Water Applications Combined With Mechanical Stimulation

USAGE OF WATER FOR THERAPEUTIC PURPOSES

USE OF WHIRLPOOL BATH HAS BECOME INCREASINGLY VALUABLE MEANS OF PHYSIOTHERAPEUTIC TREATMENT

Principle of applicationTHE PRINCIPLE OF WHIRLPOOL THERAPY IS

TO COMBINE THE EFFECTS OF TEMPERATURE WITH THE MECHANICAL EFFECTS OF WATER

WARM WHIRLPOOL CONTAINS WATER AT TEMPERATURE RANGES BETWEEN 36-45 DEGREE CELECIUS AND A JET OF WATER OR AIR STREAM ALLOWED TO PRODUCE TURBULENCE IN WATER

THIS TURBULENCE IS PRODUCED BY A ELECTRICAL MOTOR INCORPORATED INTO THE APPARATUS

DEPENDING UPON THE APPARATUS,WHIRLPOOL BATH CAN BE USED FOR THE TREATMENT OF LIMBS OR WHOLE BODY

Types of Whirlpool BathsLow boy tankHigh boy tankHubbard tankExtrimity tank

Low boy tank- The Low Boy Tank can be used to allow an adult to sit in the tank and can range in capacity from 75 to 105 gallons

High boy tank-

sometimes referred to as a hip or leg tank, can allow for the immersion of both lower extremities

Capacity can range from 60 to 105 gallons

Full body immersion/Hubbard tank- The Hubbard Tank has a greater potential for exercise during treatment due to it's size and can accomodate a full body treatment

Capacity can range anywhere from 200 gallons to more than 400 gallons

Full body immersion/Hubbard tank- figure 8 pattern.  The pattern can allow for easy access to the patient.  Note that the larger tanks can also have more than one turbine for agitation.

•Full body immersion/Hubbard tank-

•Butterfly shape

•Underwater exercises

Hubbard tank8 feet long * 6 feet wide * 4 feet deep425 gallons of waterTurbines, stretcher, hoistChances of contaminationExpensive secondary to amount of water,

time to clean

Extrimity tank- The Extremity Tank is usually used for the upper or lower extremities and has a capacity of 10 to 45 gallons of water

Temperature RangeCold:     55-65 degrees F acute inflammationCool:     65-80 degrees F acute inflammationTepid:     80-95 degrees F exercise, acute

inflammation if cold not tolerated, open wound, dec tone

Warm:   96-99 degrees F mobility, burnsHot:        99-104 degrees F pain, ROM, soft

tissue extensibilityVery Hot: 104-110 degrees F-chronic

conditions

Technique of application1. The whirlpool tank is filled with water2. The water temperature is checked by hand and

thermometer3. Adjust the patient’s position in accordance to the

treated body part and considering both comfort and security.

4. Explain the procedure and reassure the patient5. Place the body part in the water6. Encourage the patient to move while keeping the

body part under water during the treatment in case of joint involvement

7. After completion of treatment, dry the body part and wrap it keeping it warm

Therapeutic effectsThe whirlpool bath combines the values of

conductive heat and gentle massage

A sedative action.A relief of pain by stimuli which act through

the pain gait mechanism.A relaxation of muscle spasms.

Actions1. Producing vasodilatation2. Improving local arterial and lymphatic

circulation.3. Softening of scar tissue.4. Breaking down old adhesions after fractures of

sprains.5. Cleaning and stimulation of wounds.6. Mechanically removing dirt, dead tissue and pus.7. Causing regression of the inflammatory process.8. Diminution of edema and effusion.

THE PART TO BE TREATED IS IMMERSED INTO THE WATER AND JET OF STREAM IS ALLOWED TO PRODUCE TURBULENCE IN THE HOT WATER

TREATMENT IS USUALLY GIVEN FOR 15-20 MINUTES

WHIRLPOOL BATHS IS USED IN RHEUMATIC DISORDERS,POST TRAUMATIC STIFFNESS AND JOINT PAIN

IT IS EFFECTIVELY USED IN SPORTS MEDICINE FOR RELAXATION AFTER PRACTICE OR COMPETITION

USESBurns if no agitation is usedOpen wounds for debridment purposesPost-operative orthopedic conditions where

the water will add a bouyancy element to eliminate the weight of the extrmity for movement

As a resistance force for exercise

BEWARE OFAny adverse conditions that may appearSkin pallorShiveringDizzinessRapid , weak pulseHeadacheIncrease in edemaDecrease in ROMHyperventilation“Seasickness".

Indications1. Poor circulation2. Chronic edema3. Separate dead tissue4. Pain relief in amputations ( phantom pain)5. After removal of plaster cast (fractures)6. Stiff joints7. Infected wounds → with added antiseptic agent8. Arthritis with stiff and swollen joints9. Polyomyelitis and paraplegia to improve circulation10. Traumatic and chronic inflammatory conditions11. Weak and painful feet12. As preparation to massage, passive stretching and

exercises

CONTRAINDICATIONSFVERISH PATIENTRECENT SKIN GRAFTSCIRCULATORY IMPAIRMENTACTIVE BLEEDINGOPEN WOUNDSHAEMMORHAGESKIN ALLERGY