proc i chapt 5

7/31/2019 Proc I Chapt 5

1/18

Hydrotherapy

Chapter 5


2/18

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)


3/18

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


4/18

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


5/18

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


6/18

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


7/18

Hydromechanics of water

Term used to refer to movement through water

The faster the movement, the greater the

resistance


8/18

Water temperature

Chart pg 141

Therapeutic warmth is considered to be 94 F,

which is appropriate for performing

therapeutic exercises


9/18

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


10/18

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


11/18

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


12/18

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


13/18

Deep water exercises

Open chain exercises are performed here

Buoyancy-assistive devices can be worn to

help pt maintain an upright posture in water


14/18

Middle-level to shallow-level

exercises

Promotes some weight bearing

Considered closed-chain exercises

Pain with exercises can be minimized


15/18

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


16/18

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


17/18

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


18/18

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

proc i chapt 5

Documents