is positioned proximally on the affected extremity.

Which guides the patient’s extremity through the desired motion and applies the stretch force, is typically the opposite (contralateral) hand as the patient’s affected extremity and is positioned distally.

Describes the motion of the movement hand.