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A role for water-based rehabilitation
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Renae J. McNamara, Jennifer A. Alison
Aquatic therapy is a relatively new term used to describe the practice of physical therapy in water with the aim to assist with rehabilitation, to improve or maintain function, prevent deterioration, or prevent injury of an individual (4). Water-based exercise is the performance of exercise with the body immersed in water. In this chapter, water immersion is defined as upright immersion with the head out of water, as opposed to water-based activities with the head immersed, such as swimming, which requires specific skills and technique.
Arthritis and Common Musculoskeletal Conditions
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Jennifer H. Paul, Katarzyna Iwan, Claudia Ramirez
Activity modification is essential. It is important to provide education about activities that can increase arthritis pain such as excessive use of stairs. For hand OA, it is helpful to instruct in joint protection techniques. It is also helpful to emphasize that rest is important for up to 24 hours following an acute flare, but after 24 hours, increase in activity is generally recommended. Physical therapy including both land and aqua therapy is essential for patients. Supervised formal physical therapy programs seem to be more likely to succeed. The focus is on strengthening, improving range of motion especially, gait training, and evaluating need for assistive device. Ability to perform ADLs should also be evaluated. There is high-quality evidence that exercise and weight reduction reduces pain and improves physical function in patients with OA of the knee and hip. Studies show that even a small amount of weight loss can help significantly with a patient’s pain and risk for progression of the disease. It is strongly recommended that patients with symptomatic knee or hip OA who are overweight be counseled regarding weight loss. Patients should participate in cardiovascular (aerobic) and resistance exercise. Aquatic therapy may be preferred to land therapy by some patients. Generally, encourage low impact conditioning exercises such as walking, swimming, biking, elliptical, and tai chi programs. Weight loss is best achieved through both diet and exercise. Dieticians can play an important role in helping these patients lose weight.6
Management of residual physical deficits
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Velda L. Bryan, David W. Harrington, Michael G. Elliott
Although the healing elements of water have been used for centuries, organized therapeutic protocols for the neurologically impaired have emerged only during the past decade. Current programs for musculoskeletal injuries (e.g., neck and back) are widely accepted by therapists and well received by those being treated. In this regard, the use of a pool program is a positive aspect to the physical rehabilitation for the person with MTBI. Aquatic therapy can address difficulties with balance and coordination, muscle weakness, poor endurance, and sensory dysfunctions. The buoyancy and warmth of the water, together with use of appliances to introduce resistive exercises, make a good combination for therapeutic application. Subtle vestibular impairments may manifest in aquatic activities as water reduces proprioceptive feedback, making balance functions more dependent upon visual and vestibular feedback. Precautions for cardiac or other medical considerations should be taken prior to introduction of an aquatic program.
Aquatic strength training improves postural stability and walking function in stroke patients
Published in Physiotherapy Theory and Practice, 2023
Xudong Gu, Ming Zeng, Yao Cui, Jianming Fu, Yan Li, Yunhai Yao, Fang Shen, Ya Sun, Zhongli Wang, Dingyi Deng
Hydrotherapy, which is also known as aquatic therapy, is a type of comprehensive rehabilitation that involves the completion of exercises in a therapy pool (Burns and Burns, 1997). According to the literature, this type of physical activity can serve as an excellent treatment for stroke patients and provides a safe yet effective exercise environment. Studies have reported that aquatic therapy can improve: postural stability (Noh, Lim, Shin, and Paik, 2008); cardiovascular adaptability (Chu et al., 2004); gait velocity (Noh, Lim, Shin, and Paik, 2008); and strength (Chu et al., 2004; Noh, Lim, Shin, and Paik, 2008) of chronic stroke patients. Some studies have also evaluated the effects of lower extremity strength training on the gait and functional indexes of stroke individuals. Furthermore, studies have verified that lower extremity training can improve the walking ability of stroke patients (Kim, Eng, MacIntyre, and Dawson, 2001; Wist, Clivaz, and Sattelmayer, 2016). However, no study has been conducted on aquatic lower extremity strength training owing to the buoyancy and resistance of water. Thus, the present study aimed to explore the effects of aquatic lower extremity strength training on the postural stability and walking ability of stroke patients.
Metabolic and cardiopulmonary impact of aquatic exercise and nutritional guidance for four individuals with chronic motor incomplete spinal cord injury: a case series
Published in Physiotherapy Theory and Practice, 2023
Paula Richley Geigle, Anna Ogonowska-Slodownik, Joanne E Smith, Kylie James, William H. Scott
Exercise in an aquatic environment is frequently utilized to improve functioning for individuals with SCI (Stevens, Caputo, Fuller, and Morgan, 2015). Hydrodynamic principles, specifically buoyancy and multi-direction resistance, favor increased muscle contraction and potential cardiopulmonary improvement (Gorman et al., 2019). Aquatic therapy offers multi-dimensional health benefits for individuals with SCI (Marinho-Buzelli et al., 2019); indeed, a systematic review reported hydrotherapy improved underwater gait kinematics, cardiorespiratory and thermoregulatory responses and reduced spasticity in patients with SCI (Ellapen, Hammill, Swanepoel, and Strydom, 2018). However, Li, Khoo, and Adnan (2017) reported weak evidence supporting the value of aquatic exercise training in improving physical function and aerobic fitness for adults with SCI.
Reliability of pain scores during a body weight support protocol in individuals with knee osteoarthritis
Published in Disability and Rehabilitation, 2022
Rebecca Greenwood, Jennifer Ellison, Peggy Gleeson, Katy Mitchell
The OARSI guidelines for the non-surgical management of knee OA published in 2019 strongly recommend structured land-based exercises programs to include cardio [12]. Additionally, aquatic therapy was recommended conditionally because, despite many benefits related to pain and function, there are considerations related to accessibility, financial burden, may not align with individual preferences, and is not recommended for individuals who suffer from frailty. The 2019 American College of Rheumatology/Arthritis Foundation guidelines strongly recommends exercise for knee OA [13]. The authors went on to state that the specific type of exercise should focus on the patient’s preferences and access. They noted that in most studies that looked at aerobic exercise, walking was the most common form of exercise evaluated and showed good outcomes. However, they additionally recognized that individuals that are in pain might be hesitant to participate in exercise and this must be considered when determining an appropriate rehabilitation activity for a patient. LBPP treadmills offer an alternative method for exercises and rehabilitation to achieve the cardio aspects of land-based exercises along with the pain relief benefit of unweighting and functional improvements over time including decreased pain with full body weight walking [8,9,11].