The document outlines an aquatic physical therapy protocol for total knee arthroplasty (TKA) patients, including beginner, intermediate, and advanced exercises that can be done in the pool to increase range of motion, decrease pain and joint impact, and allow for longer exercise times compared to land therapy. Benefits seen in TKA patients who participated in aquatic PT included quick progression through exercises, less reported pain and soreness, and enjoyment of the pool environment. Drawbacks included a lack of specialized pool equipment and patients progressing quickly between twice weekly aquatic and land therapy sessions.

1. Aquatic PT Capstone
TKA Protocol
Kate Anderson

2. Pathology
• Total Knee Arthroplasty
• Patient must wait for their incision to heal
completely before submerging it in water
• Benefits of Aquatic PT on TKA patients:
– Inc ROM
– Decrease impact/load on joint
– Decrease pain
– Increase time exercise time compared to land
therapy

3. Beginner
• Walking
– Forward/backward
– Side stepping
– Marching/soldier kicks
• HS/quad stretching with pool noodle (for
stretching and ROM)
• Hip flex/ext & abd/add
• Noodle step downs
• Calf stretch/calf raises
• Bicycle kicks/flutter kicks

4. Intermediate
• Inc. walking pace/# of laps
• Mini squats
• HS/quad stretch will be more stretching benefit
and less ROM benefit
• Add ankle weights or wings for all ther-ex
• SL calf raises
• Step ups/step downs on pool stairs
• Flutter kicks
• LAQ sitting on noodle no weight

5. Advanced
• Begin swimming laps
• Inc sets and reps on all ther-ex
• Inc weight of ankle weights or inc speed of
exercise if using wings
• SL balance while moving arms
• Progress out of pool to land only exercise

6. Outcomes
• All of our TKA patients progressed quickly through
aquatic PT
• all patients saw benefit/enjoyed the pool
• Patients were able to complete Ther-ex for longer
duration in water vs. land
• Patients reported less pain/soreness from aquatic PT
• Drawbacks:
– Lack of pool equipment
– Patients progressed very quickly esp b/c most were in PT
2x/wk once in the pool and once on land
– Low # of patients