Aquatic therapy

For immersion, hot/cold, and pressure application of water, see Hydrotherapy.

Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, and Watsu. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.

Overview

Aquatic therapy refers to water-based treatments or exercises of therapeutic intent, in particular for relaxation, fitness, and physical rehabilitation. Treatments and exercises are performed while floating, partially submerged, or fully submerged in water. Many aquatic therapy procedures require constant attendance by a trained therapist, and are performed in a specialized temperature-controlled pool. Rehabilitation commonly focuses on improving the physical function associated with illness, injury, or disability.[1][2]

Aquatic therapy encompasses a broad set of approaches and techniques, including aquatic exercise, physical therapy, aquatic bodywork, and other movement-based therapy in water (hydrokinesiotherapy). Treatment may be passive, involving a therapist or giver and a patient or receiver, or active, involving self-generated body positions, movement, or exercise. Examples include Halliwick Aquatic Therapy, Bad Ragaz Ring Method, Watsu, and Ai chi.[1]

For orthopedic rehabilitation, aquatic therapy is considered to be synonymous with therapeutic aquatic exercise, aqua therapy, aquatic rehabilitation, water therapy, and pool therapy. Aquatic therapy can support restoration of function for many areas of orthopedics, including sports medicine, work conditioning, joint arthroplasty, and back rehabilitation programs. A strong aquatic component is especially beneficial for therapy programs where limited or non-weight bearing is desirable and where normal functioning is limited by inflammation, pain, guarding, muscle spasm, and limited range of motion (ROM). Water provides a controllable environment for reeducation of weak muscles and skill development for neurological and neuromuscular impairment, acute orthopedic or neuromuscular injury, rheumatological disease, or recovery from recent surgery.[3]:1

Various properties of water contribute to therapeutic effects, including the ability to use water for resistance in place of gravity or weights; thermal stability that permits maintenance of near-constant temperature; hydrostatic pressure that supports and stabilizes, and that influences heart and lung function; buoyancy that permits floatation and reduces the effects of gravity; and turbulence and wave propagation that allow gentle manipulation and movement.[4]

Techniques

Techniques for aquatic therapy include the following:[1][5]

Applications and effectiveness

Applications of aquatic therapy include neurological disorders,[14] spine pain,[15] musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.[1]

A 2006 systematic review of effects of aquatic interventions in children with neuromotor impairments found "substantial lack of evidence-based research evaluating the specific effects of aquatic interventions in this population".[16]

Professional training and certification

Aquatic therapy is performed by diverse professionals with specific training and certification requirements.

For medical purposes, aquatic therapy, as defined by the American Medical Association (AMA), can be performed by various legally-regulated healthcare professionals who have scopes of practice that permit them to offer such services and who are permitted to use AMA Current Procedural Terminology (CPT) codes.[17]

References

  1. 1.0 1.1 1.2 1.3 Becker, BE and Cole, AJ (eds). 2011. Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  2. "How physiotherapy works". NHS Choices. 14 May 2012. Retrieved March 2014.
  3. Koury JM. 1996. Aquatic therapy programming: guidelines for orthopedic rehabilitation. Human Kinetics. ISBN 0-87322-971-1.
  4. Becker, BE. 2011. Biophysical aspects of hydrotherapy. pp 23-75. Chapter 2 In Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  5. 5.0 5.1 Audette JF and Bailey A. 2008. Integrative pain medicine: the science and practice of complementary and alternative medicine in pain management. Humana Press. ISBN 978-1588297860.
  6. 6.0 6.1 Lambeck J and Bommer A. 2011. Ai Chi: applications in clinical practice. pp 171-192, Chapter 7 In: Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  7. Wilder, RP and Brennan DK. 2011. Aqua running. pp 155-170, Chapter 6 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  8. 8.0 8.1 Dutton M. 2011. Orthopaedics for the physical therapist assistant. Jones & Bartlett Learning. ISBN 978-0763797553.
  9. Ainslie T. 2012. The concise guide to physiotherapy - 2-volume set: Assessment and Treatment. pp 1096-1106, Bad Ragaz Ring Method. Elsevier Health Sciences. ISBN 9780702053030.
  10. McAtee RE and Charland J. 2007. Facilitated stretching: PNF stretching and strengthening made easy, 3rd ed. pp 11-18, Focus on facilitated stretching. Human Kinetics. ISBN 978-0736062480.
  11. Gamper U and Lambeck J. 2011. The Bad Ragaz Ring Method. pp 109-136, Chapter 4 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  12. Ainslie T. 2012. The concise guide to physiotherapy - 2-volume set: Assessment and Treatment. pp 1106-1116, Halliwick Concept. Elsevier Health Sciences. ISBN 9780702053030.
  13. Schoedinger P. 2011. Watsu in aquatic rehabilitation. pp 137-154, Chapter 5 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  14. Morris DM. 2011. Aquatic rehabilitation for the treatment of neurological disorders. pp 193-218, Chapter 8 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  15. Cole AJ, Johnson J, Alford JM, Hard K, Moschetti M, Fredericson M, Eagleston RA, and Stratton SA. 2011. Spine pain: aquatic rehabilitation strategies. pp 219-244, Chapter 9 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
  16. Getz M, Hutzler Y, Vermeer A (2006). "Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature". Clin Rehabil (Systematic review) 20: 926. doi:10.1177/0269215506070693. PMID 17065536.
  17. Salzman, AP. 2007. Aquatic therapy: procedure or profession? Aquaticnet.com web site. http://www.aquaticnet.com/qualifications.htm, accessed 20-Mar-2014.