Lecture 4 whirlpool tanks .pdf

Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Hydrotherapy Immersion Tanks and Pool 1- Whirlpool tank 2- Hubbard tank 3- Exercise pool Dr. Wael Osama Aly, Lecturer of Basic Science, BUC 1- Whirlpool Whirlpool composition and function: -A whirlpool is composed of: • A tank that can hold wat...

Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Hydrotherapy Immersion Tanks and Pool 1- Whirlpool tank 2- Hubbard tank 3- Exercise pool Dr. Wael Osama Aly, Lecturer of Basic Science, BUC 1- Whirlpool Whirlpool composition and function: -A whirlpool is composed of: • A tank that can hold water • A turbine that provides agitation and aeration to move the water in the tank. The tank is usually made of stainless steel, although fiberglass and plastic tanks are also available. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Whirl pool turbine Dr. Wael Osama Aly, Lecturer of Basic Science, BUC • Whirlpools are available in different shapes and sizes to allow for treatment of different body parts, they also may be stationary or mobile (on wheels), common whirlpool types are: Extremity, Lo-boy and Hi-boy tanks. Extremity tanks: 1- Extremity tanks are suitable for immersion of upper or lower extremity only, commonly used for exercise for hand or foot, and to limited extent of range for elbow and knee movements. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Extremity whirlpool tanks Stationary Extremity whirlpool Mobile Extremity whirlpool Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Lo-boy and Hi-boy tanks are intended for immersion of larger parts of the extremities and the trunk. 2- The Lo-Boy whirlpool combines full-body immersion with easy access and allowing more extremity movements of the hip and back areas. These long and shallow units are designed at a lower height with ease of access. With the addition of an Adjustable Head Rest, the patient’s upper back, shoulder and neck areas can also be treated. 3- The Hi-Boy whirlpool offer complete coverage of all back, hip and shoulder areas for full immersion and full-body treatment, either in long sitting or squat sitting position. An optional Adjustable Suspension Seat or Tank Top Seat can be added, so lower extremities such as the lower leg, ankle and foot areas can still be treated separately. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Lo-boy whirlpool Stationary Lo-boy whirlpool Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Mobile Lo-boy whirlpool Adjustable Head Rest Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Stationary Hi-boy whirlpool Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Mobile Hi-boy whirlpool • A whirlpool turbine is composed of a motor attached securely to the side of the whirlpool, along with pipes, for air and/ or water circulation, suspended in the water. • The height and direction of the turbine can be adjusted to project the water pressure toward or away from the involved area. • The turbine may be directed toward the involved area to apply maximum force, as may be desired to control pain or to remove tightly adhered wound debris. • The turbine should be directed away from the involved area if the area is hypersensitive, or if granulation tissue is present. • Most turbines allow the clinician to open or close the aeration/aggitation valve to further modify the pressure of air/water flow. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Whirlpool Water Temperature and uses: •1-A cold whirlpool, at 0° C to 26° C, can be used instead of an ice pack or a cold pack to treat acute inflammatory conditions of the distal extremities. •Low temperatures can be achieved by adding ice to the whirlpool water; however, to decrease the risk of tissue damage, therapist should avoid using very low temperatures on large areas. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC • 2-Tepid water, at 26° C to 33° C, should be used in the whirlpool if the water is being used as a medium for exercise. • Warmer temperatures are likely to produce fatigue, and colder temperatures can inhibit muscle contraction (due to prolonged application). • If the inflammation is not acute, tepid whirlpool may be used when the inflammatory condition is still present but the patient does not tolerate lower temperatures. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC • 3-A neutral warmth whirlpool, at 33° C to 35.5° C should be used for the treatment of wounds and in patients with circulatory, sensory, or cardiac disorders. • Neutral warmth may also be used to decrease tone in patients with neurologically based hypertonicity. • 4-Mild warmth, at 35.5° C to 37° C, may be used for the treatment of burns once epithelialization has occurs to improve mobility and relaxation and minimizes energy loss caused by cooling or shivering. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC • 5- A hot whirlpool, at 37° C to 40° C, is recommended for the control of pain . • 6- A very hot whirlpool, at 40° C to 43° C, is recommended to treat chronic conditions as in patients suffering from osteoarthritis and rheumatoid arthritis, (in non acute phases), and also increase soft tissue extensibility, because this temperature range of whirlpool water has been shown to increase the temperature of subcutaneous tissue. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Table: Whirlpool Water Temperature and uses Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Rules and principles of using whirlpool: 1. The whirlpool temperature should not exceed 43° C at any time because higher temperatures may cause burns. 2.The tank should be filled with water immediately before it’s usage to prevent heat loss. 3. If an antimicrobial is being used, it should be added to the water as the whirlpool is being filled. 4. Check and record the vital signs before treatment. 5. Monitor the patient throughout the treatment session. 6. Whirlpools are generally applied for 10 to 30 minutes; shorter periods may be sufficient for softening wound scar, whereas longer periods will increase the amount of heat transferred to the patient. 7. Dry the skin thoroughly after treatment, and inspect the treated area. 8. Keep the patient covered or wrapped after treatment to avoid chilling. 9. Drain, rinse, and clean the whirlpool after treatment. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Advantages • Can be used for heat transfer, cleansing and debriding wounds, or for exercise • Portable, occupying small area, less water and time consumption to for filling and emptying it, and also cheaper than other total body immersion techniques (hubbard tank and exercise pool) • Patient can be positioned securely and comfortably (no risk of drowning). • Weaker muscles can move more freely than on dry land. • Allows movement/exercising the affected part while heat is being applied, unlike other conductive thermal agents such as hot packs, this movement is beneficial when treating joint stiffness or impaired ROM, or when edema without acute inflammation is present. Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Disadvantages • The small size of the tank limits the variety of exercises and also the area that can be treated. • Risk of infection • Cost of the tank and time associated with cleaning the whirlpool (in comparison to using hot packs). • Costs associated with heating the water. • Time consumption in assisting the patient to dress and undress Dr. Wael Osama Aly, Lecturer of Basic Science, BUC Dr. Wael Osama Aly, Lecturer of Basic Science, BUC