therapy acuatic wonded warrios

7/28/2019 Therapy Acuatic Wonded Warrios

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Pi lot prog ram s o ffer injured soldiers

water -based rehabi l i ta t ion

f

OCTORS HAVE FOR DECADES PRESCRIBED AQUATIC THERAPY for re-

building and streng thenin g injured bo dies while m anag ing pain. Recently,in an effort to standardize alternative therapies for wounded warr iors , the

U.S. Army has piloted a two-pronged aquatic rehabil ita tion pro gram . The

Aquatic Warrior Exercise Prog ram (AWEP), com mission ed by the U.S. Army Surgeon

General's office and deve loped by aquatics and fitness ex pe rt Dr. Mary W ykle, is up

and running at thr ee Army installations: Fort Belvoir and Fort Eustis in Virginia and

Fort Lewis, W ashingto n. Each of the se sites has m ultiple indoo r pools and h osts War-

rior T ransi tion Units (WTUs) of 250 to 500 —a manageable numb er for data collection

and follow-up. Thepilot program has bee n comple ted and the final report submM

ted for official review. The Army is currently reviewing the repor t and is expec ted

to make recomm endations and decisions sometime in the next several months con-

ce rn ing the implementation of Wy kle 's two-phase pr og ram .



Overall, the AWEP program focuses on inclu-

siveness and individualization—even while ac-

commodating large groups in a pool at one time.

Because no swimming ability is required for any

of the exercises, the only thing necessary for par-

ticipation is a medic al clea ran ce. Activities that take

place in deeper water include flotation belts, so noheads are ever submerged. And participants are in-

structed on how to customize the exercises: Since

water provides 10 times m ore resistan ce than air, it

is an ideal me dium in which to exper im ent with dif-

ferent intensities of exercise.

Not only is the program flexible and simple to

implement, but, given the sheer number and vari-

ety of injuries, the cas e for a stan dardiz ed aquatics-

based alternative to traditional physical therapy is

compelling. "As of mid-Decem ber 2010, the number

of com bined soldier injuries for the Army is abou t

30,000 wounded, with many seriously wounded,"Wykle points out. "The program s would be available

[through WTUs and the Army's physical therapy d e-

partments] for soldiers recommended for aquatic ac-

tivity as a part of their recovery. The Marine C orps is

also interested in the progra m b eca use of the ever-

increasing number of wounded Marines."

The Two Stages of a Soldier's Reha bilitation

The two ph ase s of the pilot aquatic exerc ise p rog ram

reflect the stages of reco ver y that most pers ons with

muscu loskeletal injuries g o through. The first part

is the Aquatic Rehabilitation P rogra m: a set of ther-apy protocols designed for those under the care of

a doctor or physical therapist. Many of the soldiers

in need of therapy are returning from service with

lower back or joint injuries—and the weight-bear-

ing exercis es involved in traditional physical therap y

can put additional stress on the back and the bo dy's

major joints. Aquatic therapy, on the other hand, re -

lieves joint stiffness and increases range of motion

and flexibility Immersion inwater also redu ces pain,

due to water's dispersion of pres sure . Fu rthermore,

Wykle's progra m puts special emp hasis on stabiliz-

ing the lumbar region of the spine and strengthen-ing those core m uscles that help support the spine.

The secon d part of the progr am is for soldiers

who have finished their rehabilitation programs—

but who continue to need help overcoming limita-

tions and manag ing pain. Cne of the primary goals

of that second phas e is to pre par e the soldiers for

return to their regu lar units, through an alternative

cross-training pr ogr am that offers the same overall

fitness benefits as land-b ased training.

One surp rising a spect of the prog ram is its in-

structor training regimen which requires no back-

ground in aquatics. Trainers in the pilot programs



important facts

to remember are that

anyone can participate

in this program.

Soldiers love thisprogram—and at my

club, senior ladies are

participating as well.

It is also great cross-

training for swimmers.

are soldiers who have themselves reap ed

the benefits of aquatic therapy for ser-

vice-related injuries, Wykle personallytrained the AWEP instructors—none of

whom had any previous training in water

safety, ph ysical therapy, or m edicine,

"I'll admit, w hen I was first told that I

was picked for the program, I imagined

little old ladies in the water, and I was

very resistant," says Sgt. 1st Class Robert

Sallade, an activated National Gu ard Sol-

dier who is one of the first training team

members at the Eustis WTU certified by

Wykle. "After I went through the two days

of training, muscles I didn't even know Ihad w ere so re, and I had a whole differ-

ent outlook ab out it,"

Pilot Results: Reduced Pain, Greater

Streng tii and Fitness

The results of the pilot study have been noth-

ing short of dramatic— especially consider-

ing that soldiers recommended for aquatics

therapy are often tho se with incapacitating

pain, atrophied muscles, and serious inju-

ries. As one wounded warrior describes his

experience, "I enjoyed staying physically fit

untu I broke my neck in a hum vee accident

was no longer able to lift weigh ts or run du

to severe muscle atrophy and nerve damage. .. Then, I was introduced to the aquat

ics program. Since then my strength and

endu rance are returning, but most impor

tant, my confidence in myself." Anothe

participant with lower body wea knes s from

brain surgery speaks proudly of being able

thanks to the strength and cardiovascula

benefits of the program , to run up to three

miles on land now.

The numbers back up the glowing

pra ise from pilot prog ram participants, A

variety of pain scale tests showed an avera ge 50 percent redu ction in pain levels

And general fitness improvements were

just as striking. Study results showed the

resting heart rate decreased an average

of 49 percent, the ending heart rate in-

creased 61 percen t, and time to comp let

the steps decre ased 75 percent.

Adap ting AWE P to Pari( Aquatics

Programs

Wykle stresses that the AWEP program

is easily ada ptable to park and recreation



aquatics programs—and not necessarily as a course with a

purely military focus.

"The important facts to remember are that anyone canparticipate in this program," she says. "Soldiers love this

program— and at my club, senior ladies are participating as

well. It is also great cross-training for swimmers."

The program can be offered as a stand-alone course

conducted three t imes a week—or as a once per week

course with tracking options and deep-water time allotted

for individual training. Part of the b eauty of the program is

that step count and training time are determined individu-

ally, and in a class format it is possible that no two people

will hav e the same step count. (Neither music nor metro-

nomes are used, so that each participant can have the full

training effects of his or her individual step count.) Wykleoften arranges training for aquatic leaders in the one-day

Dee p Water Interval Cade nce Running Progr am (the AWEP

component with the greatest cardiovascular benefits). A

second day of training is requi red for those interested in

including additional strength training an d som e shallow wa-

ter options. Both of these mo dules are approved for Aquat-

ics Education Association CEU 's, and training is available

through Wykle and several other certified trainers.

To find out more about adapt ing the AWEP program

to your agency's aquatics offerings, visit the websi te at

www.aquaticwarrior.com or contact Dr. Mary Wykle di-

rect ly at [email protected] •

800.325 .5439CIRCLE 30ON PRODUCT INFORMATION FORM ON PAGE 79

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