Lecture 10 Hydrotherapy Applications 2024 PDF

Hydrotherapy applications Dr. Hisham Mohamed PT, MSc, PhD @202401 1 1 Uses of hydrotherapy pools Apply heating or cooling Apply underwater exercises Mechanical massage effect Debridement of wound...

Hydrotherapy applications Dr. Hisham Mohamed PT, MSc, PhD @202401 1 1 Uses of hydrotherapy pools Apply heating or cooling Apply underwater exercises Mechanical massage effect Debridement of wounds / dressings @202401 2 2 1  Specific advantages for pools and tanks – Effective heat transfer. – Provide secure patient positioning. – Can provide easier muscle movement than occurs on land. – Allow combined heating and movement at the same time. @202401 3 3 Disadvantages of whirlpool – Size of the tank might limit amount and types of exercises. – Requires space. – Cross infection. – Use large amount of water. – Time consuming; especially for filling, emptying, cleaning. @202401 4 4 2  Indications Muscular spasm Back pain Chronic musculoskeletal conditions Preliminary treatment to other modalities @202401 5 5 Contraindications 1. Advanced peripheral vascular disease. 2. Arterial insufficiency 3. Diabetes 4. Loss of sensation 5. Hydrophobia 6. Fecal/urine incontinence @202401 6 6 3  Different applications and techniques 1. Pools: 1. Whirlpool. 2. Hubbard tank. 2. Contrast baths. 3. Hot packs 4. Paraffin @202401 7 7 1. Whirlpool bath Description: form of local bath for treatment of the extremities with the limb submerged in rapidly circulating water. Types: – Extremity tank: used for upper & lower extremity. – High boy & low boy tank: used for body immersion. @202401 8 8 4  immersion in whirlpool bath @202401 9 9 Large size whirlpool Small size whirlpool @202401 10 10 5  Upper extremity whirlpool application @202401 11 11 @202401 12 12 6  2- Hubbard tank Description: it is a large 8 or keyhole-shaped bath used for total body immersion Made of: plastic or stainless steel. Dimensions: 2 m length, 1.5m width, 1m depth. Accessories: stretcher, overhead carrier for non-ambulatory patients. @202401 13 13 @202401 14 14 7  Hubbard tank system @202401 15 15 Effects Same as whirlpool bath. But it allows more exercises than whirlpool do as active assisted, resisted and stretching exercises can be performed inside the Hubbard tank. @202401 16 16 8  Bath temperature 36ºc - 39ºc. It is lower than whirlpool temperature because with total body immersion, the ability of the body to dissipate heat through sweating is markedly decreased @202401 17 17 Specific Hubbard tank Advantages Therapist doesn’t have to enter the tank. Allow free space for upper and lower extremity exercises. Used for gait and walking exercises especially for infected patients that cannot use hydrotherapy pool. @202401 18 18 9  Disadvantages Hubbard 1. No buoyancy effect. 2. Time consuming; especially for filling, emptying, cleaning. 3. Use a large amount of water. 4. Therapist can't get too close to the patient as in the pool. 5. By leaning over the edge of the tank, the therapist is not in good working position. This situation may be improved if the tank is on a raised area. @202401 19 19 Application of exercises inside Hubbard tank @202401 20 20 10  3- Contrast baths Definition: alternating immersion of the part in hot then cold water. Effects: relatively vigorous because each time neural accommodation starts to occur, temperature stimulation is reversed. It is thought of as vascular exercise. Preparation: hot application for 10min. @202401 21 21 Contrast bath unit for extremities @202401 22 22 11  Physiologic effects 1. Marked immediate vasodilatation. 2. Rapid increase of skin temperature. 3. Deep circulation increases rapidly. 4. Marked sedative effect. 5. Its effects more vigorous and lasts longer than either heat or cold alone. @202401 23 23 Specific Indications for contrast bath Excessive sweating (hyper-hydrosis) @202401 24 24 12  Hydrocollator Packs Equipment: Hydrocollator unit Hot packs. Towels @202401 25 25 Hydrocollator unit Definition: is a stainless-steel tank in which hydrophilic silica gel packs are heated Unit have: – insulated bases – wire rack which acts as divider for the packs prevents contact of the packs with the bottom of the tank. Temperature of water: between 76°c and 80ºc. @202401 26 26 13  @202401 27 27 Silica gel packs @202401 29 29 14  Covering (padding) technique @202401 30 30 Commercial towels @202401 31 31 15  Considerations – The patient must not lie on the packs because this will force the silicate gel out through the covering fabric sleeves. – If the patient can’t tolerate the weight of the packs the therapist can modify patient position to side lying and most of the pack weight placed on the side of the patient, and the other parts supported with additional towels and pillows. @202401 32 32 @202401 33 33 16  Paraffin Bath Definition: It’s a form of conductive heat in which a mixture of milted paraffin and mineral oil is used to heat a part of the body Proportion: – 4 units wax to 1 oil. – Sometimes 6 or 7 : 1 @202401 34 34 Patient tolerance This method of treatment is well tolerated by the patient compared with hot water because of lower specific heat of the wax. Wax releases less energy than water while cooling. But because of its nature it provides a good insulation that maintains this low-level heating for prolonged time. @202401 35 35 17  Equipment The wax is placed in a bath (small or large). Metal baths have an electric heating element with a large jacket around the tank. The machine is of light weight. The bottom of the bath is covered by bakelite-slats to prevent the patient from coming in contact with it. The top is covered with a lid. Have an average capacity of 25 Kg. @202401 36 36 Advantages Well tolerated Can be easily performed Used as home routine @202401 37 37 18  Disadvantages Messy Cannot be applied effectively on proximal body parts Need effort to clean and maintain it clean @202401 38 38 Techniques of application 1. Dipping followed by wrapping. 2. Dipping followed by immersion. 3. Wrapping. – limited use, – Insufficient rise in temperature – Useful as a home technique. @202401 39 39 19  Dipping @202401 40 40 Dipping followed by wrapping @202401 41 41 20  Modified techniques  Dipping & Elevation:  Dipping & Active exercises: @202401 42 42 To apply paraffin bath over skin grafted area; – The graft should be stable, – Non-fragile – At least 10 days post graft. – The treatment is daily for 2 -3 weeks – temperature around 47 °c. @202401 43 43 21  Notes ROM may be increased from 7 – 10 degrees after application of wax. Paraffin is used in the non-flare phases to decrease pain and increase tissue extensibility. Modified technique of dipping and elevation is useful for oedematous extremity. @202401 44 44 @202401 45 45 22  Thank you @202401 46 46 23