Hydrotherapy

This presentation is complete about hydrotherapy and its role in medical care. How hydrotherapy helps patients to recover along with some precautions etc. Hydrotherapy has a lot of benefits, That why we prepare that presentation for those who are willing to learn about it. This presentation may helpful for you in your studies. I hope this will helps you a lot.

1. Hydrotherapy Author: SaimaMustafa(pt)

2. Hydrotherapy Definition; Hydrotherapy derived from the Greek word , hydro = water and therapy= healing “A method of treating diseases , physical or psychological dysfunction by using water internally and externally at different temperatures and pressures in different ways ” Explanations; It is a part of medicine, Specially in physiotherapy, that involves the use of water for pain relief and treatment.

3. Cont.… Water is being used widely throughout the world as a form of physical therapy. Patients are instructed through a specific program designed to help their physical conditions. Categories of Hydrotherapy There are two main Categories of Hydrotherapy (1) Internal Hydrotherapy (2) External Hydrotherapy Internal Hydrotherapy This form of therapy includes insertion of water into body Examples Colonic irrigation . Involves cleaning the entire bowel. This helps to cure numerous digestive problems and conditions. Enemas A liquid treatment of rectal injections of fluid intended to clean or stimulate the emptying of your bowel. It has been used to treat severe or chronic constipation to stimulate stool evacuation. so on own its own . For Big surgery or for C section for baby birth ;

4. Conti.. Mineral water drinking therapy The treatment is by drinking the prescribed quantity of curative water, Indication; Dyskinesia of biliary tract and gallbladder Cholelithiasis Liver ailments Dosage Duration of the mineral water drinking therapy is 3-4 week, 1-3 times a day in the amounts recommended by a physician according to the case. It is done on an empty stomach and the dose of the water is usually measured in glasses (250 ml). Before the treatment begins, the examination of the visitor by the doctor of the hydrotherapy center is mandatory.

5. External Hydrotherapy Application of ice or water to the body. It also involves immersion of the body in water. Aims at using temperature-based hydrotherapy techniques, Contract bath; such as the effects of hot and cold water on the skin as well as the underlying tissue. When used, hot water causes sweating and relaxes muscles. It is a very effective method of treating poor circulation, sore muscles. Ice packs or cold compresses are used to relieve pain associated with dental surgery, headaches and sprains. External hydrotherapy is conducted in various ways ; Example sits baths, Contrast hydrotherapy ,Wirlpool bath etc..,

6. How does hydrotherapy work/principle Hydrotherapy relies on its mechanical and temperature (Cold and thermal effects), in order to induce healing. Principles Hot and cold water induce physiologic changes that are beneficial to human health Hot water causes superficial blood vessels to dilate, activating sweat glands, and removing toxic wastes from tissues. Cold water causes superficial blood vessels to constrict, moving blood flow away from an affected area to relieve inflammation When Patient submerged in water like a pool or a bath, experience some kind of weightlessness. During this period, the water relieves the body of gravity’s effects. In addition,. Moving water stimulates the skin’s touch receptors. This effect increases blood circulation while releasing tight muscles.

7. Clinical Case of Heel Spur Created by a bony-like growth, called a calcium deposit, underside of the heel bone Diagnosis Via X-ray - Heel purr Sign and symptoms sharp pain like a knife in the heel when standing up in the morning. a dull ache in the heel throughout the rest of the day. inflammation and swelling at the front of the heel. heat radiating from the affected area small, visible bone-like protrusion under the heel. Treatment plan Contrast bath Put salt in water ,Dip effected heel in hot water for 30sec then in cold water for 30sec till 1o times twice in a day ,For 2 weeks

8. Precautions Do not walk bear foot on floor wear soft shoe or cushioning gel Complications Corticosteroid injections Ultimate solution is surgical removal

9. Therapeutic Effects/Goal of Hydrotherapy Treatment of Wounds ;aims to provide an optimal healing environment. The wound consist of pus after c section surgery washed by alted water Relieve pain and muscle spasm To gain relaxation To maintain or increase the range of joint movement Re-educate paralyzed muscles To strengthen weak muscles and to develop their power and endurance To encourage walking and other functional and recreational activities To give the patient encouragement and confidence in carrying out his exercises, thereby improving his morale.

10. Conti .. The warmth of water blocks nociception by acting on thermal receptors and mechanoreceptors Initiate resistance training Facilitate weight-bearing activities and reduce risk of injuries Facilitate cardiovascular exercise Minimize risk of injury or re-injury during rehabilitation monitored aquatic-based exercises effectively improve muscle strength, fatigue, and quality of life, and skin disease activity than land-based exercises in children with juvenile dermatomyositis ( childhood disease that causes muscle weakness and skin rash )

11. Properties of Water The four most important properties of water from a treatment point are: (1). Water is non-irritating, non-allergic, and totally compatible with human physiology both inside and outside of the body. (2). Water is a good heat conductor and at the same time greatly heat storing in capacity so that it is the ideal agent for manipulating body temperature. (3). Water is totally conformable to the body surfaces. This means that it makes an intimate interface with whatever it comes in contact, which greatly facilitates its ability to affect the temperature the object it contacts. (4). Water is inexpensive in spite of all its marvelous properties.

12. CONT .. Water has some other certain physical properties which include; weight, density, buoyancy, Hydrostatic pressure, and surface tension. The most important physical laws of water that physiotherapist should understand and apply when giving hydrotherapy, are buoyancy and hydrostatic pressure. Density of water The weight of the water per its unit volume, Value 997 kg/m³ It depends on the temperature of the water. At temperature decreases its velocity aloe lessen Example Ice floats on water due to low density Density of ice =0.92 g cm -3

13. Buoyancy The force experienced as an up thrust which acts in the opposite direction to the force of gravity. A body in water is therefore subjected to two opposing forces. When the weight of the floating body equals the weight of the liquid displaced, and the centers of buoyancy and gravity are in the same vertical line, the body is kept in stable equilibrium. If the centers are not in the same vertical line the two forces acting on the body will cause it to roll over until it reaches a position of stable equilibrium.

14. Clinical Use of Buoyancy Decrease stress and compression to body tissues (weight-bearing surfaces) Assist weak muscles. used in rehabilitation therapy to assist in movement, as resistance to movement, and to support movement on the water's surface. Hydrostatic Pressure Pressure exerted by fluid on body immersed in fluid Cardiovascular effects: Increased Venous circulation ,Then Increase Cardiac Volume as a result Increase Cardiac Output. Respiratory effects: Immersion of the whole body in water increases the Work of Breathing. Hydrostatic Pressure on the chest wall increases the resistance to lungs expansion. Exercise- induced asthma Water based exercise is recommended for patients with because it appears that High Humidity of the air inspired during water exercise, which prevents drying of Respiratory mucosa.

15. Type and Modalitie of Hydrotherapy Whirlpool hydrotherapy: stainless steel tanks of various sizes, It has an attached motor called – Turbine. The turbine – Mixes the water in the tank to create the whirlpool effect. Parts of WP Turbine ejector Hot and cold-water mixing valve Temperature gauge drainer Seat / Chair Clinical Benefits Increase circulation and improved tissue repair after a burn, ulcer, or other skin injuries Precaution These WP are intended to used as single-patient treatments & must be drained & cleaned after each use to avoid preying of diseases

16. high boy tank It requires a chair or lift to transfer the patient in & out of the tank. Patients in a high boy tank usually sit on a removable seat attached to stairs on the side of the tank or may sit on a chair outside the tank with their lower extremity hanging in the tank. Dimensions Width: 20 -24 inches , Length: 36 -48 inches , Depth: 28 inches Extremity Tank This WP tank is smaller in size, designed especially to treat distal extremities (Ankle/foot/hand) It is often portable with attached wheels for ease of movement. Dimensions width: 15 inches ,length: 28 – 32 inches , depth: 18 – 25 inches Low boy tank It is designed for ease of transfer in & out of the tank by virtue of low walls & length.  Patients in a low boy are usually in a long sitting position. Dimensions width: 24 inches , length: 52 – 66 inches depth: 18 inches

17. Aquatic exercises: Exercising in a pool of warm or cool water allows you to exercise with less resistance and pressure on joints. It can be helpful for people back pain, arthritis, obesity, advanced age, or physical disability. Compresses : This form of hydrotherapy involves wrapping towels soaked in warm or cool water on a body part to increase circulation or reduce inflammation. Aromatics are often added to the wraps for various therapeutic purposes. Floatation tanks: Also known as isolation tanks or immersion tanks, the practice involves floating in a shallow pool of saltwater in a sealed, darkened tank. Doing so is said to relieve stress and anxiety, improve sleep, and relax muscles. Foot baths: Soaking your feet can reduce swelling and pain after a long day on one's feet. But, it can also be used to soften tissues before a spa foot treatment. Some people even claim that food baths can balance circulation and decrease congestion in the head, lungs, and pelvic organs.

18. Sitz bath: A sitz bath involves sitting a tub of water to treat conditions affecting the rectal area, or genital areas. Sitz baths are commonly used for hemorrhoids. Steam baths: Steam baths involve rooms filled with warm, humid air that proponents claim can amplify the benefits of a sauna. Turkish baths are a form of steam bathing that employs higher humidity and lower temperatures. Ice bath: Popular among athletes, ice baths involve soaking in a tub of water between 45 F and 65 F to speed recovery from an injury or extreme exercise. Hot fomentation: The application of warm compresses or hot water bottles to the chest is said to relieve acute symptoms of a cold or bronchitis.

19. CONTRAINDICATION Local immersion: Maceration ; Increased maceration, increased size of wound--(Maceration is defined as the softening and breaking down of skin resulting from prolonged exposure to moisture). Bleeding In or near the area For full body immersion Infectious conditions that spread with water , like UTI’s-Urinary tract infections can affect different parts of your urinary tract, including your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection) plantar warts, tinea pedis (pool) Cardiac instability Uncontrolled hypertension or heart failure Severe epilepsy Increased risk of drowning Suicidal patients Increased risk of drowning Acute inflammatory conditions Hyperpyrexia – Increase tissue temperature Malignancies Active bleeding – Prolonging arterial blood flow

20. conti .. Cardiac dysfunction – Not able to adapt to thermal homeostasis Respiratory dysfunction – Not able to resist hydrostatic pressure, tolerate heat or both Decreased thermal sensation – Inability to sense too much heat / cold Not able to meet increase metabolic demand Venous ulcers – May promote venous blocking Surface infections – Cross contamination Uncontrolled bowels – Contaminate water Dermatological conditions(Atopic eczema) – Exacerbate Severe epilepsy – Risk of drowning (Full body immersion)

21. PRECAUTION for Hydrotherapy Local immersion Impaired thermal sensation – cause Burns Check temperature of water with thermometer first Infection in area to be treated – Need additional infection control measures Universal Precautions Clean Whirl Pool modality Impaired cognition – Not able to report problems or discomfort Use constant, direct supervision Temperature of water near body temperature Not for Recent Skin Grafts Precaution full body immersion Confusion, Disorientation Keep head above water skin grafts – May not able to tolerate agitation or not able to compensate for extreme of heat or cold

22. Conti.. Patients on medications-Physician clearance sometimes required Patients with fear of water Patients with respiratory problem Watch for signs of respiratory distress, especially in hot or very warm water Low temperature ,gradually increase Patients with limited strength, endurance, balance, ROM Hands-on approach required Fear of water (full body immersion) – May refuse to participate After ingestion of alcohol– Impaired judgment – risk of drowning. Limited strength, endurance, balance or ROM – Safety hazard – risk of drowning Urinary incontinence– Risk of UTI Medications – May alter CVS Multiple sclerosis– Increase fatigue & weakness Sea sickness – Cause anxiety

23. Parameter to be documented in patient’s file after hydrotherapy   Patient’s Skin status Health & mental status which Hydro equipment's used used Accessories Water temperature Water Additives (When applicable) – Name & concentration of solution. Body part treated Treating method – non immersion or immersion If immersion – Then its level – partial or full and Duration of immersion

24. Thank you for your Attention.