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Aquatic Neurological Physiotherapy Rehabilitation / Hydrotherapy

Neurological Conditions treated with Hydrotherapy include: Alzheimer's disease, ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, spinal cord injury and stroke.

Water is a completely different environment to do rehabilitation in than land-based therapy. There are two main principles to keep in mind namely : hydrostatic and hydrodynamic principles. When incorporating the hydrostatic principles, factors like buoyancy, density, the metacentric effect and hydrostatic pressure is concidered. All of these can be applied and used advantageously in treatment of the patient suffering from any neurological condition like strokes, traumatic brain injuries and parkinsons. Hydrodynamic principles also play a role and include resistance which is affected by the body shape and speed of movement in water and turbulence. Turbulence can be used to challenge and improve balance and coordination.

Water is a very safe and comforting environment for patients with neurological conditions.

A few benefits of rehabilitation in water include:

  • Modification of abnormal muscle tone (Immersion and neutral warmth as well as constant fluid movement decreases weight bearing and thus tone)
  • Increase of range of motion actively and passively (buoyancy assists movement towards surface)
  • Potential pain decrease due to increased blood flow to muscles
  • Improving of functional mobility (walking and transfers are easier in water and patients can take a bigger risk with higher-level activities without negative consequences of falling)
  • Allowing the assuming of an upright standing or sitting position earlier than on land where weakness and gravity plays a role
  • Increase in aerobic fitness and strength
  • Enhancing of psychological mood
  • Improvement of balance and proprioception
  • Building of confidence with successful completion of movements not possible on land which leads to increased confidence and motivation
  • Decrease potential formation of contractures
  • Increasing core strength and general stability

Rehabilitation can be done using an active or more passive approach. Passive techniques are often applied with the patient lying on his/her back with buoyancy assistive devices like floatation belts, pool noodles, inflated rings or neck cuffs keeping them afloat which allows the therapist to work comfortably with any part of the body while the patient is completely relaxed. When using more active techniques, the patient’s functional activities and impairments are used to guide the activity level.

Water is a higly adaptable environment. A few ways of adapting treatment to specific needs could include:

  • Different direction of movement could change from a buoyancy assisted to buoyancy resisted movement which helps increase muscle strength and lend itself to more repetitions of movement without fatigue.
  • Progressing patients from deeper into shallower water allows gradual progression into increased weightbearing which is very benificial for patient who have suffered strokes.
  • Speed of activity can be decreased with resistance and use of buoyance devices for patients with Parkinsons where accurate and directed movements can be practiced and mastered.

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