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Introduction to Aquatic Therapy: Summary
○ Environmental communicable conditions—lice, athletes’ foot ○ Open access port to lungs (open stoma, ventilator) ○ Colostomy, urostomy, or ileostomy bag ○ NG or G-tubes • Skin conditions : ○ Rashes/skin conditions (eczema, psoriasis) ○ Minor skin irritations ○ Healed incisions • Special populations : ○ Fear of water ○ Cultural considerations ○ Limited mobility ○ Mentally impaired or combative Contraindications to aquatic therapy include the following: 1. Acute conditions : ○ Fever > 101 ○ Active infection ○ Uncontrolled seizures ○ Severe cardiac conditions—ejection fraction <25% or vital capacity of <1.5L 2. Skin integrity : ○ Open wounds
3. Flexibility 4. Endurance 5. Speed 6. Strength:
■ Level 1-2-3: 80% water; 20% land (horizontal exercises) ■ Level 4-5: 60% water; 40% land (sitting exercises) ■ Level 5-6 40% water; 60% land
(vertical/dynamic vertical) CLINICAL APPLICATIONS AND CONDITIONS Aquatic therapy is beneficial for various conditions, as follows: • Orthopedic conditions :
○ Joint replacements ○ Spinal conditions ○ Sports injuries
○ Post-surgical rehabilitation ○ Chronic pain syndromes
• Neurological conditions : ○ Stroke rehabilitation ○ Multiple sclerosis ○ Parkinson's disease ○ Traumatic brain injury ○ Spinal cord injury
○ Unhealed surgical sites ○ Active skin infections
• Chronic conditions : ○ Fibromyalgia ○ Arthritis
3. Medical issues :
○ Chronic pain management ○ Balance disorders ○ Cardiopulmonary conditions
○ Uncontrolled diabetes ○ Severe respiratory conditions ○ Active bleeding ○ Unmedicated DVT ○ Tracheotomies ○ Risk of aspiration
Safety Considerations Precautions regarding aquatic therapy include the following: • Medical conditions : ○ Controlled diabetes ○ Stable cardiac conditions ○ Controlled seizures ○ Pregnancy (with physician clearance) ○ Orthostatic hypotension—must be careful getting out ○ Chemotherapy—risk of medication being excreted in the pool
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