Presentación de la RHB acuática de la mano en el HandFun Meeting 2013.

1. LAURA BACARDIT RIU - @cerviman
Physical Therapy Certificate
Internacional Expert in Hydrotherapy and NDS
Official Master in Neurorehabilitation with researcher profile
Expert in Neuroscience
DAVID ARES SUÁREZ - @davidarsu
Physical Therapy Degree
Internacional Expert in Hydrotherapy and NDS
Official Master in Neurorehabilitation with researcher profile
Instructor of PMA Matwork recognized by SNS

3. Table from the CIF clasification

4. UPPER QUARTER - SPECIFIC
PATHOLOGY OUTCOMES EVIDENCE LEVEL &
RECOMMENDATION
RA (Al-Qubaeissy, KY et
al. 2013)1
Pain reduction, better physical and
emotional state
1+,B
Hand OA, RA (Francon
A., et al. 2009)2
(Kamioka et a. 2010)3
Pain reduction, reducing the intake of
anti-inflammatory, better
functionality and QoL
1+, B
Breast cancer (Tidhar D
et al. 2010)4
Reducing lymphedema and improved
functionality
1+, B
Pusher sdme (CHZ
Meneghetti et al. 2009)5
Increased strength and alignment 3, D
Parkinson (Vivas J et al.
2011)6
Better functional scope & others 1+, B
CRPS Type I (Sherry DD,
et al, 1999)7
Symptoms disappeared in 92% of cases
and held for at least 2 years by 88%
1 +, B
Guillain-Barre sdme:
(Taylor S, 2003)8
Improved joint range, rigidity & strength
-> more ventilation
3, D

5. Also nonspecific upper quarter results in other
pathologies (PCI, stroke, MS, spasticity…)
QoL & DLA
Example of a water treatment of the shoulder
(Thein JM et al., 2000)9

6. 1 2 3 4
PROBLEMS!!
Sample
size
Disparity of
interventions
Disparity of
times in the
interventions
Rating
scales

7. Are there different muscle activation in
function of depth? (Colado JC et al.,
2013)10
Are there different shoulder muscle
activations on land and water? (Kelly
BT et al., 2000)11
Is there less tissue damage in water?
(Pantoja PD et al., 2009)12

8. PSYCHOLOGICAL EFFECTS - fun, freedom,
independence, facilitates concentration, noise
limitation…
THERMODYNAMICS - pain, hypertension,
hyporeflexia, spasticity, MS*…
HYDROSTATIC PRESSURE - urination, GCS,
edema, hypertension, hyporeflexia, spasticity...
VISCOSITY – Slow movements / equilibrium
TURBULENCE - Resistance
BUOYANCY – Metacentric effects / progression

9. ★ Halliwick: Detachments?
★ Bad-Ragaz
★ Water specific therapy
★ Neurodinamic solutions
★ Mobilizations
★ Ai-Chi / Ai-Chi-Ne
★ Aqua-T-relax: Active?
★ Watsu: Active?
★ Sensitivity: Superficial (tactile & thermal)
Deep (baresthesic & kinesthetic)

10. TECHNIQUES AND OBJECTIVES
Halliwick Ai Chi BRRM Aqua T
Relax
Fitness
Motor
control
 
Muscular
Activity
  
Strength   
Rigidity     
Resistance  
Table from the IAFT (International
Aquatic Therapy Faculty)

11. CIF AND AQUATIC THERAPY
Body function Activity Participation
Halliwick   
Aqua T Relax 
BRRM 
Obstacles  
Fitness  
Ai Chi   
Table from the IAFT (International
Aquatic Therapy Faculty)

12. MOTOR
CONTROL
Task

13. MULTI
PLURI
INTER
INTRA
TRANS
DISCIPLINARY

14. HALLIWICK – BAD RAGAZ – AI CHI – AI CHI NE

16. 1. Al-Qubaeissy, K.Y., Fatoye, F. A., Goodwin, P.C. and Yohannes, A.M. The Effectiveness of
Hydrotherapy in the Management of Rheumatoid Arthritis: A Systematic Review.
Musculoskelet. Care, 11:3-18. doi: 10.1002/msc.1028
2. Françon A., Forestier R. [Spa therapy in rheumatology. Indications based on the clinical
guidelines of the French National Authority for health and teh European League Against
Rheumatism, and the results of 19 randomized clinical trials]. Bull Acad Natl Med. 2009
Jun;193(6):1345-56; discussion 1356-8.)
3. Kamioka H, Tsutani K, Okuizumi H, Mutoh Y, Ohta M, Handa S, et al. Effectiveness of aquatic
exercise and balneotherapy: a summary of systematic reviews based on randomized
controlled trials of water immersion therapies. J. Epidemiol. Jpn. Epidemiol. Assoc.
2010;20(1):2-12.
4. Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who suffer from breast
cancer treatment-related lymphedema: a randomized controlled study. Support.
Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer. marzo de
2010;18(3):383-92.
5. Meneghetti CHZ, Basqueira C, Fioramonte C, Ferracini Júnior LC. Influence of hydrotherapy
on trunk control in the pusher syndrome: case report. Fisioter. E Pesqui. septiembre de
2009;16(3):269-73) 3, D
6. Vivas J, Arias P, Cudeiro J. Aquatic therapy versus conventional land-based therapy for
Parkinson’s disease: an open-label pilot study. Arch. Phys. Med. Rehabil. agosto de
2011;92(8):1202-10

17. 7. Sherry DD, Wallace CA, Kelley C, Kidder M, Sapp L. Short- and long-term outcomes
of children with complex regional pain syndrome type I treated with exercise
therapy. Clin. J. Pain. septiembre de 1999;15(3):218-23
8. Taylor S. The ventilated patient undergoing hydrotherapy: a case study. Aust. Crit.
Care Off. J. Confed. Aust. Crit. Care Nurses. agosto de 2003;16(3):111-5)
9. Thein JM, Brody LT. Aquatic-based rehabilitation and training for the shoulder. J
Athl Train. 2000 Jul;35(3):382-9.
10. Colado JC, Borreani S et al. Neuromuscular responses during aquatic resistance
exercise with different devices and depths. J Strength Cond Res. 2013 Mar 27.
11. Kelly BT, Roskin LA et al. Shoulder muscle activation during aquatic and dry land
exercises in nonimpaired subjects. J Orthop Sports Phys Ther. 2000 Apr;30(4):204-
10.
12. Pantoja PD, Alberton CL et al. Effect of resistive exercise on muscle damage in
water and on land. J Strength Cond Res. 2009 May;23(3):1051-4. doi:
10.1519/JSC.0b013e3181a00c45.