complete review of hydrotherapy

1. HYDROTHERAPY

2. Content
• Introduction
• Properties of water
• Physiological effects of water
• Equipments used in hydrotherapy
• Indication
• Application of hydrotherapy
• Forms of hydrotherapy
• Precautions
• Contraindications
• Summary

3. Introduction
Hydrotherapy derived from the Greek word hydro
and therapy meaning water and healing
Hydrotherapy formerly called hydropathy involves
the use of water for pain relief .
Hydrotherapy is applied externally either by
immersion of the whole body or of parts of the body
in water or without immersion by spraying or
pouring water onto the body

4. Properties of water
a) Buoyancy
b) Density
c) Hydrostatic pressure
d) Viscosity

5. BUOYANCY
Archimedes principle: when a body is fully or
partially submerged in fluid at rest, it
experiences an upward thrust equal to the wt.
of fluid displaced.

6. BUOYANCY

8. Density
Determines whether the object will float.
Density = weight of object/
wt of equal vol of water
>1 – sink
<1 – float

9. Hydrostatic pressure

10. Hydrostatic pressure
Water exerts a perpendicular pressure
against the surface of body
Dependent upon :
Depth of submerged water
Density of liquid.
It increases as depth & density of liquid
So movement is performed more easily near
the surface of water than at greater depth.

11. RESISTANCE
Resistance or drag force Fd= PCV2A/ 2G
P=fluid density/ viscosity C= coefficient of drag
V-velocity of object
A= frontal area of object G= gravitational constant
So drag force is proportional to square of velocity
Frontal area is directly proportional to drag force
Viscosity refers to the magnitude of internal friction
(resistance) specific to the fluid.

12. RESISTANCE
If fluid is more viscous, more force is required to
create a movement
As temperature of water increases, viscosity
decreases, because molecules move farther apart.
This is beneficial for small weak muscles.
Greater the speed of motion, higher the resistance.

13. RESISTANCE

14. Hydromechanics
Definition: Hydromechanics comprise the physical
properties and characteristics of fluid in motion
Laminar flow: Movement where all molecules move
parallel to each other, typically slow movement.
Turbulent flow: Movement where molecules do not
move parallel to each other, typically faster
movements.
Turbulence creates an unstable environment
encouraging the core muscles of the body to become
stronger to maintain correct position and posture.

15. Physiological Effects Of Water
• Pressure
• Dissolved surfactant and
antimicrobials
Cleaning effects
• Decreased weight bearing
• Strengthening
• Slow bone density loss
Musculoskeletal
effects
• Increased venous circulation
• Increased cardiac output
• Decreases heart rate and Sys BP
Cardiovascular
effects

16. Physiological Effects Of Water
• Decreases vital capacity
• Increases work load
• Decrease exercise induced asthma
Respiratory
effects
• Diuresis
• Increased sodium and potassium
excretion
Renal effects
• Relaxation
Psychological
effects

17. Cardiovascular effects

18. RESPIRATORY EFFECTS

19. RENAL EFFECTS

20. THERMOREGULATION
Hot water
HR is increased
Increased cardiac output
Rise in core temperature
Muscle blood flow increased
Cold water
Slowed HR initially
HR returns to baseline in 10
min
Stroke volume increased
Cardiac output remains same

21. Equipments
• Equipment used for aquatic running or
exercise-
1. Collars, Rings, Belts

22. 2. Swim Bars or Buoyant dumbbells

23. 3. Gloves, Hand Paddles

24. 4. Kickboards

25. Rehabilitation pool

26. Indication
The specific indication include
Facilitate ROM exercise
Initiate resistance training
Facilitate weight bearing activities
Facilitate CVS exercise
Minimize risk of injury and reinjury during rehab
Enhance patient relaxation
Post event recovery

27. APLLICATIONS OF HYDROTHERAPY
1)Orthopaedic disorders
Decreased weight bearing
Closed or open chain exercise
Velocity dependent resistance
2)Neurological disorders
Propioceptive input
Improved balance
3)Cardiac fitness
Cardiac conditioning in persons with poor tolerance to land
based exercises.

28. APLLICATIONS OF HYDROTHERAPY
4)Exercise in water during pregnancy
Decreased weight bearing
Less elevation of heart rate
Decreased risk of maternal hyperthermia
5)Reducing Exercise induced asthma symptoms
Less exercise induced asthma than with other forms
of exercise.

29. Precautions
Hydrophobic disorder
Neurological disorder
Seizures
Cardiac dysfunction

30. Contraindication
Unstable angina and cardiac failure
Respiratory dysfunction
Severe peripheral vascular disease
Bleeding disorder
chronic kidney disease
Open wounds
Uncontrolled seizure
Water or airborne infection
Bowel and bladder incontinence

31. Exercise intervention using aquatic
environment
• Exercise prescribed using aquatics are
a) Stretching
b) Strengthening
c) Aerobic conditioning

32. Cervical Stretching

33. Shoulder stretching

34. Lateral trunk flexion

35. Hamstring stretch

36. Strengthening exercise

37. Strengthening exercise

38. Strengthening exercise

39. Forms of hydrotherapy
a) Contrast bath
b) Whirlpool baths
c) Sauna bath
d) Steam bath
e) Aromatic bath

40. Contrast bath
Treatment involves both hot and
cold therapy on same body part
Application procedure:
Start with cold and end with cold
Affected part should be moved
from warm to cold water
repeatedly
Goal :
Decreases swelling
Decreases pain
Decreases muscle spasm

41. Contrast bath

42. Contrast bath

43. Whirlpool baths
• Goal of whirlpool therapy
a) Decreases swelling
b) Control inflammation
c) Improve ROM
d) Decreases pain
e) Decrease muscle spasm

44. Whirlpool baths
• Application procedure:

45. Sauna bath
A sauna is a small room
designed as a place to
experience wet/dry heat
sessions
Ideal temperature is
maintained between 70oC
and 100oC

46. Sauna bath

47. Sauna bath
Physiological effects of sauna bath
Musculoskeletal System:
• Muscles relax and joints become more flexible.
• Heat enhances the circulation to joint capsule and
reduce the viscosity of synovial fluid.
Endocrine System:
• Endocrine functions respond to thermal changes mainly
through activation of Sympathetic nervous system(SNS).
• The stimulation of SNS is manifested by increased levels
of the nor-adrenaline.

48. Sauna bath
Cardiovascular system:
• Heart rate may accelerate up to twice the
resting rate.
• Acceleration of cutaneous circulation leads to
redistribution of blood flow.
• Blood flow to kidneys and viscera is reduced.
• Skin blood flow increases up to 20-40 times.
• Stroke volume is unaffected, whereas cardiac
output increases about 70 %.

49. Sauna bath
Respiratory System:
• Respiration becomes more faster and shallow.
• Air with 15-30% of humidity allows mucous
membrane of the upper respiratory tract to
remain moist.

50. Sauna bath
Other Physiological Effects:
Metabolism: Sauna increases the metabolism
• A 30 minute sauna session can burn up to 300
calories
• The water lost due to sweat can be replaced by
drinking water to avoid dehydration.
Relaxation : Sauna are traditionally known to
promote general relaxation.

51. Sauna bath
INDICATIONS:
• Promote general relaxation
• Relief from tension or anxiety
• Regular sauna baths may reduce the
incidence of common colds
In Sports
• Sauna helps to promote relaxation.
• Plays a good role in post event recovery.

52. CONTRAINDICATIONS
• Unstable angina or myocardial infraction.
• Severe orthostatic hypotension and severe
aortic stenosis
• Rheumatoid arthritis in acute inflammatory
phase
• Skin conditions such as Urticaria, abrasions
and rashes.
• During pregnancy

53. PRECAUTIONS
• Do not use alcohol prior to or during a sauna bath
• Make sure not to eat any large meals before.
• Person with low blood pressure(as sauna bath decreases
BP).
• Drink 1-2 glass of water or sports drink which has
electrolytes.
• Shower First, as this is to moisten the skin
• Do not take a sauna bath for over 15-30 minutes.
• Exit the sauna bath if you feel uncomfortable or become
sleepy.

54. Steam bath
• A steam room is a virtually airtight room
• Steam is produced by steam generator
which has about 100% humidity
• Typically between 115 to 120° F (40°C)
Benefits:
• Relieves nasal congestion
• Lower blood pressure
• Detoxification
• Promote general relaxation
Risk:
• Symptoms of dizziness, vertigo, excessive
thirst.

55. Steam bath

56. • Hydrotherapy Versus Conventional Land-Based
Exercise for the Management of Patients With
Osteoarthritis of the Knee: A Randomized Clinical Trial
• Conclusion: Both water-based and land-based
exercises reduced knee pain and increased knee
function in participants with OA of the knee.
Hydrotherapy was superior to land-based exercise in
relieving pain before and after walking during the last
follow-up. Water-based exercises are a suitable and
effective alternative for the management of OA of the
knee.

57. Summary
Hydrotherapy in Sports rehabilitation:
1) Increases ROM of joint
Water provides support & reduces need for splintage.
Warmth of water decreases spasticity, promotes relaxation & helps
prepare connective tissue for stretching.
2) Decrease in muscle spasm
Warm water decreases muscle tone & spasticity
3) Increases muscle strength & endurance
Strength training can begin in water before it is possible on land. This
helps to prevent atrophy of skeletal muscles
4) Improves body awareness, balance & trunk stability:
Warm water stimulates awareness of having body parts & provides
ideal medium for muscle re-education.
Stabilization can be obtained using railings

59. Reference

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