This presentation is complete about hydrotherapy and its role in medical care. How hydrotherapy helps patients to recover along with some precautions etc. Hydrotherapy has a lot of benefits, That why we prepare that presentation for those who are willing to learn about it. This presentation may helpful for you in your studies. I hope this will helps you a lot.

1. Author: SaimaMustafa(pt)

2. Definition;
Hydrotherapy derived from the Greek word ,
hydro = water and therapy= healing
“A method of treating diseases, physical
or psychological dysfunction by using
water internally and externally at different
temperatures and pressures in different
ways ”
Explanations;
It is a part of medicine, Specially in
physiotherapy, that involves the use of
water for pain relief and treatment.

3.  Water is being used widely throughout the world as a form of physical therapy.
 Patients are instructed through a specific program designed to help their physical
conditions.
Categories of Hydrotherapy
There are two main Categories of Hydrotherapy
(1) Internal Hydrotherapy (2) External Hydrotherapy
Internal Hydrotherapy
This form of therapy includes insertion of water into body
Examples
Colonic irrigation. Involves cleaning the entire bowel. This helps to cure numerous
digestive problems and conditions.
Enemas
 A liquid treatment of rectal injections of fluid intended to clean or stimulate the
emptying of your bowel. It has been used to treat severe or chronic constipation
to stimulate stool evacuation.
so on own its own .
 For Big surgery or for C section for baby birth ;

4. Mineral water drinking therapy
The treatment is by drinking the prescribed quantity of
curative water,
Indication;
 Dyskinesia of biliary tract and gallbladder
 Cholelithiasis
 Liver ailments
Dosage
 Duration of the mineral water drinking therapy is 3-4 week,
1-3 times a day in the amounts recommended by a
physician according to the case.
 It is done on an empty stomach and the dose of the water is
usually measured in glasses (250 ml).
 Before the treatment begins, the examination of the visitor
by the doctor of the hydrotherapy center is mandatory.

5.  Application of ice or water to the body. It also involves
immersion of the body in water.
 Aims at using temperature-based hydrotherapy
techniques, Contract bath; such as the effects of hot and
cold water on the skin as well as the underlying tissue.
 When used, hot water causes sweating and relaxes
muscles. It is a very effective method of treating poor
circulation, sore muscles.
 Ice packs or cold compresses are used to relieve pain
associated with dental surgery, headaches and sprains.
 External hydrotherapy is conducted in various ways ;
Example sits baths, Contrast hydrotherapy,Wirlpool
bath etc..,

6.  Hydrotherapy relies on its mechanical and temperature (Cold and
thermal effects), in order to induce healing.
 Principles
 Hot and cold water induce physiologic changes that are beneficial
to human health
 Hot water causes superficial blood vessels to dilate, activating
sweat glands, and removing toxic wastes from tissues.
 Cold water causes superficial blood vessels to constrict, moving
blood flow away from an affected area to relieve inflammation
 When Patient submerged in water like a pool or a bath, experience
some kind of weightlessness. During this period, the water relieves
the body of gravity’s effects.
 In addition,. Moving water stimulates the skin’s touch receptors.
This effect increases blood circulation while releasing tight
muscles.

7. Clinical Case of Heel Spur
Created by a bony-like growth, called a calcium deposit, underside of the heel bone
Diagnosis
 Via X-ray - Heel purr
Sign and symptoms
sharp pain like a knife in the heel when standing up in the morning.
a dull ache in the heel throughout the rest of the day.
inflammation and swelling at the front of the heel. heat radiating from the affected area
small, visible bone-like protrusion under the heel.
Treatment plan
 Contrast bath
 Put salt in water ,Dip effected heel in hot water for 30sec then in cold water for 30sec till 1o times
twice in a day ,For 2 weeks

8. Precautions
Do not walk bear foot on floor
wear soft shoe or cushioning gel
Complications
Corticosteroid injections
Ultimate solution is surgical removal

9. Therapeutic Effects/Goal of Hydrotherapy
 Treatment of Wounds ;aims to provide an optimal healing environment.
The wound consist of pus after c section surgery washed by alted water
 Relieve pain and muscle spasm
 To gain relaxation
 To maintain or increase the range of joint movement
 Re-educate paralyzed muscles
 To strengthen weak muscles and to develop their power and endurance
 To encourage walking and other functional and recreational activities
 To give the patient encouragement and confidence in carrying out his
exercises, thereby improving his morale.

10.  The warmth of water blocks nociception by acting
on thermal receptors and mechanoreceptors
 Initiate resistance training
 Facilitate weight-bearing activities and reduce risk
of injuries
 Facilitate cardiovascular exercise
 Minimize risk of injury or re-injury during
rehabilitation monitored aquatic-based exercises
effectively improve muscle strength, fatigue, and
quality of life, and skin disease activity than land-
based exercises in children with juvenile
dermatomyositis (childhood disease that causes
muscle weakness and skin rash)

12. The four most important properties of
water from a treatment point are:
(1). Water is non-irritating, non-allergic,
and totally compatible with human
physiology both inside and outside of the
body.
(2). Water is a good heat conductor and
at the same time greatly heat storing in
capacity so that it is the ideal agent for
manipulating body temperature.
(3). Water is totally conformable to the
body surfaces. This means that it makes
an intimate interface with whatever it
comes in contact, which greatly
facilitates its ability to affect the
temperature the object it contacts.
(4). Water is inexpensive in spite of all its
marvelous properties.

13.  Water has some other certain physical
properties which include;
 weight, density, buoyancy, Hydrostatic
pressure, and surface tension.
 The most important physical laws of water
that physiotherapist should understand and
apply when giving hydrotherapy, are
buoyancy and hydrostatic pressure.
Density of water
The weight of the water per its unit volume,
Value 997 kg/m³
It depends on the temperature of the water.
At temperature decreases its velocity aloe
lessen
Example Ice floats on water due to low density
Density of ice =0.92 g cm-3

14. Buoyancy
The force experienced as an up thrust which acts in
the opposite direction to the force of gravity.
A body in water is therefore subjected to two
opposing forces.
When the weight of the floating body equals the
weight of the liquid displaced, and the centers of
buoyancy and gravity are in the same vertical line,
the body is kept in stable equilibrium.
 If the centers are not in the same vertical line the
two forces acting on the body will cause it to roll
over until it reaches a position of stable equilibrium.

15.  Decrease stress and compression to body tissues (weight-
bearing surfaces)
 Assist weak muscles.
 used in rehabilitation therapy to assist in movement, as
resistance to movement, and to support movement on the
water's surface.
Hydrostatic Pressure
Pressure exerted by fluid on body immersed in fluid
Cardiovascular effects:
Increased Venous circulation ,Then Increase Cardiac Volume as a
result Increase Cardiac Output.
Respiratory effects:
Immersion of the whole body in water increases the Work of
Breathing. Hydrostatic Pressure on the chest wall increases the
resistance to lungs expansion.
Exercise- induced asthma Water based exercise is
recommended for patients with because it appears that High
Humidity of the air inspired during water exercise, which
prevents drying of Respiratory mucosa.

16. Type and Modalitie of Hydrotherapy
Whirlpool hydrotherapy:
 stainless steel tanks of various sizes,
 It has an attached motor called – Turbine.
 The turbine – Mixes the water in the tank to create the whirlpool effect.
Parts of WP
Turbine ejector
Hot and cold-water mixing valve
Temperature gauge
drainer
Seat / Chair
Clinical Benefits
Increase circulation and improved tissue repair after a burn, ulcer, or other skin
injuries
Precaution
These WP are intended to used as single-patient treatments & must be drained &
cleaned after each use to avoid preying of diseases

17.  It requires a chair or lift to transfer the patient in & out of the tank.
 Patients in a high boy tank usually sit on a removable seat attached to stairs on the side
of the tank or may sit on a chair outside the tank with their lower extremity hanging in
the tank.
Dimensions
Width: 20 -24 inches , Length: 36 -48 inches , Depth: 28 inches
Extremity Tank
 This WP tank is smaller in size, designed especially to treat distal extremities
(Ankle/foot/hand)
 It is often portable with attached wheels for ease of movement.
Dimensions
 width: 15 inches ,length: 28 – 32 inches , depth: 18 – 25 inches
Low boy tank
It is designed for ease of transfer in & out of the tank by virtue of low walls & length.
Patients in a low boy are usually in a long sitting position.
Dimensions
 width: 24 inches ,
 length: 52 – 66 inches

19. Aquatic exercises:
Exercising in a pool of warm or cool water allows you to exercise with less resistance and
pressure on joints. It can be helpful for people back pain, arthritis, obesity, advanced age, or
physical disability.
Compresses:
This form of hydrotherapy involves wrapping towels soaked in warm or cool water on a body part to
increase circulation or reduce inflammation. Aromatics are often added to the wraps for various
therapeutic purposes.
Floatation tanks:
Also known as isolation tanks or immersion tanks, the practice involves floating in a shallow pool of
saltwater in a sealed, darkened tank. Doing so is said to relieve stress and anxiety, improve sleep, and
relax muscles.
Foot baths: Soaking your feet can reduce swelling and pain after a long day on one's feet. But, it
can also be used to soften tissues before a spa foot treatment. Some people even claim that food baths
can balance circulation and decrease congestion in the head, lungs, and pelvic organs.

20.  Sitz bath:
 A sitz bath involves sitting a tub of water to treat conditions affecting the rectal area,
or genital areas. Sitz baths are commonly used for hemorrhoids.
 Steam baths:
 Steam baths involve rooms filled with warm, humid air that proponents claim can
amplify the benefits of a sauna. Turkish baths are a form of steam bathing that employs
higher humidity and lower temperatures.
 Ice bath:
 Popular among athletes, ice baths involve soaking in a tub of water between 45 F and
65 F to speed recovery from an injury or extreme exercise.
 Hot fomentation: The application of warm compresses or hot water bottles to the
chest is said to relieve acute symptoms of a cold or bronchitis.

21. CONTRAINDICATION
Local immersion:
 Maceration ; Increased maceration, increased size of wound--(Maceration is defined as
the softening and breaking down of skin resulting from prolonged exposure to moisture).
 Bleeding In or near the area
For full body immersion
 Infectious conditions that spread with water , like UTI’s-Urinary tract infections can
affect different parts of your urinary tract, including your bladder (cystitis), urethra
(urethritis) or kidneys (kidney infection)
 plantar warts, tinea pedis (pool)
 Cardiac instability Uncontrolled hypertension or heart failure
 Severe epilepsy
 Increased risk of drowning
 Suicidal patients
 Increased risk of drowning
 Acute inflammatory conditions
 Hyperpyrexia – Increase tissue temperature
 Malignancies
 Active bleeding – Prolonging arterial blood flow

22.  Cardiac dysfunction – Not able to adapt to
thermal homeostasis
 Respiratory dysfunction – Not able to resist
hydrostatic pressure, tolerate heat or both
 Decreased thermal sensation – Inability to
sense too much heat / cold
 Not able to meet increase metabolic
demand
 Venous ulcers – May promote venous
blocking
 Surface infections – Cross contamination
 Uncontrolled bowels – Contaminate water
 Dermatological conditions(Atopic eczema)
– Exacerbate
 Severe epilepsy – Risk of drowning (Full
body immersion)

23.  Local immersion
 Impaired thermal sensation – cause Burns
 Check temperature of water with thermometer first
 Infection in area to be treated – Need additional infection control measures
Universal Precautions
 Clean Whirl Pool modality
 Impaired cognition – Not able to report problems or discomfort Use constant,
 direct supervision
 Temperature of water near body temperature
 Not for Recent Skin Grafts
Precaution full body immersion
 Confusion, Disorientation
 Keep head above water
 skin grafts – May not able to tolerate agitation or not able to compensate for extreme of heat or cold

24. Conti..
 Patients on medications-Physician clearance sometimes
required Patients with fear of water
 Patients with respiratory problem
 Watch for signs of respiratory distress, especially in hot
or very warm water
 Low temperature ,gradually increase
 Patients with limited strength, endurance, balance,
ROM Hands-on approach required
 Fear of water (full body immersion) – May refuse to
participate
 After ingestion of alcohol– Impaired judgment – risk of
drowning.
 Limited strength, endurance, balance or ROM – Safety
hazard – risk of drowning
 Urinary incontinence– Risk of UTI
 Medications – May alter CVS
 Multiple sclerosis– Increase fatigue & weakness
 Sea sickness – Cause anxiety

25.  Patient’s Skin status
 Health & mental status
 which Hydro equipment's used
 used Accessories
 Water temperature
 Water Additives (When applicable) – Name &
concentration of solution.
 Body part treated
 Treating method – non immersion or
immersion
 If immersion – Then its level – partial or full
 and Duration of immersion