Hydrotherapy Lecture 2 PDF

Physiological Effects of Hydrotherapy Descriptions of physiological effects of hydrotherapy on different body systems as: 1. Cardiovascular System 2. Pulmonary System 3. Renal System 4. Central and Peripheral Nervous System 5. Musculoskeletal system Water Temperature Classification...

Physiological Effects of Hydrotherapy Descriptions of physiological effects of hydrotherapy on different body systems as: 1. Cardiovascular System 2. Pulmonary System 3. Renal System 4. Central and Peripheral Nervous System 5. Musculoskeletal system Water Temperature Classification Classification Temperature Very Cold 1°C - 13°C Cold 14°C - 18°C Cool 19°C - 26°C Tepid 27°C - 32°C Neutral 33°C - 35°C Warm 36°C - 37°C Hot 38°C - 40°C Very Hot 41°C - 43°C Effects on Cardiovascular System The hemodynamic effects of hydrotherapy include local changes in circulation and systemic effects on cardiac function. The water’s temperature will either increase localized circulation secondary to vasodilation or decrease localized circulation secondary to vasoconstriction. Generally, warm water temperatures of about 35.5°C will result in vasodilation. Cold water temperatures below 27°C will cause vasoconstriction. Central venous pressure is increased as blood displaced centrally secondary to hydrostatic pressure. The amount of blood displacement depends on the depth of submersion causing an increase in right atrial pressure, stroke volume, cardiac output, and muscle circulation, as well as a decrease in systemic vascular resistance. Cardiac output with a normal heart rate, for example, 86 beats per minute (bpm) is 5 liters/minute; with immersion, it increases to 8.6 liters/minute at 86 bpm.  Effect of hydrotherapy on cardiovascular system Effects on Pulmonary System Hydrostatic pressure against the chest will tend to inhibit lung expansion. Increased circulation to the center of the body during immersion will increase circulation in the chest cavity, further inhibiting lung expansion. Maximal oxygen uptake is lower during most forms of water exercise than during exercise on land. These effects result in an increase in the total work of breathing. Immersion in water up to the neck has been shown to decrease expiratory reserve volume by approximately 50% and to decrease vital capacity by 6% to 12%; these effects, when combined, increase the total work of breathing by approximately 60%. That is because of maximal oxygen, uptake is lower during most forms of water exercise than during exercise on land. The challenge on the respiratory system that occurs when exercise is performed in water can be used to improve the efficiency and the strength of the respiratory system. However, this additional respiratory demand may overload patients with respiratory or cardiovascular impairments that prevent or limit adaptation to the additional workload, such patients should always be carefully monitored during the water-based exercise. Water based exercise is often recommended for patients with exercise induced asthma because studies have shown that it is less likely to cause asthma in this individual than exercising on dry land.  Pulmonary effects of immersion Effects on Renal System Water immersion can affect renal function, resulting in increased urine output (diuresis), creatinine clearance, increased sodium excretion, and increased potassium excretion. It is proposed that these effects are the result of increased renal blood flow and decreased production of anti-diuretic (ADH), aldosterone and renin hormones. Patients should empty their bladders before entering a therapeutic pool. Water immersion is thought to cause this circulatory and hormonal changes in response to the redistribution of blood volume. Volume and the relative central hypervolemia result from the hydrostatic pressure that water exerts on the periphery. These renal effects can be taken advantage of to treat patients with hypertension or peripheral edema. Full body immersion has been recommended as a treatment for edema in patients with nephrotic syndrome and cirrhosis that is resistant to diuretic intervention. Renal effects of immersion Effects of Hydrotherapy on the Neurological System 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 invigorating or stimulating. Pain modulation is affected by a rise in the pain threshold. The relaxation effect of hydrotherapy is most likely multifactorial, secondary to hypothesized effects occurring within the reticular activating system of the brain. Effects of Water on the Musculoskeletal System Immersion of muscles in water has been shown to significantly increase oxygen delivery to the muscles and increase the removal of metabolic waste products. This effect is secondary to reflex changes in blood vessel tone and the compressive effect of hydrostatic pressure. Clinical use of hydrotherapy for relaxation of muscle spasm as result of increased blood flow caused by immersion in warm water. Agitation of the water, as in a whirlpool bath, may also help relax muscle spasm by breaking the “pain/spasm” cycle by increasing sensory stimulation of the water against the skin overlying the spastic muscle. Muscle strength may be increased with exercise in water, especially when exercising against turbulence. The buoyancy of the water provides joint protection by off-loading via upward force of buoyancy counterbalancing gravity’s downward effects. Effects of Water on the Psychological State Hydrotherapy has a Relaxing or stimulating effect depending on temperature.