HYDROTHERAPY

WHAT IS HYDROTHERAPY

Hydrotherapy is also known as water therapy which in medical term implies using water for therapeutic purpose or simply treatment by water in which water is used as a medium for exercise and provides several opportunities, which are not available in exercise and also hydrotherapy is one of the oldest therapeutic method for the management of body physical dysfunction.

Hydrotherapy has been advocated for the treatment of joint stiffness, painful scars, arthritis and adhesions as warm up with exercise.

hydrotherapy is used due to the therapeutic properties of water for the effects on body tissues of heating, cooling, debridement, pain relief and relaxation of muscles.

when hydrotherapy is not planned well or well performed, it can give side effects, especially on cardio-vascular system, this water therapy is used for the treatment of various diseases, additionally hydrothermal therapy has temperature effects, as in hot baths, saunas, wraps e.t.c.

Mostly non-weight bearing is required in the initial stages of the treatment which provides beneficial effects of warmth and support provided by water which is also very helpful in the treatment. nowadays hydrotherapy has become popular with the development of knowledge regarding the therapeutic effects of water and new pattern of movement in water and more exercises especially done in water because in water, body is acted upon by two forces: gravity (downthrust) and buoyancy (upthrust), hence in hydrotherapy three dimensional exercise programme can be planned for the patient.

THERAPEUTIC PROPERTIES OF WATER

(1) Tonic: this has effect on vital activities, body functions, blood circulation and nutrition is increased to rehabilitate the body to normal tone 

(2) Antispasmodic: water is very helpful in relaxation of muscles, hence is used for relieving spasm and convulsions.

(3) Antipyretic: water has the effective in reducing the increased body temperature

(4) Eliminative: under this effect, water promotes the elimination of toxic products from kidneys, skin and lungs

(5) Diuresis: water increases the excretion of urine from the system and hence helps in detoxication 

(6) Diaphoretic: water helps in production of sweat, because water act as diaphoretic agent.

WORKING PRINCIPLE OF HYDROTHERAPY

Hydrotherapy healing properties are based on its mechanical effects.

it utilize the body's reaction of hot and cold stimuli to the prolonged application of pressure exerted by the water and to the sensation it gives, the nerves carry impulses felt deeper in the body, where they are agents in stimulating the immune system, influencing production of stress hormones, invigorating the circulation and digestion, encouraging the blood and relieve pain sensation.

Generally, heat quiets and soothes the body, solving down the activity of internal organs while cold stimulates and invigorates, increasing  internal activity. 

"Hydrotherapy" and "Whirlpool" are used interchangeably. Tanks used for full body immersion are referred to as Hubbard tanks, walking tanks or hydro-therapeutic exercise tanks or pools. when the body is immersed, thermal energy is exchanged by water in the tank by two methods:

(a) Conduction

(b) Convection

Thermal effects of hydrotherapy:

(a) Heat application:

• The physiological effects of heat and cold apply to hydrotherapy is same like other thermal agents, the only difference is in hydrotherapy larger body surface area is usually immersed in water than that covered by hot or cold packs. therefore, exposure of the whole body to varying temperatures will not only produce local effect but also systematic effects on cardiovascular and other organ systems.
• In hydrotherapy more intense reaction is produced on the body when there is greater difference in temperature between the water and skin temperature
• Application of heat to the whole body will cause an initial increase in blood pressure followed by a decrease in blood pressure as a result of vasodilation. also respiratory rate will increase with the application of heat, in which cardiac output, oxygen consumption, heart rate and blood pressure was found with study subjects in resting position and during exercise.
• In addition, sweating will be increased depending on the temperature, the size of the body surface exposed and the length of the treatment
• Another physiologic effects of heat that can have therapeutic value include increasing tissue temperature and blood flow

(b) Cold application:

• Application of cold to the entire body decreases heart rate and lengthens diastole. the tone of cardiac muscle is improved, and blood pressure increased as a result of peripheral vasoconstriction
• The increase in peripheral resistance requires the heat to work harder to maintain adequate blood flow to the periphery. the effects of application of heat was explained above.

GENERAL GUIDELINES OF HYDROTHERAPY

(1) Take full case history of the patient client to find out any contraindications, like checking for cardiac problems e.t.c and determine overall status of health of the patient or client 

(2) Take the patients or clients temperature before start treatment in order to determine the temperature of the treatment and ask the patient his or her normal body temperature, if is above normal then use less heat

(3) Always explain well about the treatment to the patient or client before beginning including the procedure and duration of the treatment

 (4) Stay with the client throughout the treatment time or have an emergency signal like bell or use baby monitor in the room, if you use bell (make sure it can be heard above anything else)

(5) Provide a clean room with adequate temperature control to ensure the client does not become too hot, "depending on the treatment"

(6) Moderation with key to positive treatment. hence, hydrotherapy can be exhausting and dehydrating to the body, and too much can cause adverse reaction

(7) Keep fresh drinking water available at all times and encourage the client to drink regularly

(8) Watch for adverse reactions and stop immediately.

REQUIREMENTS FOR GENERAL APPLICATION OF HYDROTHERAPY 

Certain factors need to be considered before starting a hydrotherapy treatment. the more simpler design and construction of pool is the better it proves.

The main factors for consideration are:

• Pool, design and dimensions

• Temperature and ventilation

• Equipment

• Lighting

• Facilities

• Surfaces

• Noise factors

• Staffing, care and maintenance

• Safety and emergency equipment

• Cost and costing.

GENERAL THERAPEUTIC EFFECTS OF HYDROTHERAPY

• Relieves pain

• Relieves muscle spasm

• Increases blood flow

• Decrease chronic joint stiffness

• Increase the extensibility of collagen fibres

• Can assist in removal of oedema and waste products from the areas of injury.

INDICATIONS OF HYDROTHERAPY

(1) Joint contractures: in order to stretch tendons and increase flexibility

(2) Chronic muscle spasm

(3) Rheumatoid arthritis: because heat increases the viscosity of the synovial fluid in the joint.

CONTRAINDICATIONS OF HYDROTHERAPY

(1) Impaired sensation

(2) Weakness

(3) Abrations

(4) Skin lesions

(5) Cancer 

(6) Hemorrhage

(7) Pregnancy

(8) Tuberculosis

(9) Anaemia

(10) Diabetes mellitus

(11) Heart disease

(12) Hypertension

(13) Hyperthyroidism

(14) Tachycardia

(15) Peripheral vascular disease

(16) Abnormal temperature of the body such as high temperature 104°C

(17) Inflammation such as bursitis, tendinitis, sprains and strains

(18) Kidney problems.