Hydrotherapy intro

1. 1
台灣大學物理治療學系暨研究所
佳樂水國際教育有限公司
2019.04.19

2. Outline
• Hydrotherapy
• The physical properties of water and hydrodynamic principles
• The intervention design
• Aquatic techniques
• Halliwick method
• Bad Ragaz Ring Method
• Ai Chi
• Watsu
• Clinical application
• Population: Stroke
• Intervention: Watsu
• Q A
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4. The physical properties of water
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5. Relative Density
! The human body has a RD of 0.974.
! The tendency to sink or float
! Metacentric effect
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http://tinyurl.com/j3vuhrm
Floater Sinker
Body
composition
Fat mass Lean body
mass
Muscle tone Paralysis Spasticity
Body tension Relax Tense
Breathing Breathe in Breathe out
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Buoyancy
! Buoyancy is a force that can assist, resist,
or support movement in the water.
! The progression of weight-bearing status in
the water
! Use of the water for decreased joint loading
allows earlier, safer, and more comfortable
rehabilitation.
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http://tinyurl.com/j3vuhrm

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http://tinyurl.com/z7f3xsu
http://tinyurl.com/hjz33kl
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8. Hydrostatic Pressure (HP)
! HP is directly proportional to
the depth of immersion with
a pressure of 22.4 mmHg/
30 cm of water depth.
! HP has a significant effect on
the cardiopulmonary system.
! To reduce edema, challenge
cardiopulmonary fitness, and
improve the stability of trunk
and joints.
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9. Viscosity, Cohesion, Adhesion and
Surface Tension
9http://tinyurl.com/hf2vuwm
http://tinyurl.com/jsffufr
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10. Refraction
! In aquatic therapy, refractions occur when
light rays pass from the air to the water.
! Use the goggles to observe underwater
10http://tinyurl.com/zupjvn3
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11. Fluid Dynamic Properties
! Streamlined Versus Turbulent Water Flow
! Eddies, Wakes and Drag Force
! Streamlined or Unstreamlined Movement
11http://tinyurl.com/z6ffyyt
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12. Aquatic equipment
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13. Thermodynamics
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14. Psychological
benefits
• Establish camaraderie
and compliance may
dispel feelings of
isolation, anger,
depression, or anxiety
that commonly
accompany an injury
or disease process. Aqua aerobics class can be fun. Photo Credit Maria
Adelaide Silva/iStock/Getty Images
http://tinyurl.com/zzbjfqa
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15. Indications
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16. Contraindication
! Unstable vital signs
! Uncontrolled: cardiac
conditions,
hypertension, DM,
seizures
! Incontinence
! Infections
! Skin disease
! Open wounds
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http://www.dreamstime.com
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17. Precaution
! Limit the treatment
time
! Metabolic syndrome
! Pregnancy
! Limited chest
expansion: SCI,COPD,
PPS, Smoker
! Low tolerance to
vestibular stimulation
! Multiple Sclerosis
18http://tinyurl.com/zf4wotr
http://www.dreamstime.com
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18. •
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19. Aquatic intervention
Mobility exercises
Stretching
Strengthening
Cardiopulmonary training
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20. Aquatic techniques
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Halliwick BRRM
Watsu Spinal
mobilization
http://tinyurl.com/hgq35d5
http://tinyurl.com/jxaoa8ehttp://tinyurl.com/z5383gx
http://tinyurl.com/j4s3c7c
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21. Aquatic exercises
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Ai Chi Water aerobics
Therapeutic
swimming
http://tinyurl.com/h5njdfp http://tinyurl.com/z342qp7
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22. Halliwick -1
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23. Halliwick concept -2
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https://tinyurl.com/y4jx5y9b
https://tinyurl.com/y4jx5y9b
• Entering into pool
• Sit to stand
• Float to stand
• Breathing control

24. Bad Ragaz Ring Method
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25. Ai Chi
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26. Watsu
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https://www.youtube.com/watch?v=ET0mVCpLvrY

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N=7
N=15
N=2
N=1

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Fig 1. Searching engines and
the process of article
selections in this study

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http://tinyurl.com/y234v6v4
http://tinyurl.com/y65hdwgo
1
2
http://tinyurl.com/y2etgg3y
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32. 3257 99.9

33. 33
Ref First author Population InterVention
Comparison Outcome
measures
Results
1 Agnes M.
Schitter, 2015
Pregnancy
(=34
wks)
n=17
Watsu, n=9
2 sessions *60'
Water Temp
(WT):35°C
Control, n=8
No treatment
(matching)
SF-36,
PSS
VAS,
MDMQ
Significantly
decreased
stress and
pain; improved
mental
function and
mood
2 Ana Isabel
Useros-olmo,
2018
Cervical
dystonia
(5 yrs)
n=27
Watsu, n=15
4 sessions *50'
(1 session/wk);
WT:33-35 °C
(Autogenic
training, 2*15'/
day, 30 days)
Control, n=12
No treatment
(matching)
SF-36,
VAS,
TWSTRS,
BDI-II,
STAI
Significantly
decreased
pain, improved
physical and
social function
3 Kieren Faulk,
2005
FMS
(~4.3 yrs)
n=13,
crossover
(washout
3 wk)
Watsu, n=13
4 sessions
*45’ ;WT:32-35
°C (2 sessions/
wk)
Aix massage,
n=13
4 sessions
*30’ ; WT:
35-39 °C (2
sessions/wk)
SF-36 Significantly
decreased
pain, improved
physical,
vitality and
social function

34. • Warm water is the ideal medium to provide integrative
therapy that frees not only the body but also the mind and
spirit (Harold Dull, 1997)
• Holistic medicine, defined as the art and the science of
healing the body, mind and spirit ( Graham-pole, 2001).
• Watsu is a holistic intervention and it worth of developing a
full study to explore the therapeutic effects.
• Watsu for 45-60 minutes/ session and 2-4 sessions could
significantly improved quality of life, pain and mental health.
34
Clinical
implication

35. Reduced hypothalamic-
pituitary-adrenal axis
activity, that is, lower
plasma cortisol levels
along with increased
mental and physical
relaxation in context
with immersion, has
previously been reported
[J. W. Turner Jr., 1983, A.
Kjellgren, U. ,2001)
35
Hypothalamic-
pituitary-adrenal
axis activity
Decrease HPA axis activityà
increased mental and physical relaxation
àbetter functional mobility?
https://tinyurl.com/y427bcb2

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Hydro
Hydro
Hydro

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46. APPENDIX
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47. Evidence-based Halliwick -1
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48. Evidence-based Halliwick -2
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49. Evidence-based Halliwick -3
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50. Evidence-based Halliwick -4
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51. Evidence-based Halliwick -5
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52. Evidence-based BRRM -1
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53. Evidence-based BRRM -2
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54. Evidence-based BRRM -3
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