Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.
Overview
Aquatic therapy refers to water-based treatments or exercises of therapeutic intent, in particular for relaxation, fitness, and physical rehabilitation. Treatments and exercises are performed while floating, partially submerged, or fully submerged in water. Many aquatic therapy procedures require constant attendance by a trained therapist, and are performed in a specialized temperature-controlled pool. Rehabilitation commonly focuses on improving the physical function associated with illness, injury, or disability.
Aquatic therapy encompasses a broad set of approaches and techniques, including aquatic exercise, physical therapy, aquatic bodywork, and other movement-based therapy in water (hydrokinesiotherapy). Treatment may be passive, involving a therapist or giver and a patient or receiver, or active, involving self-generated body positions, movement, or exercise. Examples include Halliwick Aquatic Therapy, Bad Ragaz Ring Method, Watsu, and Ai chi.
For orthopedic rehabilitation, aquatic therapy is considered to be synonymous with therapeutic aquatic exercise, aqua therapy, aquatic rehabilitation, water therapy, and pool therapy. Aquatic therapy can support restoration of function for many areas of orthopedics, including sports medicine, work conditioning, joint arthroplasty, and back rehabilitation programs. A strong aquatic component is especially beneficial for therapy programs where limited or non-weight bearing is desirable and where normal functioning is limited by inflammation, pain, guarding, muscle spasm, and limited range of motion (ROM). Water provides a controllable environment for reeducation of weak muscles and skill development for neurological and neuromuscular impairment, acute orthopedic or neuromuscular injury, rheumatological disease, or recovery from recent surgery.
Various properties of water contribute to therapeutic effects, including the ability to use water for resistance in place of gravity or weights; thermal stability that permits maintenance of near-constant temperature; hydrostatic pressure that supports and stabilizes, and that influences heart and lung function; buoyancy that permits flotation and reduces the effects of gravity; and turbulence and wave propagation that allow gentle manipulation and movement.
History
The use of water for therapeutic purposes first dates back to 2400 B.C. in the form of hydrotherapy, with records suggesting that ancient Egyptian, Assyrian, and Mohammedan cultures utilized mineral waters which were thought to have curative properties through the 18th century.
In 1911, Dr. Charles Leroy Lowman began to use therapeutic tubs to treat cerebral palsy and spastic patients in California at Orthopedic Hospital in Los Angeles. Lowman was inspired after a visit to Spaulding School for Crippled Children in Chicago, where wooden exercise tanks were used by paralyzed patients. The invention of the Hubbard Tank, developed by Leroy Hubbard, launched the evolution of modern aquatic therapy and the development of modern techniques including the Halliwick Concept and the Bad Ragaz Ring Method (BRRM). Throughout the 1930s, research and literature on aquatic exercise, pool treatment, and spa therapy began to appear in professional journals. Dr. Charles Leroy Lowman's Technique of Underwater Gymnastics: A Study in Practical Application, published in 1937, introduced underwater exercises that were used to help restore muscle function lost by bodily deformities. The National Foundation for Infantile Paralysis began utilizing corrective swimming pools and Lowman's techniques for treatment of poliomyelitis in the 1950s.
The American Physical Therapy Association (APTA) recognized the aquatic therapy section within the APTA in 1992, after a vote within the House of Delegates of the APTA in Denver, CO after lobbying efforts spearheaded starting in 1989 by Judy Cirullo and Richard C. Ruoti.
Techniques
Techniques for aquatic therapy include the following: