LC1 Hydrotherapy PDF

HYDROTHERAPY Dr. Hend Ahmed Saad Lecturer of physical therapy for women health Objectives: Define hydrotherapy and explain its importance. Describe the benefits of water in any form or temperature. Prepare a description of Physical principles of hydrotherapy. Determine the sequenti...

HYDROTHERAPY Dr. Hend Ahmed Saad Lecturer of physical therapy for women health Objectives: Define hydrotherapy and explain its importance. Describe the benefits of water in any form or temperature. Prepare a description of Physical principles of hydrotherapy. Determine the sequential nature of a variety of aquatic exercises.  Hydrotherapy ▪ Hydrotherapy is a Greek words hydro means "water" and therapeia means "healing". ▪ Hydrotherapy is defined as: therapeutic modality that uses water in any form or temperature (hot, cold, steam, liquid, ice) for the treatment of physical or psychological dysfunction. ▪ Hydrotherapy is specifically designed to improve neuromuscular, skeletal and proprioceptive functions in patients with acute, subacute and chronic disabilities.  Physical principles of Hydrotherapy 1. Buoyancy / Specific gravity 2. Hydrostatic pressure 3. Viscosity and Resistance 4. Turbulence: 5. Moment of Force 6. Specific heat 7. Thermal conductivity  Physical principles of Hydrotherapy 1. Buoyancy / Specific gravity: Buoyancy is a force experienced as an upward thrust on the body in the opposite direction to the force of gravity. According to The Archimedes Principle states that when a body is entirely or partially immersed in fluid at rest, it experiences an upward thrust equal to the weight of the fluid displaces. Buoyancy / Specific gravity  Buoyancy / Specific gravity ▪ The amount of fluid displaced depends on the density of the immersed body relative to the density of the fluid. ▪ Specific gravity is the ratio of the density of a substance to the density of water. ▪ Water has specific gravity of 1.0 at 4°C, and the human body has a specific gravity of 0.974.  Buoyancy / Specific gravity ▪ Buoyancy is used to help weakened body parts to rise against gravity or to assist the therapist in supporting the weight of the patient's body during therapeutic activities. ▪ The buoyancy of the body in water is used clinically to decrease stress and compression on weight-bearing joints, muscles and connective tissue.  Clinical implication of buoyancy: ▪ Weight relief depending on the proportion of the body below water level: When the body is immersed to waist level, the weight relief is approximately 50% of the body weight. If the water is at shoulder level, weight relief is approximately 90% of the body weight. So pain due to weight bearing can be relieved in hydrotherapy pool. ▪ Weight relief depending on the proportion of the body below water level:  Clinical implication of buoyancy: ▪ Progression in muscle power: A) By changing the position of the patient in the pool. B) By changing the length of the lever arm, a flexed limb is less assisted or resisted by the water than a straight limb. C) Alteration of the shape: as if we asking the patient to hold a ball in the hand will result in alteration in the shape of the limb, so this increase the resistance to movement. Starting position for stretching hip Alternative position for stretching flexors by using floats hip flexors by using floats Stretching hip adductors using floats  2. Hydrostatic pressure Defined as : the pressure exerted on an immersed body by the water that surrounds it. According to Pascal's law: a fluid exerts equal pressure on all surfaces of a body at rest at a given depth, and this pressure increases in proportion to the depth of the fluid.  Hydrostatic pressure Water exerts a pressure of 22.4 mm Hg/1.36 cm (0.54') H2o depth. Therefore, a body immersed to a depth of 48 inches is subject to a force equal to 88.9 mm Hg, slightly greater than human diastolic blood pressure. Since pressure increases as depth increases, a pressure gradient exists between shallow and deeper water; standing in water can assist patients with lower limb edema by encouraging fluids in higher-pressure areas to flow proximally.  Hydrostatic pressure Hydrostatic pressure can be used to apply resistance if doing exercise. Also hydrostatic pressure of water will vary with patient positioning. The greater effects will occur with vertical positioning. Hydrostatic pressure and buoyancy together can facilitate improvement of balance activities. Pressure gives the body support and buoyancy can assist in maintaining an upright position if it deviates from the vertical.  3. Viscosity and Resistance Viscosity is the internal friction that occurs between molecules of water. As a body moves through water, there is a resistance to the motion of body in water. Resistance in water is 42 times greater than in air. The viscosity of water makes it a useful strengthening medium because resistance becomes greater as more force is exerted against it.  4. Turbulence: Eddy currents result from moving in water. The more vigorous the Movement (and the more people moving), the greater the turbulence created. It may be created by an under water douche, or may be created by the physiotherapist moving through the water. The massaging action of the water on the skin is pleasurable for most people. It enhances circulation, improves venous return and reduces pain.  5. Moment of Force Moment of force is the turning effect of a force about any point. The moment of force is defined as the product of the force and the perpendicular distance between the line of action of that force and the fulcrum.  A float is attached to his hand and the elbow is flexed to a right angle The moment of force =AB x F AB, is the perpendicular distance between the line of action of the force and the fulcrum. F, is the result of buoyancy acting on the floats.  6. Specific heat Specific heat is the amount of heat energy required to raise unit mass of material by 1°C. The specific heat capacity of water is equal to 1. The specific heat capacity of air is 0.001. Given these specific heat capacities, it is apparent that water holds heat well, approximately 1000 times more than an equivalent volume of air.  7. Thermal conductivity Thermal conductivity is the ability of a tissue to absorb heat and conduct it across the tissue. Water is 1000 times more dense than air. It retains and transfers heat far better than air. Water efficiently conducts heat. In fact, water conducts heat 25 times faster than air does. Water retains four times as much thermal energy as an equivalent mass of air at the same temperature, and it transfers this thermal energy 25 times more rapidly than air at the same temperature.  Thermal conductivity Exercise in warmer pools (87°F - 98°F) should not be too vigorous, since there will be no opportunity to lose heat created by the working muscles. In warm pools, participants should drink cool water, and focus on muscle conditioning and flexibility exercises, rather than vigorous cardiovascular training. These pool temperatures are ideal for gentle aqua and rehabilitation classes. In water that is very cool (below 80°F), blood is shunted toward the core of the body to maintain body heat. As the water gets colder, muscles work less efficiently.  Any Question Thank you …… Dr/ hend