Hydrotherapy by pradeep

complete review of hydrotherapy

1. HYDROTHERAPY

2. Content Introduction Properties of water Physiological effects of water Equipments used in hydrotherapy Indication Application of hydrotherapy Forms of hydrotherapy Precautions Contraindications Summary

3. Introduction Hydrotherapy derived from the Greek word hydro and therapy meaning water and healing Hydrotherapy formerly called  hydropathy  involves the use of water for pain relief . Hydrotherapy is applied externally either by immersion of the whole body or of parts of the body in water or without immersion by spraying or pouring water onto the body

4. Properties of water Buoyancy Density Hydrostatic pressure Viscosity

5. BUOYANCY Archimedes principle: when a body is fully or partially submerged in fluid at rest, it experiences an upward thrust equal to the wt. of fluid displaced.

6. BUOYANCY

7. Density Determines whether the object will float. Density = weight of object/ wt of equal vol of water >1 – sink <1 – float

8. Hydrostatic pressure

9. Hydrostatic pressure Water exerts a perpendicular pressure against the surface of body Dependent upon : Depth of submerged water Density of liquid. It increases as depth & density of liquid So movement is performed more easily near the surface of water than at greater depth.

10. RESISTANCE Resistance or drag force F d = PCV 2 A/ 2G P=fluid density/ viscosity C= coefficient of drag V-velocity of object A= frontal area of object G= gravitational constant So drag force is proportional to square of velocity Frontal area is directly proportional to drag force Viscosity refers to the magnitude of internal friction (resistance) specific to the fluid.

11. RESISTANCE If fluid is more viscous, more force is required to create a movement As temperature of water increases, viscosity decreases, because molecules move farther apart. This is beneficial for small weak muscles. Greater the speed of motion, higher the resistance.

12. RESISTANCE

13. Hydromechanics Definition: Hydromechanics comprise the physical properties and characteristics of fluid in motion Laminar flow: Movement where all molecules move parallel to each other, typically slow movement. Turbulent flow : Movement where molecules do not move parallel to each other, typically faster movements . Turbulence creates an unstable environment encouraging the core muscles of the body to become stronger to maintain correct position and posture.

14. Physiological Effects Of Water

15. Physiological Effects Of Water

16. Cardiovascular effects

17. RESPIRATORY EFFECTS

18. RENAL EFFECTS

19. THERMOREGULATION

20. Equipments Equipment used for aquatic running or exercise- Collars, Rings, Belts

21. 2. Swim Bars or Buoyant dumbbells

22. 3. Gloves, Hand Paddles

23. 4. Kickboards

24. Rehabilitation pool

25. Indication The specific indication include Facilitate ROM exercise Initiate resistance training Facilitate weight bearing activities Facilitate CVS exercise Minimize risk of injury and reinjury during rehab Enhance patient relaxation Post event recovery

26. APLLICATIONS OF HYDROTHERAPY 1) Orthopaedic disorders Decreased weight bearing Closed or open chain exercise Velocity dependent resistance 2)Neurological disorders Propioceptive input Improved balance 3)Cardiac fitness Cardiac conditioning in persons with poor tolerance to land based exercises.

27. APLLICATIONS OF HYDROTHERAPY 4)Exercise in water during pregnancy Decreased weight bearing Less elevation of heart rate Decreased risk of maternal hyperthermia 5)Reducing Exercise induced asthma symptoms Less exercise induced asthma than with other forms of exercise.

28. Precautions Hydrophobic disorder Neurological disorder Seizures Cardiac dysfunction

29. Contraindication Unstable angina and cardiac failure Respiratory dysfunction Severe peripheral vascular disease Bleeding disorder chronic kidney disease Open wounds Uncontrolled seizure Water or airborne infection Bowel and bladder incontinence

30. Exercise intervention using aquatic environment Exercise prescribed using aquatics are Stretching Strengthening Aerobic conditioning

31. Cervical Stretching

32. Shoulder stretching

33. Lateral trunk flexion

34. Hamstring stretch

35. Strengthening exercise

36. Strengthening exercise

37. Strengthening exercise

38. Forms of hydrotherapy Contrast bath Whirlpool baths Sauna bath Steam bath Aromatic bath

39. Contrast bath Treatment involves both hot and cold therapy on same body part Application procedure: Start with cold and end with cold Affected part should be moved from warm to cold water repeatedly Goal : Decreases swelling Decreases pain Decreases muscle spasm

40. Contrast bath

41. Contrast bath

42. Whirlpool baths Goal of whirlpool therapy Decreases swelling Control inflammation Improve ROM Decreases pain Decrease muscle spasm

43. Whirlpool baths Application procedure:

44. Sauna bath A sauna is a small room designed as a place to experience wet/dry heat sessions Ideal temperature is maintained between 70 o C and 100 o C

45. Sauna bath

46. Sauna bath Physiological effects of sauna bath Musculoskeletal System: Muscles relax and joints become more flexible. Heat enhances the circulation to joint capsule and reduce the viscosity of synovial fluid. Endocrine System: Endocrine functions respond to thermal changes mainly through activation of Sympathetic nervous system(SNS). The stimulation of SNS is manifested by increased levels of the nor-adrenaline.

47. Sauna bath Cardiovascular system: Heart rate may accelerate up to twice the resting rate. Acceleration of cutaneous circulation leads to redistribution of blood flow. Blood flow to kidneys and viscera is reduced. Skin blood flow increases up to 20-40 times. Stroke volume is unaffected, whereas cardiac output increases about 70 %.

48. Sauna bath Respiratory System: Respiration becomes more faster and shallow. Air with 15-30% of humidity allows mucous membrane of the upper respiratory tract to remain moist.

49. Sauna bath Other Physiological Effects: Metabolism: Sauna increases the metabolism A 30 minute sauna session can burn up to 300 calories The water lost due to sweat can be replaced by drinking water to avoid dehydration. Relaxation : Sauna are traditionally known to promote general relaxation.

50. Sauna bath INDICATIONS: Promote general relaxation Relief from tension or anxiety Regular sauna baths may reduce the incidence of common colds In Sports Sauna helps to promote relaxation. Plays a good role in post event recovery.

51. CONTRAINDICATIONS Unstable angina or myocardial infraction. Severe orthostatic hypotension and severe aortic stenosis Rheumatoid arthritis in acute inflammatory phase Skin conditions such as Urticaria , abrasions and rashes. During pregnancy

52. PRECAUTIONS Do not use alcohol prior to or during a sauna bath Make sure not to eat any large meals before. Person with low blood pressure(as sauna bath decreases BP). Drink 1-2 glass of water or sports drink which has electrolytes. Shower First, as this is to moisten the skin Do not take a sauna bath for over 15-30 minutes. Exit the sauna bath if you feel uncomfortable or become sleepy.

53. Steam bath A steam room is a virtually airtight room Steam is produced by steam generator which has about 100% humidity Typically between 115 to 120° F (40°C) Benefits: Relieves nasal congestion Lower blood pressure Detoxification Promote general relaxation Risk: Symptoms of dizziness, vertigo, excessive thirst.

54. Steam bath

55. Hydrotherapy Versus Conventional Land-Based Exercise for the Management of Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial Conclusion:  Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee.

56. Summary Hydrotherapy in Sports rehabilitation: 1) Increases ROM of joint Water provides support & reduces need for splintage . Warmth of water decreases spasticity, promotes relaxation & helps prepare connective tissue for stretching. 2) Decrease in muscle spasm Warm water decreases muscle tone & spasticity 3) Increases muscle strength & endurance Strength training can begin in water before it is possible on land. This helps to prevent atrophy of skeletal muscles 4) Improves body awareness, balance & trunk stability: Warm water stimulates awareness of having body parts & provides ideal medium for muscle re-education. Stabilization can be obtained using railings

57. Reference

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