Download to read offline
More Related Content
![Posture- Physical Therapy [VNSGU]](https://cdn.slidesharecdn.com/ss_thumbnails/posture-180915145350-thumbnail.jpg?width=640&height=640&fit=bounds)
Similar to hydrotherapy-.pptx
hydrotherapy-.pptx
- 1.
- 2. Definition of Hydrotherapy Definitionof Hydrotherapy Application of Application of water, water, internally internally or or externally, externally, for for the treatment of physical or psychological the treatment of physical or psychological dysfunction. dysfunction.
- 3. Types of Hydrotherapy ofHydrotherapy Types Immersion Immersion Non-Immersion Non-Immersion
- 4. Primary Use ofHydrotherapy Primary Use of Hydrotherapy Treatment Treatment of of Wounds Wounds Enhanced Environment Enhanced Environment for for exercise exercise Pain Pain Edema Edema Health maintenance /disease prevention Health maintenance /disease prevention
- 5. Physical Properties of ofWater Water Physical Properties High Specific High Specific Heat Heat & Thermal & Thermal Conductivity Conductivity Transfers Transfers heat heat by by Conduction and Convection Conduction and Convection Can be used as superficial superficial heating and cooling agent heating and cooling agent Can be used as
- 6. Physical Properties of ofWater Water Physical Properties Specific Specific Heat Heat 4 times 4 times that that of of air air Water retains retains 4x 4x as as much thermal much thermal energy energy as as an an Water equivalent mass of air r Thermal Thermal Conductivity Conductivity 25 x 25 x air air Water transfers transfers thermal thermal energy energy 25 x 25 x more rapidly more rapidly Water than air (at the same temperature) t )
- 7. Physical Properties of ofWater Water Physical Properties Transfers Transfers heat heat rapidly, efficiently Advantage of Advantage of exercising patient in pool colder colder than patient’s body temperature. Immersion dissipates heat generated by exertion
- 8. Physical Properties of ofWater Water Physical Properties Water that is is stationary transfers heat heat by by Conduction. . Moving water Moving water transfers heat by by Conduction and and Convection. . Heating (WP) accelerated with increased agitation of water. Cooling (swimming) acceleratedas patient patient moves moves more more quickly through water.
- 9. Physical Properties of ofWater Water Physical Properties Buoyancy Buoyancy A force experienced as an upward thrust on the body in the opposite direction to the force of gravity Archimedes Archimedes Principle Principle When a body is is entirely entirely or or partially partially immersed in a fluid at rest.. • It experiences an upward thrust equal an upward thrust equal to weight of fluid it displaces. Principle used for volumetric volumetric measurements m
- 10. Archimedes Principle Archimedes Principle Amount Amountof of fluid depends fluid depends on density on density of of body body relative to density of fluid. density of of body body less than density less than density of of fluid, fluid, it it will will If displace a smaller volume of fluid (Floats) • Opposite also true If density density of of body body further further decreased ( decreased (adding salt I to water or air-filled objects at rest), ), Body will float higher
- 11. Clinical Uses ofBuoyancy Clinical Uses of Buoyancy Decrease stress and compression to body tissues (weight-bearing surfaces) Assist weak muscles Assist w
- 12. Physical Properties of ofWater Water Physical Properties Resistance Viscosity of of water water provides provides resistance to motion Resistance occurs against direction of motion Resistance increases Resistance increases proportional to… Speed Frontal area of body part in contact with water Varying resistance ( Varying resistance (and pressure and pressure) ) can be beneficial in debriding and cleansing wounds
- 13. Physical Properties of ofWater Water Physical Properties Hydrostatic Hydrostatic Pressure Pressure Pressure exerted by fluid on body immersed in fluid. Pascal’s Pascal’s Law Law A fluid exerts equal equal pressure on all pressure on all surfaces surfaces of of a body a body at rest, at a given depth… This pressure increases pressure increases in proportion to depth of fluid
- 14. Hydrostatic Pressure Water Water =0.73 mmHg/cm of = 0.73 mmHg/cm of depth (22.4 mmHg/ft) Patient Patient upright Pressure on distal extremities Pressure on distal > proximal proximal extremities Hydrostatic pressure at patient’s feet… Hydrostatic • 4 ft of water water = 89.6 mmHg = 89.6 mmHg
- 15. Hydrostatic Pressure Hydrostatic Pressure Water Watercan have similar can have similar effect as compression compression devices/ bandages Helpful in decreasing edema If limb in dependent limb in dependent position, counteracts this this effect effect If Greatest effects Greatest effects of of hydrostatic hydrostatic pressure occur in vertical position NO hydrostatic pressure effects with non-immersion hydrotherapy
- 16. Physiological Effects ofHydrotherapy Physiological
- 17. Physiological Effects Cleansing Cleansing Pressure (Force= Rate of Flow) Dissolved antimicrobial agents, etc. (Wounds Wounds) ) Musculoskeletal Musculoskeletal Effects Decreases weight-bearing ( weight-bearing (Arthritis) • 75% immersion WB 75% Increases blood flow to muscles Strengthening
- 18. Physiological Effects Physiological Effects Decreasedbone density Decreased bone density loss loss Decreased fat Decreased fat loss loss • Compared to other forms of of exercise exercise Good for obese secondary to non-weight obese secondary to non-weight bearing Good for exercise exercise • Not good for general general weight loss
- 19. Cardiovascular Effects Cardiovascular Effects Increasedvenous Increased venous circulation circulation Secondary to hydrostatic to hydrostatic pressure, pressure, increased venous increased venous pressure pressure Increased cardiac Increased cardiac volume volume Increased cardiac Increased cardiac output Up to 30% while upright to neck Decreases Decreases HR and Systolic Bp cool water water) ) May increase in warm or increase in warm or hot hot water water
- 20. Respiratory Effects Respiratory Effects Increases Increaseswork work of of breathing breathing Due to hydrostatic pressure on lungs • up to 60% • May need to be very careful careful with respiratory with respiratory and/or and/or cardiac cardiac patients Decreases Decreases exercise-induced asthma High humidity
- 21. Renal Effects Effects Renal Increases Increases urineproduction urine production Increases Increases sodium and potassium excretion sodium and potassium excretion May be used to patient’s be used to patient’s advantage with hypertension, peripheral edema
- 22.
- 23. Clinical Uses ofHydrotherapy
- 24. Superficial Heating andCooling Superficial Heating and Cooling Advantages Even contact with skin Even contact with skin Does not need to be fastened Does Allows movement of heat/cold Allows Disadvantages Extremity often in dependent position Extremity
- 25. Wound Care Wound Care Cleansingproperties facilitate Rehydration Rehydration Softening and debridement of of necrotic tissue Softening and debridement Removal of of wound debris Removal Hydrostatic pressure and heat increase circulation circulation Provides moist environment to optimize healing healing
- 26. Immersion vs. Non-Immersion Immersionvs. Non-Immersion Non-immersion therapy becoming more popular Concern for increased pressure on regenerating Concern for tissues by water and turbine tissues by water Potential for for infection in contaminated tank Potential WP recommended for Extensive thick exudate Extensive thick exudate Slough or necrotic tissue Slough or Gross purulence Gross purulence Dry eschar Dry eschar
- 27. Immersion versus Non-Immersion Non-Immersion Immersionversus Discharge all forms of hydrotherapy when wound is clean wound is clean Many antimicrobial Productsare cytoxic to normal Many tissue (unless very diluted tissue (unless very diluted) Tank and turbine must be thoroughly cleaned and disinfected and disinfected
- 28. Non-Immersion Techniques Non-Immersion Techniques Fluiddelivered at pressure of 4-15 psi Below this bacteria not microbacterial Below this Above this, wound trauma may occur, occur, or or bacteria Above this, wound trauma may driven into wound driven into wound Saline squeeze bottle, Water Pik Saline squeeze bottle,
- 29. Non-Immersion Techniques Recommended for Necrotic,nonviable tissue or debris • Continue until all removed and full granulation bed present present • Often use both With both types, must thoroughly With both types, must thoroughly dry intact skin s in surrounding area prevents maceration
- 30. Treatment of Burns Treatmentof Burns Similar, Similar, but but burns burns particularly particularly painful painful when when debrided debrided Wounds sometimes sometimes less deep, less deep, sensory nerves sensory nerves intact intact Wounds Monitor Monitor patient patient closely closely often high-dose analgesics often high-dose analgesics Hubbard Tank Hubbard Tank for for large body large body surface area surface area Chance of contamination contamination Chance of Greater loss of loss of sodium ( sodium (add salt Greater add salt) ) Shower Shower (non-immersion) (non-immersion) in early in early stages stages After After re-epithelialization, re-epithelialization, water water for for exercise exercise
- 31. Pain Control Pain Control Increasedsensory Increased sensory stimulation to peripheral stimulation to peripheral mechanoreceptors mechanoreceptors Gait Theory Theory Gait Cold water Cold water decreases decreases inflammation inflammation Decreases Decreases weight-bearing, weight-bearing, increases increases “ease “ease of movement”. of movement”.
- 32. Edema Control Edema Control Hydrostatic Hydrostaticpressure pressure Cool Cool water water Vasoconstriction Vasoconstriction Decreased vascular permeability permeability Decreased vascular Hot water water increases Hot increases edema edema • Increased arterial Increased arterial blood flow, blood flow, increased vasodilation. increased vasodilation.
- 33. Edema Control Edema Control ContrastBaths Contrast Baths “Trains” smooth muscles of “Trains” smooth muscles of blood vessel; blood vessel; vasoconstriction/vasodilation. vasoconstriction/vasodilation. No research to solidly support support No research to solidly
- 34. Contraindications, Precautions Precautions Contraindications, and AdverseEffects and Adverse Effects
- 35. Contraindications, Local Immersion Contraindications,Local Immersion Maceration Maceration Increased maceration, increased size of increased size of wound wound Increased maceration, Bleeding Bleeding In or near near the area the area In or
- 36. Precautions, Local Immersion Precautions,Local Immersion Impaired thermal Impaired thermal sensation sensation Check temperature of water water with thermometer with thermometer first first Check temperature of Infection Infection Universal Precautions Precautions Universal Clean WP Clean WP Confusion, Confusion, impaired cognition impaired cognition Use constant, direct supervision direct supervision Use constant, Temperature of water water near near body body temperature temperature Temperature of Recent Recent Skin Grafts Skin Grafts Direct agitator away away from graft. from graft. Direct agitator Neutral or mild warmth (96 - (96 - 98 98 F) Neutral or mild warmth 0 0 F)
- 37. Contraindications, Full Body Contraindications,Full Body Immersion Immersion Cardiac Cardiac instability instability Uncontrolled hypertension or heart failure heart failure Uncontrolled hypertension or Infectious Infectious conditions conditions that that spread with water spread with water UTI’s, plantar warts, tinea pedis warts, tinea pedis (pool (pool) UTI’s, plantar ) Bowel Bowel or or bladder bladder incontinence incontinence Use non-immersion techniques Use non-immersion techniques Severe epilepsy Severe epilepsy Increased risk of drowning drowning Increased risk of Suicidal Suicidal patients patients Increased risk of drowning drowning Increased risk of
- 38. Precautions, Full BodyImmersion Precautions, Full Body Immersion Confusion, Confusion, Disorientation Disorientation Keep head above water Keep head above water Constant supervision supervision Constant Low temperature Low temperature After After ingestion of ingestion of alcohol alcohol Hypotensive effects Hypotensive effects Drowning Drowning Patients Patients with limited strength, with limited strength, endurance, endurance, balance, ROM ROM balance, Hands-on approach required Hands-on approach required
- 39. Precautions, Full BodyImmersion Precautions, Full Body Immersion Patients Patients on medications on medications Physician clearance sometimes required required Physician clearance sometimes Patients Patients with fear with fear of of water water Patients Patients with respiratory with respiratory problems problems Watch for signs signs of of respiratory distress, especially respiratory distress, especially in in Watch for hot or very warm water hot or very warm water
- 40. Precautions, Full BodyImmersion Precautions, Full Body Immersion Patients Patients that that are Pregnant are Pregnant 1st trimester (maternal (maternal hyperthermia 1st trimester hyperthermia) ) Use normal water water temperature temperature Use normal Can be very good therapeutic intervention intervention Can be very good therapeutic Patients Patients with MS with MS Temperature >88 F may Temperature >880 0 F may cause increase fatigue, cause increase fatigue, weakness. weakness. Patients Patients with poor with poor thermal thermal regulation regulation Elderly, infants Elderly, infants
- 41. Precautions, Non-Immersion Hydrotherapy Precautions,Non-Immersion Hydrotherapy Maceration Maceration Ineffectiveness Ineffectiveness Drowning Drowning
- 42. Adverse Effects ofHydrotherapy of Hydrotherapy Adverse Effects Burns, Burns, Fainting, Fainting, Bleeding Bleeding Check with thermometer, and gloved hand Check with thermometer, and gloved hand Hypotension Hypotension Immersion in warm/hot water, hypertension water, hypertension Immersion in warm/hot medications medications Hyponatremia ( Hyponatremia (burns burns) ) Increased edema Increased edema Use of hot hot water water Use of Dependent positioning positioning Dependent
- 43.
- 44. Application, General Rules GeneralRules Application, Assess problem and set Assess problem and set goals goals of of treatment treatment Determine if Determine if most appropriate treatment most appropriate treatment Make sure no contraindications Make sure no contraindications Select appropriate form of Select appropriate form of hydrotherapy hydrotherapy Whirlpool Hubbard Tank Whirlpool Hubbard Tank Contrast bath Non-immersion device bath Non-immersion device Contrast Pool Pool Explain the procedure, Explain the procedure, purpose, purpose, sensations sensations Apply Apply appropriate form of hydrotherapy appropriate form of hydrotherapy Assess outcome Assess outcome Document Document
- 45. Selection of Hydrotherapy Selectionof Hydrotherapy Base decision on Base decision on Desired effects Desired effects Size of area to be treated area to be treated Size of Allowance for safety, safety, control control of of infection infection Allowance for Cost-effectiveness Cost-effectiveness
- 46.
- 47. Whirlpool Whirlpool Turbine Turbine Agitator Agitator • Adjustable height, Adjustableheight, direction, direction, aeration. aeration. • Should be grounded Should be grounded • Do NOT run without Do NOT run without water water in tank. in tank.
- 48.
- 49.
- 50.
- 51. Temperature Range Temperature Range Cold Cold(32-79 (32-79 F) 0 0 F) Acute inflammation Acute inflammation Tepid Tepid (79-92 (79-92 F) 0 0 F) Exercise Exercise Acute inflammation if cold not cold not tolerated tolerated Acute inflammation if Neutral Neutral warmth warmth (92-96 (92-96 F) 0 0 F) Open wound Open wound Medically compromised patients compromised patients Medically Decrease tone Decrease tone
- 52. Temperature Range Temperature Range Mildwarmth Mild warmth (96-98 (96-98 ) 0 0 ) Increase mobility Increase mobility Burn Burn Hot Hot (99-104 (99-104 ) 0 0 ) Pain, Pain, Increase ROM Increase ROM Increase soft tissue extensibility tissue extensibility Increase soft Very Hot Very Hot (104-110 (104-110 ) 0 0 ) Limited body area area Limited body Chronic conditions conditions Chronic DO NOT DO NOT use WP use WP at at temperatures temperatures > 110 > 110 F 0 0 F !! !!
- 53. Hubbard Tank Hubbard Tank 8feet 8 feet long x long x 6 feet 6 feet wide, wide, 4 feet 4 feet deep deep 425 gallons 425 gallons water water Turbines, Turbines, stretcher, stretcher, hoist hoist Expensive secondary Expensive secondary to amount to amount of of water, water, time to time to clean clean
- 54. Contrast Bath Contrast Bath Alternateimmersion (distal) Alternate immersion (distal) First warm/hot water, then cool/cold water water, then cool/cold water First warm/hot Uses Uses Decrease edema Decrease edema Pain relief Pain relief Decrease sensitivity (desensitize) (desensitize) Decrease sensitivity
- 55. Application, Non-Immersion Irrigation Application,Non-Immersion Irrigation PulsaVac: PulsaVac: Lab Lab
- 56. Application, Pool Application, Pool Temperature79 - Temperature 79 - 97 970 0 Never below 65 below 65 Never 0 0 • Impairs Impairs muscles muscles ability ability to contract to contract
- 57. Cleaning, WP/Hubbard Tank Cleaning,WP/Hubbard Tank Wear Wear gloves, gloves, goggles, goggles, gown gown Drain tank Drain tank Rinse with clean water Rinse with clean water Scrub tank Scrub tank with brush and detergent with brush and detergent and rinse and rinse again again Disinfect Tank Disinfect Tank
- 58. Disinfecting the Tank Disinfectingthe Tank Levels Levels of of disinfection disinfection Low level Low level • Intact skin Intact skin • 70-90% ethyl 70-90% ethyl alcohol, alcohol, • sodium hypochloride bleach sodium hypochloride bleach • germicidal germicidal solution solution Intermediate Level Intermediate Level • 70-90% ethyl 70-90% ethyl alcohol alcohol • phenolic phenolic germicidal germicidal detergent detergent High Level High Level • Chlorine-based products Chlorine-based products • Can corrode tank Can corrode tank
- 59. Disinfecting the Tank Disinfectingthe Tank Change disinfectant Change disinfectant periodically periodically to decrease to decrease risk of resistant strains risk of resistant strains Fill Fill tank tank Add solution ( Add solution (hot hot water water) ) expose all inside surfaces inside surfaces x x 10 minutes 10 minutes expose all Clean and disinfect Clean and disinfect turbine, turbine, bucket with water/detergent with water/detergent x x 5 minutes 5 minutes bucket bucket with disinfectant with disinfectant x x 10 minutes 10 minutes bucket
- 60. Disinfecting the Tank Disinfectingthe Tank Drain tank Drain tank Rinse with clean water Rinse with clean water Dry Dry thoroughly thoroughly with towels with towels Culture tank, turbines, drains, Culture tank, turbines, drains, and water and water supply supply periodically periodically
- 61.
- 62. Aquatic Exercise Aquatic Exercise Uses Uses Increasecirculation Increase circulation Increase muscle strength Increase muscle strength Increase joint ROM, flexibility ROM, flexibility Increase joint Improve ambulation Improve ambulation Improve coordination Improve coordination Increase cardiovascular, respiratory conditioning Increase cardiovascular, respiratory conditioning Decrease pain, spasm spasm Decrease pain, Decrease weight-bearing on joints Decrease weight-bearing on joints Relaxation/ psychological psychological well-being well-being Relaxation/
- 63. Types of AquaticExercise of Aquatic Exercise Types Swimming Swimming Running ( Running (with or with or without without vest vest) ) Walking Walking Cycling Cycling Stretching Stretching Underwater Underwater treadmill treadmill or or parallel parallel bars, etc. bars, etc.
- 68.