hydrotherapy Hydrotherapy

Objective History Define hydrotherapy Effects physical prosperities of water

History Carlos Andreson 1943 Using thermal water for therapeutic purposes: balneotherapy, spa therapy, hydrotherapy Hippocrates (460-375BC) used hot and cold water immersion to treat many diseases Romans used baths for hygiene 19th-20th century: therapeutic & pleasure

Definition Hydrotherapy may be defined as the use of water, in any of its forms, for the maintenance of health or the treatment of disease. hydrotherapy has been used to treat disease and injury by many different peoples. Also called( Hydrothermal therapy) additionally uses its temperature effects, as in hot baths, saunas, wraps, etc.

Benefits of hydrotherapy The goal of hydrotherapy is to improve the circulation and quality of blood. This is important, since blood deliveries nutrient to and remove the waste products from the tissues and organs. If circulation is poor or slow, healing nutrients could not be delivered and toxins could not be removed, which causes degeneration of tissues and organs. By improving the quality of blood, more nutrients are available for cells to use and toxins are managed more efficiently

Physiological Effects Thermal effects: are produced by the application of water at temperatures above or below that of the body. The mechanical: effects are produced by the impact of water upon the surface of the body in the form of sprays, douches, frictions, whirlpools, etc. The chemical: effects are produced when it is taken by mouth or used to irrigate a body cavity, such as the large colon.

Common techniques baths and showers, neutral baths, sitz baths, contrast sitz baths, foot baths, cold mitten friction rub, steam inhalation, hot compresses, cold compresses, alternating hot and cold compresses, heating compresses, body wrap, wet sheet pack, and salt glow.

                                                                                                                                                                                                                         

Therapeutic properties of water   Physical properties chemical prosperities

Physical properties of water (Aquatic Physics ) These properties include High specific heat and thermal conductivity Bouncy Resistance and hydrostatic pressure

Physical properties 1-Specific heat and thermal conductivity Water can transfer heat by conduction (stationary water) and convection (moving water) and can therefore be used as a superficial heating or cooling agents. It is effective for this application because of its high specific heat and thermal conductivity

Specific heat. Cont., Is the amount of heat, in calories, required to raise temp of 1 gram of substance 1 degree C. Specific heat of water = 1.0 Cool water temps are best for long exercise session, warm water is indicated for short-duration exercises

Specific heat. Cont., The specific heat of water is approximately four times that of air and its thermal conductivity is approximately 25 times that of air. Thus it transfers the thermal energy 25 times more rapidly than air at the same temperature.

Clinical benefits Clinically, during hydrotherapy, heat is generally transferred from warm water to a patient by placing the patient's limb in warm water. Heat may also be transferred from the patient to cooler water by immersion of a limb or part of it in cold or ice water.

Physical properties 2-Bouncy Buoyancy: upward force generated by the volume of water displaced – force opposing gravity Archimede’s Principle: “the upward thrust that a fully or partially immersed body experiences is equal to the weight of the water that it displaces” -The amount of the fluid it displaces depends on the density of the immersed body relative to the density of the fluid.

Physical properties Buoyancy Water density change with temperature and atmospheric pressure change The density of salt water is greater than fresh water Density is proportional to its depth Specific Gravity (SG): pure water at 4oC is 1.0 SG>1.0 sink SG<1.0 float Body SG ~ 0.974

Specific gravity Is the weight of a particular substance compared with the weight of an equal volume of water Specific gravity of a person increases when there is increased bone mass and muscle mass and decreases when there are greater amounts of adipose tissue An object with low specific gravity (less than 1.0) will float Objects with high specific gravity ( greater than 1.0) will sink The human body has a specific gravity of 0.87 – 0.97

Center of Buoyancy The COB is a point or location on the human body that needs to be maintained within a base of support to establish & maintain an upward & stable posture Similar to center of gravity COB located in chest region

Physical properties Clinical benefits Buoyancy Torque = F x L Help exercise when weight bearing is contraindication (decrease stress and compression on weight bearing joints,muscles and connective tissues). Can be used as assistive or resistive force Raise weakened body parts against gravity. Combination of Buoyancy and Hydrostatic pressure help in balance exercises Torque = F x L Center of Buoyancy (CB) of a body segment immersed in water + Center of Gravity (COG) of a body segment out of water used to analyze torque Buoyancy & Gravity counteracting forces Body stable: COG&CB vertical Body rotates: COG&CB not vertical

Physical properties 3-Resistance Water at rest Density: mass per unit volume ρ = m/V m= mass; V=volume

Physical properties 3) Resistance Viscosity (internal friction between the molecules) and cohesion (attractive force exerted by each molecule on those surrounding) of the water provide resistance to the motion of a body in water. Resistance occurs in the against direction of the motion of the body and increase in proportional to the relative speed of the body's motion and the frontal area of the body part(s) in contact with water.  

Clinical benefits -The velocity-dependant resistance provided by water makes it a safe and effective strengthening medium for many patients. -Variable resistance and pressure provided by moving water can be beneficial for debriding and cleansing wounds.  

Hydromechanics of water Term used to refer to movement through water The faster the movement, the greater the resistance

4-Hydrostatic pressure Physical properties 4-Hydrostatic pressure Hydrostatic pressure: pressure exerted by water on the immersed body Pascal’s law: “when a body part immersed in fluid is at rest, the fluid will exert equal pressure on all surface areas at a given depth” P = F/A F= Force; A=Surface area

Clinical benefits Immersion in water can assist in promoting circulation or alleviating peripheral edema due to venous or lymphatic insufficiency. Facilitate cardiovascular function Support provided by hydrostatic pressure may help to brace unstable joints or weak muscles. The greatest effect will occur with vertical positioning. The effect will be less pronounced if the patient is swimming in more horizontal position close to the water surface. There are also no hydrostatic pressure effects when non-immersion hydrotherapy techniques are used.

Physical properties Hydrostatic pressure Patients with respiratory problems: exercises to improve lung expansion Difficulty breathing Pressure  with density: more pressure in deeper water (patients with circulatory problems)

Physical properties Other properties Surface tension: water molecules on the surface have greater tendency to hold together Adhesion: the tendency of water molecule to adhere to other substances Cohesion: the tendency of water molecules to adhere to each other

Physical properties Water in motion Flow motion  Laminar Turbulent

Physical properties Movement of objects in water cause water movement (whirlpools or Eddy Turbulence cause resistance The faster the movement the greater the turbulence Underwater exercises vs Land exercises

Physical properties Bow wave: positive pressure in front of the moving object – caused by the displaced water (stop moving forward) Wake (drag effect): forms behind moving object caused by water flowing into the area immediately to the rear – negative pressure (hold object back)

Exercise in water Adjust resistance Speed Size and shape Change limb position – lever length Increase surface area – add apparatus