Hydrotherapy uses water and its properties for therapeutic purposes. It has a long history dating back to ancient civilizations. Various forms include whirlpool baths, Hubbard tanks, contrast baths, aquatic exercises, and sitz baths. The physical properties of water like temperature, pressure, buoyancy and viscosity provide benefits like increased blood flow, reduced joint stress, and strengthened muscles. Potential side effects include drowning, hyperthermia and disease transmission, so precautions around heat are important. Hydrotherapy continues to be used for conditions like arthritis, pain, wounds and edema.

1. HYDROTHERAPY
Dr. Lakshmi Nair

2. hydrotherapy
“ The term encompasses a broad range of
approaches and therapeutic methods that
take advantage of the physical properties of
water, such as temperature and pressure, for
therapeutic purposes, to stimulate blood
circulation and treat the symptoms of certain
diseases.”

3. history
• Various forms of hydrotherapy have been recorded in ancient
Egyptian, Persian, Greek and Roman civilizations.
• Egyptian royalty bathed with essential oils and flowers, while
Romans had communal public baths for their citizens. Iranians
classified spa waters according to effect of spa water in
treatment of illness.
• Hippocrates prescribed bathing in spring water for sickness.
Other cultures noted for a long history of hydrotherapy
include China and Japan.

4. history
• 1921, Baruch published, An Epitome of Hydrotherapy
• In 1911, Charles Leroy Lowman began using therapeutic tubs to treat
spastic patients and those with cerebral palsy.
• At Warm Springs, Georgia, Leroy Hubbard developed his famous tank,
and in 1924 Warm Springs received its most famous aquatic patient,
Franklin D. Roosevelt
• 1937, Dr. Charles Leroy Lowman published his Technique of Underwater
Gymnastics: A Study in Practical Application, in which he detailed pool
therapy methods of specific underwater exercises
• 1950s the National Foundation for Infantile Paralysis supported the
corrective swimming pools and hydrogymnastics of Charles L. Lowman
and the therapeutic use of pools and tanks for the treatment of
poliomyelitis
• 1962-the American Society of Medical Hydrology and Climatology
(ASMH),

5. Current trends
• With the end of the polio epidemic and the rise of
newer and more exciting technology in rehabilitative
therapeutics, the use of the aquatic environment in
rehabilitation waned
• Water was recognized as a wonderful surrogate for
the weightlessness of space it became essential to
forecast the effects of space flight.
• Murray Epstein and other endocrinologists realized
that aquatic immersion was a benign means of
simulating central volume expansion to better
understand volume homeostasis.

6. principle
Based on benefits of physical properties of
water :-
• Specific gravity ,
• hydrostatic pressure - edema
• bouyancy – less apparent weight
• Viscosity – viscus resistance ᾳ force applied
strenghtening
• specific heat /thermal energy transfer

7. Systemic effects
CVS :
• Submersion to the neck increases cardiac
output by more than 30%
• Diminished sympathetic vasoconstriction
produces peripheral venous pressure
decrease by 30%
Respiratory system:
• increases work of breathing

8. Systemic effects
Musculo skeletal:
• Off loading weight -range-of-motion activities,
gentle strength building, and even gait
training.
• Resistance by bouyancy/ visocity-
strengthening
• CKC / OKC
• Less joint stress – GRF less , more time taken
• More blood- supply less fatigue

10. types
• Whirlpool baths and Habbard tanks
• Contrast bath
• Acquatic exercises
• Sitz bath
• Balneo therapy / spa

11. WHIRLPOOL BATHS AND
HABBARD TANKS
• small portable whirlpools designed to treat a
single extremity
• Hubbard tanks containing thousands of liters.
• hand-held shower heads and small water jets
are often used for local treatment such as the
irrigation and debridement of deep wounds
and burns.

12. Whirlpool baths
• Water temperature choice depends on the
amount of the body immersed, treatment
goals, and the patient's medical condition.
• for a healthy patient, temperatures of 43°C
to as much as 45°C or 46°C are possible in
whirlpools.
• Agitation of water gives a massaging effect

13. Habbard tank
• Full-body immersion for 20 minutes can
increase systemic temperatures by 0.3°C ;
• Hubbard tank temperatures are usually
limited to 39°C.

14. Burns / infected wounds
• Antiseptic – sodium hypochlorite
• Habbard tank- isotonic with 0.9% saline
• Beware of cross / auto contamination -
pseudomonas
• SHOWER CART – gentle spray/shower in
relatively sterile conditions
- over head showers with independent temp /
pressure adjustments
- less water , space , easy maintenance

16. Contrast bath
• ALTERNATE IMMERSION IN HOT (42°C to
45°C) AND COLD ( 8.5°C to 12.5°C)WATER.
• Effect- cyclic vasodialation and constriction
• Rheumatologic disease, neuropathic pain ,
chronic pain syndromes -CRPS

17. CONTRAST BATH
30 min sessions- begin with an initial soaking
of the hands or feet in the warm bath for
about 10 minutes and then proceed to four
cycles of alternate 1- to 4-minute cold soaks
and 4- to 6-minute warm soaks ending with a
cool, rather than a warm, soak.

18. Acquatic excercises
• Osteoarthritis
• Rheumatoid arthritis
• CP children
• PPRP
• Spine stabilising excercises
• fibromyalgia

20. Sitz bath
• Warm sitz baths- treatment of hemorrhoids,
anorectal fistulas, and post-partum pain.
• sitting in water between 40°C and 50°C (with
warmer temperatures perhaps more
effective) lessens sphincter activity and anal
pressures in normal subjects as well as those
with hemorrhoids and anorectal fistulas .

21. Balneo therapy
• Treatments involve a combination of physical
therapy, water baths, mud treatments , vapour
bath, mineral water consumption, and
education that may take place in a resort-like
atmosphere for periods as long as 3 weeks.
• belief that water containing dissolved gases
(such as nitrogen, carbon dioxide, or methane),
elements (e.g., calcium, magnesium, zinc, and
cobalt), and compounds (e.g., hydrogen
sulphide) has therapeutic effects.

23. Adverse effects
• The general precautions of heat apply to hydrotherapy.
• Drowning, cardiac disease, systemic hyperthermia, and
disease transmission are also concerns. Hot-water-associated
seizures are rare but are known to occur
• there may be some reproductive consequences. Neural tube
defects may be increased in the children of women who take
sauna baths during early pregnancy , and sperm counts may
be lowered after isolated or repeated sauna sessions .

24. thank you..