Underwater Pulmonary Rehabilitation

Done by:

Menhal Al-RebhLoaey Al-AlawiMohammad Al-ObeadMahdi Al-Ameer

Outlines:

Definition. Properties Of Water. Equipment Used In Aquatic Therapy. Indications. Contraindications. Types Of Aquatic Therapy. Advantages. Disadvantages. Studies Regarding To Aquatic Therapy.

Definition: Treatment and exercise performed in water for relaxation, fitness, physical rehabilitation and other therapeutic benefit.

Properties of water:

Bouncy : The power of a liquid to keep something afloat.

Benefits: Decreases weight which makes movement easier. Reduces strain on joints due to body weight pressure.

Viscosity : The resistance of a liquid. Benefits:

Improve balance. Increase sensory awareness. Improve reaction time in a gentle environment.

Hydrostatic pressure : Fluid pressure exerted equally on all surface area.

Benefits: Helps return of blood to the heart. Decrease swelling in extremities.

Equipment

Foam dumbbells. Fins/Flippers. Float cuffs. Floating belt. Jug (air filled). Neck collar. Resistance paddles. Weights. Swim noodle.

Foam Dumbbells

Purpose: Strengthening:

Upper extremity. Trunk.

Floatation support.

Fins/FlippersPurpose:

Strengthening: Lower extremities. Abdomen. Low back.

Propulsion when swimming.

Float CuffsPurpose:

Strengthening: Upper extremity. Lower extremity.

The further away from your body the cuff is placed, the more difficult the exercise.

Floatation belt Purpose:

Floatation support. Strengthening:

Resistance against vertical in pool improves trunk & hip strength to maintain upright position for “running” or “walking” while floating.

Jug (air filled)

Purpose: Strengthening :

Upper extremity. Trunk.

Neck collar

Purpose Floatation support. Prevent strain to cervical spine.

Resistance paddles

Purpose Strengthening:

Upper extremity Trunk

Weights

Purpose Assistance to maintain vertical positioning.

Strengthening: Will be easier than performing

weighted exercise on land.

Coordination: Using medicine ball to dribble

like soccer ball.

Swim noodle

Purpose Floatation assistance. Strengthening:

Upper extremity. Lower extremity.

Indications:

Pulmonary rehabilitation. Neuromuscular disease. Multiple sclerosis. Parkinsonism. Obesity. Pregnancy. Arthritis. Spinal cord injuries. Athletic rehabilitation.

Contraindications:

Fever. Sensitive to heat/humidity. Cardiac failure. Urinary infection. On chemotherapy. On dialysis. Open wounds & IV lines. Uncontrolled epilepsy. Tracheostomies. Lung infection.

Types of aquatic therapy:

Ai Chi. Aquatic PNF (proprioceptive neuromuscular facilitation).

Bad Ragaz Ring Method. Back hab. Halliwick Method. Task type training.

Types of aquatic therapy:

Ai Chi: Strengthen and tone body while enhancing relaxation.

Aquatic PNF: Uses patterns of movement in different positions with specific excersice.

Bad Ragaz Ring Method: A series of movement which being supported by a ring or float at neck and hips.

Types of aquatic therapy:

Back Hab: Walking program using varying strides and stretches. Useful for back pain and decreased abdominal strength.

Halliwick Method: Rotational pattern are performed to improve balance and postural control.

Task type training: Use of functional activities in water.

Advantages :

Decreases joint compression. Improve movement and fitness. Improve psychological & emotional outlook. Cardiovascular endurance : improve diaphragmatic breathing and vascular endurance.

Neuromuscular : improve proprioception with dynamic movement, which improves motor planning & output coordination.

Disadvantages:

The cost of building and maintaining a rehabilitation pool.

Space. The patient must have the ability to stabilize his body.

Benefits on COPD patient’s

Less shortness of breath. Increase in energy levels so they can do more activities without becoming tired or short of breath.

Increase endurance. A greater sense of control over their COPD.

Studies regarding to aquatic therapy

Note: Both high-intensity and low-intensity pulmonary rehab exercise programs are effective. But in general, the more vigorous the exercise, the better.

References: Aquatic Therapy: Scientific Foundations and Clinical

Rehabilitation Applications. http://

www.update-software.com/BCP/WileyPDF/EN/CD008290.pdf