acuatic therapy

Water affords a particularly unique medium in which a therapist can accomplish specific tasks earlier in the rehabilitation process than can be attempted on land. In addition, various functional skills such as sit to stand, static and dynamic balance, reintegration of the gait sequence and sports-specific training can be initiated in the water when is may be difficult or impractical to beginthem on land. Before considering aquatic therapy, however, it is absolutely imperative that the therapist consider how most efficiently to return to land-based, functional tasks. The therapist must have an essential understanding of the physicals components of immersion and what effects these components have on various systems of the body: the use of aquatic activity and equipment to effectivelyachieve therapy goals: the limitations of aquatic therapy and how a patient transitions to land; and who is appropriate for aquatic intervention, when in the continuum of care this occurs, and how to return to land-based functional activity.
Historical documentation of the use of water as a healing medium can be traced a tat back as 2400 vce in the phroto-indian culture. However, the originaluse of water as a healing medium solely by immersion does not coincide with the current use and perception of aquatic therapy. It was not until the latter part of the 1890 that aquatic rehabilitation progressed from a passive intervention to a treatment method requiring active patient participation. This chapter provides an overview the use of aquatic therapy for treatment of clients withmusculoskeletal dysfunction of the spine or extremities. A discussion of the physical properties and fluid dynamics of water provides the scientific basis.That substantiates the use of aquatics for rehabilitation. In addition this chapter addresses the physical implications of immersion on specific body systems and the consequence of such changes on medically unstable individuals. Clinical guidelinesand specific therapeutic techniques, including the appropriate use of therapeutic aquatic equipment, are demonstrating the physical properties, fluid dynamics, and therapeutic techniques presented in this chapter.
SCIENTIFIC BASIS
PHYSICAL PROPERTIES OF WATER
Several physical properties of water are introduced in this section; these must be considered when determining whether a patient isappropriate for water therapy. One must then calculate how best to implement these hydrodynamic principles in a logical progression to ensure the best patient outcomes. Lastly, although the inclusion of water therapy is based on the properties of water, the entire treatment process must include land-based protocols; the end result of therapy is return to function





Relative density (specific Gravity)

The relative density, or specific gravity, of a substance is the ratio of the density of a given substance to the density of water. The substance referred to in the definition of specific gravity is a human body or the extremity of a human body. Pure water has a specific gravity of 1.0. Generally, the human body with air in the lungs has a specific gravity of 0.974, slightlyless than the specific gravity of water. A person’s body or extremity that has a specific gravity of less than 1.0 has a tendency to float; a person’s body that has a specific gravity of more than 1.0 has a tendency to sink. The average male body has a greater density than the average female body. The differences in specific gravity between the sexes can be accounted for by the differences in thepercentage of lean body mass to fat content.

Lean body mass is made up of bone, muscle, connective tissue, and organs and has a relative density close to 1.1 Fat mass includes both essential body fat plus any excess fat and has a relative density of about 0.9. Therefore, an individual with a relatively high proportion of lean body mass has a density that exceeds 1.0 and, thus, has a tendency...