Aquatic Therapy Watsu & Ai Chi Techniques PDF

AQUATIC PHYSICAL THERAPY TECHNIQUES: Watsu and Ai Chi General Intervention Methods Degree in Physiotherapy USP-CEU SCHEME WATSU Characteristics Performance and requirements Indications and Contraindications AI CHI Characteristics Posture a...

AQUATIC PHYSICAL THERAPY TECHNIQUES: Watsu and Ai Chi General Intervention Methods Degree in Physiotherapy USP-CEU SCHEME WATSU Characteristics Performance and requirements Indications and Contraindications AI CHI Characteristics Posture and positions Indications and Contraindications 2  WATSU® Developed by H. Dull (California) in the early 1980s. Combines elements of muscle stretching, joint mobilization, massage, Shiatsu and dance. Performed in chest-deep warm water (34-37ºC). Patient is completeley passive and is supported and moved by a therapist (backfloated) 3 WATSU® 3 MAIN COMPONENTS The effect of the immersion of the body in warm water (34-37ºC). Corporal Occidental techniques which acts directly over the body. Spiritual part from Oriental techniques which acts on mind. 4  THERAPEUTICAL PRINCIPLES Water: Temperature (34-37ºC) Depth: chest-deep Characteristics: buoyancy, viscosity and turbulences (drag). Therapist (PT): in the pool for individual (one-to-one) treatment. must search for the ideal work water depth. cradles, moves, stretches, massages the patient. Movements are centred around the patient’s own breathing pattern and PT should adapt his/her own breathing pattern (breathing coordination). 5  THERAPEUTICAL PRINCIPLES Patient : tend to relax deeply passive movements Flotation aids only if required around the upper shins or lower thighs to prevent the legs from sinking. Time: Sessions last from a few minutes to more than an hour (30-60 minutes).. 6  WATSU® TECHNIQUE PERFORMANCE Typical session: ❖breath coordination ❖movement patterns ❖massage The session starts with the patient seated or crouched at the pool edge. 7  WATSU® FIRST POSITION PT gets patient’s hands (upright position). Patient will close his/her eyes Pick up forearms Come in side: Left of the therapist and right of the patient Stablish Triangle of Head Support© 1st point: elbow under the occipital region 2nd point: hand on the far shoulder (not grabbing) 3rd point: bend the knees to contact your armpit on the near shoulder Accompany into flotation (hand under S2) 8  WATSU® TECHNIQUE PERFORMANCE Typical Watsu moves use turbulent drag to produce traction and softly stretch the limbs and torso. Movements include: ✓slow rocking ✓arm and leg stretches ✓trunk rotations and stretches ✓various oscillation and pulsing patterns PT gently sways from leg to leg ("horse to horse stance") or forcefully moves in deep lunges in alternating directions ("warrior to warrior stance"),. Progression includes more positions and joints. Moves are repeated on both sides for balance. 9  WATSU® REQUIREMENTS One of the most important parts is the end of the session. There is a loss of physical contact. Emotional release is always possible. Patient should return to normality slowly and his/her reaction and attitude must be respected. 10  WATSU® Uses of Watsu 1.For healthy people, Watsu is used for relaxation, muscle stretching, and personal development. 2. For physical rehabilitation, Watsu is used to Improve function and increase quality of life. Treat patients with orthopedic and neurologic impairment. Treat fibromyalgia syndrome. To improve psychological function by calming the nervous system, enhancing relaxation, increasing body awareness and decreasing general anxiety. 11  CONTRAINDICATIONS Fever of 38ºC or more. Bleeding or wound maceration Cardiac instability: uncontrolled hypertension or heart failure Infectious diseases Urinary or bowel incontinence Uncontrolled Epilepsy Tracheotomy 12 AI CHI  AICHI (Jun Konno, Japan) Ai Chi is a water movement and relaxation program that has been created by combining Tai-Chi concepts with Shiatsu and QiGong techniques. It is performed standing in shoulder depth water (31-33ºC) using a combination of deep breathing and slow, broad movements of the arms, legs, and torso. 14  AICHI POSITION The starting position should be comfortable. Body weight projected into the feet and pool bottom. Arms, shoulders, hips and knees should be in anatomical position. 15  AICHI POSITION ✓ The feet are in a wide stance, at least shoulder-width apart. ✓ Toes pointed slightly outward ✓ Knees soft slightly flexed until water is at shoulder level and the arms are resting just below the water surface. ✓ Both arms forward 90º shoulder flexion, palms down and thumbs in contact. 16  AICHI POSITION ✓ The rib cage lifted and the diaphragm contracts. ✓ The spine is straight with the normal curves. ✓ The head is held erect but lifted. ✓ Chin relaxed and slightly down ✓ The eyes focused straight ahead or on water 17 18 19  AICHI MOVEMENTS The first 5 movements are symmetrical and parallel from left to right. From the 6th movement, they become asymmetrical and more challenging. Coordination, shift weight from side to side Jumping, balance are included. Chart useful to patients. 20  AICHI It can be used with groups or one-on-one. Ai Chi has been successfully used with: ✓ Pain management ✓ Arthritis ✓ Fibromyalgia ✓ COPD ✓ Diabetes ✓ Neurological and orthopedic diagnoses ✓ Balance deficits. 21 OTHER TECHNIQUES Aichi Ne. Craneo Sacral Therapy in Water. Healing Dance Backhab Burdenko Method Water Pilates. Water Yoga Deep Water Running 22  AI CHI NE A partner stretching program. Breathing techniques to increase relaxation and enhance strength abilities. https://www.youtube.com/watch?v=8FApVC-qrfM 23  Cranio Sacral Therapy in Water CST in Water was born as symbiosis of Watsu® (WAter ShiaTSU or Shiatsu in Water) and Cranio Sacral Therapy (CST) in a therapeutic environment such as water. 24  Cranio Sacral Therapy in Water Importance of the breathing pattern and holding the patient. Use of flotation aids 25  Healing Dance® Healing Dance® is an aquatic technique developed by Alexander George in 1993. The practitioner establishes an empathetic connection with the receiver. It consists on 10 trainings: 7 on the surface 3 subaquatic. 26  BACKHAB This is an integrated program: individual can do on his or her own. It was developed for people with back problems. BackHab is an aquatic walking program using various strides to produce a variety of benefits. It is excellent for gait re-training. 27  THE BURDENKO METHOD Used for athletic training and as a therapeutic method for people with disabilities. The basic concepts include integrating land and water therapy, using a vertical position, focusing on the whole body, and home exercises. https://www.youtube.com/watch?v=2b2aihKZheI 28  WATER PILATES Pilates adapted for the pool. It is designed to improve strength, flexibility, and range of motion, and also encourages musculoskeletal alignment. The main elements are resisting your own weight, controlled breathing, spine alignment, and abdominal strengthening. https://www.youtube.com/watch?v=S7ayd8nVeV4 29  WATER YOGA Hatha yoga poses performed in warm, waist- to chest-depth water to develop strength and static balance simultaneously. In addition, range of motion increases in coordination with diaphragmatic breathing and long exhalations. 30  DEEP WATER RUNNING Supported by a wetbelt or aquajogger to walk or run through deep water. The base is to use a frontal plane as large as possible in order to achieve maximal impedance/resistance. This is the basis of cardiovascular/pulmonar training, in general focused on aerobic conditioning. https://www.youtube.com/watch?v=X_Hyr8 oCZW8 31  REFERENCES Pérez-de la Cruz., S., García, A. V., Lambeck, J. Effects of an Ai Chi fall prevention programme for patients with Parkinson’s desease. Neurología. 2016; 31: 176-182. Pérez-De la Cruz S, Lambeck J. Efectos de un programa de Ai Chi acuático en pacientes con fibromialgia. Estudio piloto. Revista de Neurologia, 2014;59 Bayraktar D, Guclu-Gunduz A, Yazici G, Lambeck J, BaturCaglayan HZ, Irkec C, Nazliel B. Effects of Ai-Chi on balance, functional mobility, strength and fatigue in patients with multiple sclerosis: a pilot study. NeuroRehabilitation.2013;33(3):431-7. Güeita J, Alonso M, Rodríguez C. Terapia acuática: Abordajes desde la fisioterapia y la terapia ocupacional. Elsevier. España. 2015. 32