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HYDROTHERAPY/AQUATIC THERAPY, THERMODYNAMICS, INDICATIONS - Coggle Diagram

- - - - It is the upward force that work opposite to gravity.
      - Properties:
        
        Archimedes principle states that:
        
        an immersed body experiences upward thrust
        
        equal to the volume of liquid displaced.
        
        Clinical significance:
        
        • Buoyancy provides the patient with relative weightlessness & joint unloading by reducing the force of gravity in the body hence active movement is eased
        
        • Buoyancy provides resistance to movement when an extremity is moved against the force of buoyancy = strengthening
        
        • The amnt of air in the lungs will affect buoyancy of the body. Buoyancy will be increased with fully inflated lungs & decreased with deflated lungs.
        
        • Body composition will also affect buoyancy.
        -Obese patients will have increased buoyancy due to fat tissue having a lower specific gravity.
        -Patients with decreased bone density will have less buoyancy than those with decr bone density.
  - - - • Hydrostatic pressure is the pressure exerted by the water on immersed objects,
      - Properties:
        
        Pascal’s law states that
        the pressure exerted by fluid
        on an immersed object
        is equal on all surfaces of the object.
        
        As the density of water & immersion increase,
        so does the hydrostatic pressure
        
        Clinical significance:
        
        Incr pressure
        
        reduces or limits effusion
        
        Assists venous return
        
        Induces bradycardia
        
        centralizes peripheral blood flow
        
        The proportionality of depth & pressure allows - the patients to perform exercises more easily - when closer to the surface
  - - - Viscosity is friction occurring betw molecules of liquid resulting in resistance to flow.
      - Properties:
        
        Clinical significance:
        
        Water’s viscosity creates resistance with all active movements.
        
        Increasing the velocity of movement increases the resistance.
        
        Increasing the surface area moving through water increases resistance
        
        Resistance from viscosity is proportional to the velocity of movement through liquid.
  - - - Properties
        
        Clinical significance:
        
        The effect of surface tension includes the following
        
        An extremity that moves through the surface performs more work than if kept under water.
        
        Using equipment at the surface of the water increases the resistance.
        
        The attraction of surface molecules is parallel to the surface.
        
        The resistive force of surface tension changes proportionally to the size of the object moving through the fluid surface.
      - The surface of a fluid acts as a membrane under tension.
        
        Surface tension is measured as force per unit length.
- - - - Movement in which molecules
        
        do not move parallel to each other,
        
        typically faster movements
    - - The cumulative effects of
        
        turbulence & fluid viscosity
        
        acting on an object in motion.
        
        Clinical significance of drag:
        
        As the speed of the movement through water increases,
        resistance to motion increases
        
        Moving water past the patient
        requires the patient to work harder
        to maintain his or her position in pool
        
        Application of equipment (glove/paddle/boot) increases drag & resistance
        as the patient moves the extremity through water.
    - - Movement in which molecules move
        
        parallel to each other,
        
        typically slow movement.
- - - - Water retains heat 1000 times more than air
        
        Differences in temp betw an
        immersed object & water
        equilibrate with
        minimal change in temperature of the water.
- - - - Clinical significance:
        
        In the vertical position, the human center is located at the sternum.
        
        In the vertical position
        -posteriorly placed devices cause the patient to lean forward,
        -anteriorly placed devices cause the patient to lean back
        
        during unilateral manual resistance exercises, the patient revolves around the practitioner in a circular motion
        
        a patient with a unilateral lower extremity amputation:
        -leans toward the residual limb side when in a vertical position
        
        Patients bearing weught in the floor of the pool(ie, sitting, kneeling, standing) experience aspects of both the center of buoyancy & center of gravity.
      - Vertical forces that do not intersect the center of buoyancy create rotational motion
- - - - Ataxic patients may experience increased difficulty controlling purposeful movement.
        
        Patients with heat-intolerant multiple sclerosis may fatigue with immersion in temp greater than 33 deg
        
        Patients with controlled epilepsy require close monitoring during immersed treatment & must be compliant with medication prior to treatment
      -  Respiratory disorders:
        
        Water immersion may adversely affect the breathing of the patient with a respiratory disorder.
        
        Lung expansion tends to be inhibited due to hydrostatic pressure against the chest wall
        
         Cardiac dysfunction:
        
        Patients with
        
        Angina
        
        Abnormal BP
        
        Heart disease
        
        Or compromised pump mechanisms also require close monitoring
        
         Small open wounds & lines
        
        mall open wounds & tracheostomies may be covered by waterproof dressings
        
        Patients with intravenous lines, Hickman lines, & other open lines require proper clamping & fixation
  - - - Decr peripheral blood flow
        Decr vital capacity
        Incr heart volume
        Incr intrapulmonary blood volume
        Incr R atrial blood pressure
        Incr left ventricular end-diastolic volume
        Incr stroke volume
        Incr cardiac output
        Decr or unchanged HR
      - ADVANTAGES
        
        Red pain
        
        Faster recovery frm surgery
        
        Re-education & encouragement of normal movement
        
        Allows standing in those who are unable to weight-bear out of the water-the buoyancy effect of water
        
        Improved walking technique
        
        Impr aerobic fitness levels
        
        Impr balance & coordination
        
        TYPES OF HYDROTHERAPY
        
        Hubbard Tank
        Hydrotherapy pool
        Foot bath
        Body wraps
        Contrast bath