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Aquatic Therapy after a Stroke |
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By Walt Kilcullen |
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Suit Up! What is Aquatic Therapy? Aquatic therapy (also called water therapy,
hydrotherapy, and pool therapy) is using a warm water pool facility to perform
physical therapy. It is designed to help the survivor using both the buoyancy
of the water and the resistance of the water to improve balance, strength,
and to reduce chronic pain. It has the additional benefit of reducing or
eliminating the fear of falling during the therapy. Warm water therapy offers
a safe and relaxing setting to improve physical skills. Why Aquatic Therapy? I had never heard of aquatic therapy until I
visited the “Y” in Randolph, New Jersey where I saw a demonstration using a special
treadmill in the therapy pool adjusted so that the water came up to the
patient’s chest. I was told the water temperature was kept between 85 and 90
degrees. Until recently, physical therapy applied to stroke
survivors followed traditional physical therapy at a gym, in a physical
therapy facility, or a rehabilitation hospital. Aquatic therapy will not
replace traditional physical therapy but it is a wonderful therapeutic aid
that can later be continued as traditional physical therapy in a gym or even
at home. Aquatic therapy gives the patient greater
mobility because body weight is decreased significantly (up to 90%) and water
buoyancy creates balance making movement easier. Since the water aids
balance, the patient has an easier time with flexibility and stretching
muscles. Because of the buoyancy that the pool water provides, the patient
can stand up with far less physical strength. Some survivors, who cannot walk
on land, find they are able to stand up and even walk in a pool. Aquatic therapy results in strength improvement
because the water provides resistance similar to the concept of isometrics.
Resistance increases the survivor’s ability to regain muscle performance,
motor skills, and flexibility. Aquatic therapy has also been successful in
reducing chronic pain. In a warm pool, spasticity or tone is reduced during
exercise which is often the cause of upper and lower extremity pain. Even
head pain may be reduced because the warm water calms the body releasing
endorphins, which are natural pain killers. (Much of the information for this
section on “Why Aquatic Therapy?” came from: “The Healing Benefits of Water,”
Lisa Nagg, Stroke Smart Magazine, Winter, 2012.) Specific Techniques: Aquatic therapy is often divided into two types:
deep water exercises and shallow water exercises. Deep water exercises use water buoyancy to
balance the body in an upright position so that the patient can stretch, walk
(sometimes on a treadmill when available), run in place, and perform bicycle
movements while holding on to the side of the pool. All of these exercises
are much easier in water than in the traditional physical therapy setting. Shallow water exercises are designed to help the
stroke survivor gain strength and balance as a transition to walking on land.
Walking in shallow water is the primary exercise. The patient walks around in
the pool avoiding obstacles placed randomly on the pool floor. Because the
water is no more than knee deep, balance is more difficult, but once that
skill is mastered, the patient can transition to land exercises. (Most of the
information in “Specific Techniques” above came from “Pool Therapy as Stroke
Rehab, “Linda Huey, Word Press published on-line, May
3, 2012). Published Results: In a case study concerning a patient who received
aquatic therapy at Vital Energy Wellness and Rehab Center in Lexington, South
Carolina, the following results were published: The patient suffered right
side paralysis resulting from a stroke, and was unable to stand, walk or
perform other normal functions. After
aquatic therapy, she experienced decreased pain and has improved muscle
strength and balance. She is now able to sit up in a chair, roll over in bed,
and assist with transfer to and from her wheelchair. (“Stroke Patient
Increases Mobility with Aquatic Therapy,” HydroWorx,
July 12, 2013). I found several other studies that showed there
are significant benefits using aquatic therapy after a stroke. In a 2008
study comparing two groups of stroke survivors; one group received
conventional physical therapy, the other aquatic therapy. The findings were
that the aquatic group improved significantly more in strength, balance, and
knee flexor strength than the conventional physical therapy group (study by Dong
Koog Noh et. al., Seoul National University College
of Medicine, 2008). Christine Shidla,
Director of Wellness, Summit Place Senior Campus, in Eden Prairie, Minnesota,
states, “For stroke survivors, we see at our facility, exercise in the water
has the power to change their lives. Often our clients have been discharged
from the hospital or land-based therapy because they have ceased to make
gains. Undaunted and determined, they turn to us to develop innovative
exercise programs in our underwater treadmill therapy pool. The results
normally lead them to accomplish goals they could not otherwise achieve. Finding an Aquatic Therapy: Finding a facility is easy. Finding a facility
close to your home that your insurance will cover can be more difficult. My advice
is to do your own research by using the following resources:
Editor’s Note: Many Stroke Network
members are enthusiast about Aquatic Therapy. Here are links to some article
we have published over the years sharing personal experiences.
Walt is a retired guidance counselor. He has been a mentor for stroke and traumatic brain injury survivors for the past 15 years. |
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Copyright @ November 2015 The Stroke Network, Inc. P.O. Box 492 Abingdon, Maryland 21009 All rights reserved. |
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