Aquatic Exercise Chapter 9

BACKGROUND AND PRINCIPLES FOR AQUATIC EXERCISE

Background and Principles for Aquatic Exercise Definition of Aquatic Exercise Goals and Indications for Aquatic Exercise

Precautions and Contraindications to Aquatic Exercise Fear of water Neurological disorders Respiratory disorders Cardiac dysfunction Small open wounds and lines Contraindications

Properties of Water Physical Properties of Water Hydromechanics Buoyancy Hydrostatic pressure Viscosity Surface tension Hydromechanics Components of flow motion Clinical significance of drag Figure 9.1 illustrates percentage of weight bearing at various immersion depths.

Properties of Water (cont'd) Thermodynamics Specific heat Temperature transfer Center of Buoyancy Figure 9.2 illustrates the center of buoyancy.

Aquatic Temperature and Therapeutic Exercise Temperature Regulation Mobility and Functional Control Exercise Aerobic Conditioning

Pools for Aquatic Exercise Traditional Therapeutic Pools Individual Patient Pools Shown here, Figure 9.3: Traditional therapeutic pool.

Special Equipment for Aquatic Exercise Collars, Rings, Belts, and Vests Swim Bars Gloves, Hand Paddles, and Hydro-tone® Bells Fins and Hydro-tone® Boots Kickboards

Pool Care and Safety Pseudomonas aeruginosa Cleaning and pH Level Tests Walking Surfaces Safety Rules and Regulations Life Preservers and CPR

EXERCISE INTERVENTIONS USING AN AQUATIC ENVIRONMENT

Manual Stretching Techniques Practitioner Position Patient Position Buoyancy-assisted (BA) seated or upright Buoyancy-supported (BS) supine Stretching Exercises

Manual Stretching Techniques (cont'd) Hand Placement Fixed (ipsilateral) hand stabilizes the patient, positioned proximally on the affected extremity Movement (contralateral) hand, positioned distally, guides patient’s extremity through desired motion and applies the stretch force Direction of Movement Describes motion of the movement hand Stretching Exercises

Spine Stretching Techniques Cervical Spine: Flexion Cervical Spine: Lateral Flexion Thoracic and Lumbar Spine: Lateral Flexion/Side Bending Stretching Exercises Shown here, Thoracic and Lumbar Spine: Lateral Flexion/Side Bending (Figure 9.13).

Shoulder Stretching Techniques Shoulder Flexion Shoulder Abduction Shoulder External Rotation Shoulder Internal Rotation Stretching Exercises

Hip Stretching Techniques Hip Extension Hip External Rotation Hip Internal Rotation Stretching Exercises

Knee Stretching Techniques Knee Extension With Patient on Steps Knee Flexion With Patient on Steps Knee Flexion With Patient Supine Hamstring Stretch Stretching Exercises

Self-Stretching With Aquatic Equipment Shoulder Flexion and Abduction Hip Flexion Knee Extension Knee Flexion Stretching Exercises

Manual Resistance Exercises Practitioner Position Patient Position Buoyancy-supported (BS) supine Hand Placement Guide (ipsilateral) hand directs patient’s body as muscles contract to move the body through water Resistance (contralateral) hand is placed at the distal end of the contracting segment Direction of Movement Describes motion of patient Strengthening Exercises

Upper Extremity Manual Resistance Techniques Shoulder Flexion/Extension Shoulder Abduction Shoulder Internal/External Rotation Unilateral Diagonal Pattern D1 Unilateral Diagonal Pattern D2 Bilateral Diagonal Pattern D2 Strengthening Exercises

Lower Extremity Manual Resistance Techniques Hip Adduction Hip Abduction Hip Flexion with Knee Flexion Hip Internal/External Rotation Knee Extension Ankle Motions Ankle Dorsiflexion and Plantarflexion Ankle Inversion and Eversion Strengthening Exercises

Dynamic Trunk Stabilization Frontal Plane Multidirectional Strengthening Exercises Shown here, Dynamic Trunk Stabilization: Frontal Plane (Figure 9.23).

Independent Strengthening Exercises Extremity Strengthening Exercises Lumbar Spine Strengthening Trunk-Strengthening Exercises Standing Semi-reclined Supine Prone In deep water Strengthening Exercises Table 9.1 summarizes Motions Used for Upper and Lower Strengthening Exercises. Table 9.2 summarizes Lumbar Spine-Strengthening Exercises.

Aerobic Conditioning Treatment Interventions Deep-water walking/running Mid-water jogging/running (immersed treadmill running) Immersed equipment Swimming strokes

Physiological Response to Deep-Water Walking/Running Cardiovascular Response Training Effect Aerobic Conditioning

Proper Form for Deep-Water Running Instruction for Beginners Accommodating Specific Patient Populations Aerobic Conditioning

Exercise Monitoring Monitoring Intensity of Exercise Rate of perceived exertion Heart rate Monitoring Beginners Aerobic Conditioning

Equipment Selection Deep Water Equipment Mid-Water Equipment Flotation belt Vests Flotation dumbbells Noodles Fins Specially designed boots Bells Buoyant dumbbells Mid-Water Equipment Specially designed socks Forced current Elastic tubing Noodles Kickboard Aerobic Conditioning Selection of buoyancy devices for deep water exercise should reflect the desired patient posture, comfort, and projected intensity level.

Independent Learning Activities Case Studies