1. AQUATIC THERAPY AQUATIC THERAPY

2. Intro to Aquatic Therapy  Aquatic therapy is a therapeutic modality that involves the patient to do an exercise program in water is a therapeutic modality that involves the patient to do an exercise program in water Aquatic therapy uses the physical properties of water to assist in patient healing and exercise performance. Aquatic therapy uses the physical properties of water to assist in patient healing and exercise performance. Buoyancy (up to 90% of our body weight is removed)

3. Who Benefits from Aquatic therapy  Patients with: Arthritis Arthritis Healing fractured bones Healing fractured bones Stress fractures Stress fractures Who have pain only in WB activities Who have pain only in WB activities who are overweight who are overweight Post surgery Post surgery

4. The Benefits of Aqua Therapy  Pain Control Water against the skin causes a sensory response which blocks pain receptors and therefore inhibits the sensation of pain from getting to the brain. Water against the skin causes a sensory response which blocks pain receptors and therefore inhibits the sensation of pain from getting to the brain.  Increase in Self-Esteem People who have suffered a devastating injury and need to slowly regain the movements of daily living. Once they have achieved this goal, and are not so dependent on others, they may get a psychosocial boost. People who have suffered a devastating injury and need to slowly regain the movements of daily living. Once they have achieved this goal, and are not so dependent on others, they may get a psychosocial boost.  Decrease Impact Exercises in the water decreases the impact created within the joints as compared to completing exercises on land Exercises in the water decreases the impact created within the joints as compared to completing exercises on land

5. Other Benefits  Great for patients with: Swelling Swelling Decreased ROM Decreased ROM Decreased strength Decreased strength Decreased balance, coordination, proprio Decreased balance, coordination, proprio Weight bearing restrictions Weight bearing restrictions Cardio deconditioning Cardio deconditioning Gait deviations Gait deviations Difficulty with land intervention Arthritis Healing fractured bones Stress fractures Who have pain only in WB activities who are overweight Post surgery

6. Disadvantages  Access to a pool Not every clinic will be near or have a pool suitable for aquatic therapy Not every clinic will be near or have a pool suitable for aquatic therapy  Qualified pool attendants  Qualified AT’s

7. Precautions and contraindications Open wounds Open wounds Respiratory dysfunction Respiratory dysfunction Seizure disorders, controlled by meds Seizure disorders, controlled by meds Fear of water Fear of water chlorine allergy chlorine allergy altered peripheral sensation altered peripheral sensation untreated infectious disease untreated infectious disease serious cardiac conditions serious cardiac conditions

8. Upper limb  Can be used for treatment of The shoulder complex The shoulder complex Elbow Elbow Wrist Wrist Hand Hand

9. Exercises for Shoulder Complex Injuries  Initial Level Start with patient in shoulder deep water Start with patient in shoulder deep water walking forwards and backwards trying to keep a normal arm swing walking forwards and backwards trying to keep a normal arm swing GH movements can be done with patient back against the wall to stabilize the scapula GH movements can be done with patient back against the wall to stabilize the scapula The movements can be done supine or prone depending on the patients level of comfort in the water The movements can be done supine or prone depending on the patients level of comfort in the water

10. Exercises for Shoulder Complex Injuries  Intermediate Level At this stage you can use equipment to increase the resistance to build on strength At this stage you can use equipment to increase the resistance to build on strength Keeping with in a pain free zoneKeeping with in a pain free zone Scapular stabilization can be progressed from the standing position to a supine position Scapular stabilization can be progressed from the standing position to a supine position Over head movements can be incorporated in the program by positioning the patient in a supine or prone position Over head movements can be incorporated in the program by positioning the patient in a supine or prone position (

11. Exercises for Shoulder Complex Injuries  Final Level The goal for this level is to incorporate sport specific movements, and to make it more challenging The goal for this level is to incorporate sport specific movements, and to make it more challenging By bringing in sport equipment into the pool the patient can do sport specific movements By bringing in sport equipment into the pool the patient can do sport specific movements

12. Lower Limb  Can be used for treatment of Hip Hip Knee Knee Ankle Ankle

13. Exercises for Lower Limb Injuries  Initial Level Goals Goals Increase normal movementsIncrease normal movements Increase strength of unaffected musclesIncrease strength of unaffected muscles Increase ROMIncrease ROM Walking forward, backwards and sideways help maintain a normal gait Walking forward, backwards and sideways help maintain a normal gait Deep water activities help maintain cardio for patients who can’t WB due to stress fractures or other injuries that require NWB activities Deep water activities help maintain cardio for patients who can’t WB due to stress fractures or other injuries that require NWB activities

14. Exercises for Lower Limb  Intermediate Level Goals Goals Increase ROMIncrease ROM Increase StrengthIncrease Strength Increase FlexibilityIncrease Flexibility Aqua belts can be used to allow for deep water running Aqua belts can be used to allow for deep water running Can do eccentric activities in shallow water by standing on a flutter board or a noodle Can do eccentric activities in shallow water by standing on a flutter board or a noodle

15. Exercises for Lower Limb  Final Level Best used as a compliment to on land training Best used as a compliment to on land training Can have the athlete do deep water activities without a flotation belt Can have the athlete do deep water activities without a flotation belt Can do squats on noodles, dumbbells, or flutter boards Can do squats on noodles, dumbbells, or flutter boards Pool running Pool running

16. Things you can use for Aquatic Therapy  Thera-band – to tether them to the wall for pool running  For added resistance Tennis balls on a rope Tennis balls on a rope a rope with knots a rope with knots  Milk jugs for weights  Hockey sticks, old golf clubs, old tennis racquets, clothing