Lecture 5 hubbard tank and exercise pool.pdf

Hubbard tank Dr. Wael Osama Aly, lecturer of physical therapy, BUC 1 Hubbard tank • A Hubbard tank, named according to the engineer who invented it, is a large whirlpool intended for fullbody immersion. • These tanks vary in size but generally are about 8 feet length by 6 feet width and 4 feet d...

Hubbard tank Dr. Wael Osama Aly, lecturer of physical therapy, BUC 1 Hubbard tank • A Hubbard tank, named according to the engineer who invented it, is a large whirlpool intended for fullbody immersion. • These tanks vary in size but generally are about 8 feet length by 6 feet width and 4 feet depth. • The tank is equipped with turbines, a stretcher, and a hoist to raise and lower the stretcher. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 2 Uses of Hubbard tanks: • Hubbard tanks is suitable for debridement of burns covering large areas of the body and for treatment of other painful conditions that affect large areas of the body. • It can also be used for ROM exercises for multiple areas, or for ambulation. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 3 Rules and principles of using Hubbard tanks: • Water temperature is generally kept in the slightly lower range of 36° C to 39° C because patients cannot dissipate the increase in tissue temperature as effectively when heat is applied to a large area. • Hubbard tanks must be cleaned between uses in the same manner as whirlpools of other sizes. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 4 Advantages • Can treat large areas or multiple areas of the body than whirlpool allowing greater variety of exercises. • Can be used for heat transfer, for cleansing and debriding of wounds, for water exercise and sometimes for ambulation training. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 5 Disadvantages • High Cost equipment and more difficult connection requirements and requires greater space • Uses larger amount of warm water than whirlpool. • Time-consuming to fill, empty, and clean tank and to place patient in the tank using the stretcher (lifter). • Requires extra caution and close monitoring with regard to possible systemic effects of over heating of large body area, like hypotension and fainting, and also to avoid risk of drowning. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 6 Exercise pool Dr. Wael Osama Aly, lecturer of physical therapy, BUC 7 Dr. Wael Osama Aly, lecturer of physical therapy, BUC 8 Exercise pool • The use of an exercise pool allows full-body immersion and performing exercises in water which optimize the cardiovascular, respiratory, renal, and psychological benefits of hydrotherapy, unless immersion in water is contraindicated. • An exercise pool is generally the optimal method for applying hydrotherapy to achieve the musculoskeletal benefits associated with water immersion. • Most swimming pools are at least 100 feet length and 25 feet width and have a maximum depth of 8 feet, with a sloping bottom to produce a gradual descent. • Swimming pools and purpose-designed hydrotherapy pools (gait training pools) can be used for the application of hydrotherapy, the purpose-designed hydrotherapy pools are smaller in size than swimming pool. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 9 Figure 3: Purpose-designed exercise pool with treadmill Dr. Wael Osama Aly, lecturer of physical therapy, BUC 10 • Some purpose-designed hydrotherapy pools are equipped with an underwater treadmill, an adjustable rate-of-water flow, and adjustable depths to provide graded exercise activity (Fig. 3). • Either type of pool may be used for individual or group treatment, depending on its size, with a therapist present, or for independent home exercise programs. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 11 Group therapy in an exercise pool: Dr. Wael Osama Aly, lecturer of physical therapy, BUC 12 Pool Temperature • The temperature of the water in an exercise pool should be kept at 26° C to 36° C. • The cooler end of the range, 26° C to 28° C, is recommended when more intense exercise will be performed, because the cooler temperature dissipates heat produced by patients, thereby allowing them to perform more vigorous exercise, with less fatigue. • The water temperature should not be allowed to be below this range because such low temperatures can impair the ability of muscles to contract, as prolonged application of hydrotherapy at temperatures less than 26 ° C results in muscle inhibition. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 13 • The warmer end of the range, 34° C to 36° C, should be used when low-intensity activities, such as light exercise by elderly deconditioned patients or by patients with arthritis, will be performed. This is because warmer temperatures are more comfortable and help patients who move less to conserve body heat while in the water. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 14 Advantages • Patient can move freely, with less risk of falling in water (especially in elderly patients) during exercises (when compared with land exercises). • Decreases weight bearing on joints. • Buoyancy can assist weak muscles to allow increased performance of active exercise. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 15 Precautions and disadvantages • Precautions: (Slippery floor)”outside the pool” Risk of falling when the patient gets into and out of the water.  (Group therapy) Risk of infection from other individuals who have been in the water. • Disadvantages:  Difficulty stabilizing or isolating body parts during exercise  Risk of drowning  Fear among some patients of water immersion Dr. Wael Osama Aly, lecturer of physical therapy, BUC 16 Safety precautions and infection control for whirlpools, Hubbard tanks and exercise pools Dr. Wael Osama Aly, lecturer of physical therapy, BUC 17  Safety • The tank should be properly grounded, and the turbine must have a hospital-grade plug, and well fitted and fastened to the outside of the tank . • The turbine should not be running without water in the whirlpool because this can damage the turbine motor. • Whirlpools should be inspected regularly for any breaks in wiring or insulation because of the high risk of severe electrical injury. • The treatment room should be comfortably warm and well ventilated but also avoid air drafts. Ventilation is required to keep good aeration, control the humidity of the room and to remove infectious agents from the air. A room temperature of 25° C to 30° C with a relative humidity of 50% is recommended. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 18 Safety in and Around the Pool: • To ensure safety around an exercise pool and to minimize the risk of a patient slipping and falling, the area surrounding the pool should have non slip surfaces. • Pool regulations, emergency procedures, should be clearly shown and identified in the pool area. • For safety in the pool, the depth of the water should be clearly marked at intervals around the pool edge, and hand grip bars should be provided all the way around the edge of the pool. • Means of entering the pool should be appropriate for patients’ ambulatory ability and may include stairs, ramps, ladders, or lifts for non ambulatory or impaired patients. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 19  Infection Control • The primary goal of infection control is to reduce the number of microorganisms in the environment and thus to reduce the potential for infection. • Hydrotherapy tanks provide an ideal breeding ground for infectious organisms due to frequent contact with warm contaminated water, so Antimicrobials should be added to reduce contamination with microorganisms • For optimal infection control, appropriate cleaning protocols are required, and protective garments should be worn by individuals providing hydrotherapy care, also the person cleaning the whirlpool should wear rubber gloves and goggles throughout the cleaning procedure. • The whirlpool tank and turbines should be properly drained and cleaned after each use. • Rinse the tank with clean water directly from a hose. • Scrub the inside of the tank with a brush and detergent, and then rinse the tank again. Dr. Wael Osama Aly, lecturer of physical therapy, BUC 20 Dr. Wael Osama Aly, lecturer of physical therapy, BUC 21