Physiological Effects of Hydrotherapy PDF

Physiological effects of hydrotherapy Presented By Dr. Mai Abo Elhamd, PhD, Cairo University Physiological effects of hydrotherapy 1. Cleansing effect 2. Cardiovascular effects 3. Musculoskeletal effects 4. Respiratory effects 5. Renal effects 6. Neurological effects  1- Cleaning effect Water is...

Physiological effects of hydrotherapy Presented By Dr. Mai Abo Elhamd, PhD, Cairo University Physiological effects of hydrotherapy 1. Cleansing effect 2. Cardiovascular effects 3. Musculoskeletal effects 4. Respiratory effects 5. Renal effects 6. Neurological effects  1- Cleaning effect Water is commonly used as cleanser for open wounds and ulcers; It has a hydrating and softening effects on dried gauze and debris adhered to the skin or wound. It exerts a friction force on the surface of the skin. The pressure exerted by the water can be controlled, because it is dependent on the speed. Water flows easily through contoured areas of wounds and different body parts. Antimicrobial can be added to water to increase its cleansing effect.  2-Muscloskeletal effect A- Buoyancy decreases load on weight- bearing joints and muscles, allowing patients with joint arthritis, instability, or degenerative joint diseases to perform exercises with less pain. b. Buoyancy can help obese persons to perform exercises that are extremely loading if performed on dry land. c. Water viscosity and turbulence exerts resistance against movement and help to increase or maintain muscle strength. 2- Musculoskeletal effect d. Hydrostatic pressure may increase resting muscle blood flow due to increased venous return from the extremities. This increases muscle performance. E-Immersion acts to drive out edema, lactate, and other metabolic waste products. F-increased temperature of the water causes peripheral vasodilatation, increased blood  3- Cardiovascular effect a. Is primarily produced by hydrostatic pressure with immersion: i. It increases venous return from lower limbs to the heart, which is directly proportional to the level of immersion. ii. With body immersion to the neck level, central blood volume increases by 60%, and cardiac output by 30%. iii. Heart rate decreases with water immersion B. Water resistance increases metabolic rate and energy consumption. 4- Respiratory effect a. Increased venous return increases blood flow in the chest, and hydrostatic pressure on the chest wall increases the resistance to lung expansion. b. This increases respiratory work by 60%, which increases strength and efficiency of the respiratory system.  5- Renal effect a. Body immersion increases urine production and sodium and potassium excretion due to increased renal blood flow. b. Increased urine production decreases edema. c. Hydrotherapy with full-body immersion has been recommended as a treatment for edema in patients with nephrotic syndrome and cirrhosis that is resistant to diuretic intervention.  6- Neurological effect The effects of water immersion on the neurological system are primarily temperature dependent. Warm water tends to be relaxing, whereas cold water tends to be stimulating. Therapeutic uses of hydrotherapy 1. Superficial heating and cooling: Warm or cold water can be used clinically to heat or cooling superficial tissues by different modalities (hot packs, whirlpools) 2. Wound care: Hydrotherapy used to accelerate the healing of wounds of various etiologies including diabetes mellitus, pressure, vascular insufficient or burn because of it's cleaning properties facilitates the rehydration, softening, and debridement of necrotic tissue and the removal of exogenous wound debris. 3. Edema control: a. The effects of hydrostatic pressure on circulatory and renal functions. b. Cold application prevents edema formation in acute injuries through vasoconstriction and decreasing capillary permeability. c. Hot application reduces chronic edema through vasodilatation and removal of waste products. 4. pain control: a. Stimulation of peripheral mechanoreceptors, which activates the gate control theory, e.g., contrast bath and water immersion with high temperature and high agitation. b. Reducing inflammation through cold application. c. Decreased weight bearing on painful or inflamed joints. 5. Water exercise: Various types of exercise, including swimming, running with or without a vest or belt, walking, cycle ergometry and other form of upright exercises can be performed in water. Applications of hydrotherapy for various conditions  Applications in cardiovascular and cardiopulmonary rehabilitation Research generally supported the use of aquatic environments in cardiovascular rehabilitation for ischemic cardiomyopathy. aquatic therapy is probably not safe with very severe or uncontrolled failure or very recent myocardial infarction. aquatic and thermal therapies may be very useful rehabilitative techniques in individuals with mild to moderate heart failure.  Applications in osteoarthritis and inflammatory arthritis:  The buoyancy of water combined with the hydrostatic pressure produced during immersion and the thermal properties of water make the aquatic environment uniquely beneficial in the management of patients with osteoarthritis.  Aquatic therapy has shown to be effective in reducing pain and stiffness and producing high rates of compliance with therapy. Applications in the management of spine conditions: Off-loading of body weight occurs as a function of immersion, but the water depth chosen may be adjusted for the amount of loading desired. The spine is especially well protected during aquatic exercise programs, which facilitates early rehabilitation from back injuries. Moreover, pain is reduced secondary to both afferent nociceptive and thermosensitive inputs, and compliance is usually high.  Applications in athletic training: Aquatic cross-training can sustain or even build aerobic fitness, with the side benefits of reduced joint loading, decreased muscle soreness, improved respiration and improved performance. Aquatic exercise used effectively to sustain or increase aerobic conditioning in athletes who need to keep weight off a joint, as when recovering from injury or during an intensive training program in which joint or bone microtrauma might occur. Respiratory function in athletic rehabilitation:  The pulmonary system is affected by immersion of the body to the level of the thorax.  The effect is to alter pulmonary function, increase the work of breathing, and change respiratory dynamics so strengthen respiratory muscles.  Respiratory strengthening may be an important aspect of high-level athletic performance Because inspiratory muscle fatigue seems to be a rate and performance- limiting factor even in highly trained athletes. Applications in geriatric and osteoporosis rehabilitation:  Aquatic exercise has been successfully used to improve balance and coordination in older individuals, who face an increased risk of falling.  Because of the safety of aquatic exercise, the risk of injury during the exercise period is extremely small.  Thus, it is quite reasonable to begin an active exercise regimen in the pool and, when feasible, transition to a land based exercise regimen that involves more impact loading. Applications in pain, fibromyalgia, and psychiatric rehabilitation: Studies have shown aquatic exercise to reduce anxiety scores and increase perceived well-being in addition to the relaxation effect of water immersion and the effect that water immersion has on pain perception.  Applications in obesity rehabilitation: Aquatic exercise would offer the safest and most protective environment for obese individuals due to the buoyancy effects , which minimizes the risk of joint injury. A program that begins in water and moves to land as strength, endurance, and tolerance may be the most effective method to achieve conditioning and weight Indications, contraindications, and precautions of hydrotherapy Indication of hydrotherapy 1. subacute and chronic soft tissue injury. 2. Ms spasm 3. Scar formation 4. Osteoarthtitis 5. subacute/and chronic rheumatoid arthritis 6. Post fracture pt. 7. Tension and anxiety 8. Burn with intact thermal sensation 9. Pressure ulcer 10. Ms weakness Contraindication of hydrotherapy 1. Severe cardiac dysfunction 2. Infection disease/ fever 3. Vomiting 4. Urinary infections 5. Suprapubic catheter 6. Incontinence 7. Respiratory dysfunction 8. Severe peripheral vascular disease 9. Bleeding disorders 10.Impaired thermal sensation 11.Skin infection Precautions of hydrotherapy 1. Hypersensitivity to chemicals used in pool 2. Multiple sclerosis(hot) 3. Thermoregulation problems 4. Epilepsy 5. Excessive fear of water 6. Peripheral vascular disease 7. Fever 8. HIV 9. Compromised respiration 10.Unstable blood pressure