aquatics

• buoyancy
• viscosity
• hydrostatic pressure
• turbulence

buoyancy

• decreases the effects of gravity
• decreased jt compression forces
• decreased weight bearing

• ASIS= 50%
• xiphoid= 30%
• C7= 10%

buoyancy assisted

buoyancy resistive

• dereased pressure of jts
• makes the pt more comfortable, and decreases pain

righting reactions

• may be difficult for the therapist to remain in a fixed position
• may be difficult to stabilize pt
• flaccid LE may float (may need weight)

• COG= L5-S2
• COB= T2-T4

pressure exerted by the molecules of a fluid upon an immersed body

with increased depth, the amt of pressure on the body increases

stabilizing mm. have to work harder to hold the body still

edema and pain

• decreases swelling with increased pressure
• offsets tendency of blood to pool in the LEs
• ehances proprioception
• eases pain thru constant support of the jts
• helps build up mm. of inspiration and assists with exhalation

• pts with vital capacity less than 1500ml may have difficulty breathing due to increased resistance to chest expansion
• pts may c/o or feel anxious about pressure on their chests

viscosity .. thickness

water will have less viscosity

resistance is felt throughout the entire ROM

water has 790 times greater viscosity than air

• provides resistance to mvmt - resistance increases with speed of mvmt or wider surface areas in the water
• resistance drops to 0 the instance the force/effort stops
• allows increased time of response for pts equilibrium reactions
• safer for pts with decreased balance

• streamlined flow- continous, steady mvmt of a fluid
• turbulent flow- irregular mvmt of a fluid with mvmt varying at any fixed point

• causes impedance and drag
• resistance is greater than streamline flow

• provides resistance to mvmt- increases when object is streamlined
• can use to treat balance problems
• can use it to provided more challenging trunk stabilization activities

refraction

causes objects and extremities to appear 25% larger and 25% closer to the surface than they are (leads to confusion about body position)

if pt is very sensitive to light, or prone to seizures

some pts may get motion sickness by watching the water

• increased circulation
• increased stroke volume
• increased cardiac output (without increased HR)

*HR decreases in warm water, use 10bmp less resting HR than on land

• increased:
• lung/breathing capacity
• vital capacity
• depth of ventilation
• efficiency of oxygen uptake

total work of breathing increases about 60% with submersion to the neck

*aquatics is good if you need to work on breathing, but bad if you cant handle it

• hydrostatic pressure decreases edema
• increased flexibility
• decreases abnormal tone, spasticity, muscle guarding (ish)
• decreased jt pressure
• increased muscular strength and stamina
• improved trunk/head stability and alignment
• blood supply to mm. significantly increased (improves oxygen delivery to mm. and improved removal of muscle lactate and other metabolic end products)

cool water

• sodium excretion increases up to 10 times normal
• increase in central blood volume stimulates volume receptors which cases a decrease in ADH; this leads to diuresis

• increased body temp
• easy to over exert
• chlorine and bromine can cause skin and respiratory problems
• some ppl are sensitive to chemicals

• incontinence
• uncontrolled epileptic pts
• fever exceeding 100
• open wounds/skin infections
• severe cardiopulmonary conditions

• infectious diseases
• water phobia
• external fixator
• urinary infections
• severe weakness
• allergies to pool chemicals

• difficulty maintaining BP
• selective cardiac pts
• acute CVA/TBI
• severe vestibular deficits
• absent cough reflex

pH= 7.2 and 7.5

air= 82-85

90-92

resistance- gloves, paddles, dumbells, kickboards, ankle/foot cuffs

float- noodles., belts, aquajoggers, life jackets

increase ROM- noodles, cuffs, dumbells

• orthopedic, neurological, circulatory problems, loss of ROM, strength, flexibility, endurance
• neuro, back, CP, fibromyalgia, jt pain, RSD

• put pt in deeper water (shoulder level)
• add upper/lower extremity involvement, progressing the amt of resistance
• increase amt of turbulence
• decrease amt of support in deeper end
• challanging their BOS (feet wider)