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Hydrotherapy
Chapter 5
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Buoyancy
Is a force that works in the opposite direction
to gravity
Gravity pulls downward, buoyancy pushes
upward from the bottom
A relative weightlessness occurs when a
body is immersed in water (Amount depends
on % of body below surface)
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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
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Hydrostatic pressure
Is pressure exerted by water on an object
immersed in the water
Because hydrostatic pressure is proportional to
the depth of immersion, exercises are easier to
perform closer to the surface of the water
where the pressure is less
Assists in venous return, heart rate reduction,
& centralization of peripheral blood flow
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Specific gravity
Is the weight of a particular substance compared withthe weight of an equal volume of water
Specific gravity of a person increases when there is
increased bone mass and muscle mass and decreaseswhen 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 0.870.97
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Specific heat
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
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Hydromechanics of water
Term used to refer to movement through water
The faster the movement, the greater the
resistance
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Water temperature
Chart pg 141
Therapeutic warmth is considered to be 94 F,
which is appropriate for performing
therapeutic exercises
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Equipment
Extremity tanks
Smallest tanks which holds up to 25 gallons of water
Low boys:
Full-body tanks; resemble a bathtub resting on the floorwith enough room for pt to long-sit
Hold as much as 200 gallons of water
Hubbard tank:
Tanks that were created to accommodate a pt in supineposition, and allow range of movement in both upper &lower extremities
Has lifting devices to get pt in and out of whirlpool
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Equipment cont.
Turbines:
Mix air & water to provide agitation & turbulence
to the water
Stimulation from the agitation to the skin receptors
may promote an analgesic effect
Turbines have adjustable; height, direction of flow,
& strength of flow
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Hydrotherapy treatment techniques
Additives to prevent infection
Tanks & turbines must be thoroughly cleaned in
between pts
Most common agents used to prevent or reduce
chances of infection are providone-iodine,
chloramines-T, & bleach
Important to run turbine with disinfectant agent inwater
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Aquatic pools & infection control
Water not emptied from pool following every
patient
Recommendations
Pts shower before entering pool to remove excess
soil
Have filtration system that is chlorinated
Do not use with pts who are incontinent
Do not use with pts with open wounds
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Deep water exercises
Open chain exercises are performed here
Buoyancy-assistive devices can be worn to
help pt maintain an upright posture in water
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Middle-level to shallow-level
exercises
Promotes some weight bearing
Considered closed-chain exercises
Pain with exercises can be minimized
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Bad Ragaz techniques
Uses a buoyant ring to assist the patient in
floating in the water
Ring may be placed around the trunk, under
the extremities, or may support the head and
neck
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Debridement
Is the rapid removal of necrotic & devitalized tissue
to allow reepithelialization & granulation
Necrotic & devitalized tissue impedes granulation &
prevents or slows migration of epithelial cells acrossthe wound
This tissue delays healing & provides potential for
bacterial growth
Hydrotherapy can be utilized to debride, soften, &
loosen adherent tissue
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Hydrotherapy for wound care
Cleansing
Removes dirt, foreign bodies, exudates, or residuefrom topical agents & bacteria
Hydration Provides a moist wound bed that will proceed
more rapidly through the phases of healing
Circulatory stimulation Increased circulation obtained with hydrotherapy
is the result of thermal effects
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Hydrotherapy for wound care cont.
Analgesia & sedation Mechanical stimulation of skin receptors can assist in
decreasing pain
Thermal effects also assist
Condition of surrounding tissues Assess for: color, edema, temp, areas of pain or sensory
changes, & pulses
Description of wound:
Document & describe: location, size, shape, margins,exudates
Additives to whirlpool: Most frequently used bactericidal additives are betadine,
salt, and chlorazine