Lec # 8 - Introduction to Hydrotherapy

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Presentation Transcript

Hydrotherapy : 

Hydrotherapy Roma Rosas D. Veron, MPH, PTRP

Hydrotherapy : 

Hydrotherapy Internal or external use of water in any of its three forms to treat diseases or traumas. Water : colorless, transparent, odorless, tasteless compound of oxygen and hydrogen Characteristics: Universal solvent Readily accessible Ability to absorb large amount of heat Good conductor of heat May be applied with simple and inexpensive equipment

Chemical Properties of Water : 

Chemical Properties of Water H2O Ca++, Mg++ , Na+ K+ HCO3-1 , SO4 -2 , Cl –1 , NO3 –1 Pure water is a poor conductor of electricity pH: 7.0

Physical Properties of Water : 

Physical Properties of Water Tasteless, odorless and colorless fluid Blue: layers; green: calcium carbonate; yellow/brown: decaying vegetation High specific heat: 1 cal at 15 deg C

Thermal Properties of Water : 

Thermal Properties of Water

Mechanical Properties of Water : 

Mechanical Properties of Water Buoyancy Hydrostatic Pressure Cohesion Adhesion Surface Tension Hydrodynamics

Buoyancy : 

Buoyancy Upward force of water acting on a body that creates an apparent decrease in the weight of a body while immersed Archimedes’ Principle Specific gravity and density Difference in size and shape Center of gravity (COG) and Center of buoyancy (CB) Sig: used to assist or resist exercises in the extremities and minimize stress of joints and muscles

Percentage of body weight off-loaded with increasing immersion depth : 

Percentage of body weight off-loaded with increasing immersion depth

Hydrostatic Pressure : 

Hydrostatic Pressure Ratio of the F exerted by the fluid per body surface area Pressure exerted by water on immersed body Factors: Depth of the submerged part Density of the liquid Pascal’s Law: fluid will exert equal pressure on an immersed body part at a given depth

Cohesion : 

Cohesion Tendency of water molecules to adhere to each other Water is attracted to water Directly proportional to VISCOSITY Sig: contributes to resistance when moving through water

Adhesion : 

Adhesion Tendency of water molecules to adhere to molecules of other substances Water is attracted to other materials

Surface Tension : 

Surface Tension Cohesion of water molecules at the surface of a body of water Sig: horizontal mov’ts are easier to perform in the water beneath the surface

Hydrodynamics : 

Hydrodynamics Physical properties of water in motion 2 types of fluid flow: Laminar/ streamline flow Turbulent flow Eddy currents Sig: body encounters greater resistance in turbulent water

Physiological Effects of Water : 

Physiological Effects of Water Musculoskeletal effect Decreased WB Strengthening Slowed bone density loss Less fat loss Cardiovascular effects Inc venous circulation Inc CO Dec HR and systolic BP Respiratory effects Dec VC Inc work of breathing Dec exercise-induced asthma Renal effects Diuresis Inc sodium and potassium excretion Psychological effects Relaxing or invigorating

Renal Effect : 

Renal Effect

Methods of Application of Hydrotherapy : 

Methods of Application of Hydrotherapy Hot Packs Wet Packs Paraffin Wax Moist Air Cabinets Scotch Douche Ablution Affusion Sitz Baths Contrast Baths Whirlpool Baths Hubbard Tank Pool Therapy Cryotherapy

Moist Air Cabinets : 

Moist Air Cabinets 40-45 deg C Circulate humidified air within a metal cabinet Indications: To relieve generalized joint and muscle pains To have a sedative effect To relieve general muscle spasm

Ablution : 

Ablution Sponge/towel bath 22 deg C Indication: reduction of fever Affusion procedure wherein water is poured to a patient Scotch Douche Shower spray of alternating hot and cold water is passed over the body Hot: 37.8-43.3°C ; Cold: 15.5-26.7 °C For px w/ emotional or psychiatric problems

Sitz Baths : 

Sitz Baths Water covers the pelvic region Hot sitz : 40.5 – 46°C (2-10 mins) Reduce pain Increase circulation in pelvic area Enhance tissue healing Post pregnancy/Hysterectomy Hemorrhoidectomy Cold sitz: 1.7 - 24 °C (2-10 mins) Inc tone of muscles (atonic constipation) Reduce uterine bleeding

Contrast Bath : 

Contrast Bath hot – 38-40 deg C; cold – 10-16 deg C Hot for 10 mins; cold 1 min Hot for 4 mins; cold 1 min Hot for 4 mins; cold 1 min Hot for 4 mins; cold 1 min Finish with 5 minutes in hot water Precaution: thermal shock monitor VS

Whirlpool Baths : 

Whirlpool Baths 36.5 – 40.5 deg C Types: Extremity (ankle/foot/hand) whirlpool  W: 15 inches; L: 28-32 inches; D: 18-25 inches Low-boy whirlpool designed for ease of transfer in and out of the tank patients are usually in long-sitting position   W: 24 in; L: 52-66 inches; D: 18 inches High-boy whirlpool sometimes referred as “hip” tanks patients usually sit on a high chair outside the tank with their lower extremity dangling in the tank W: 20-24 in; L: 36-48 in; D: 28 inches

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Thermal Effects of WPB : 

Thermal Effects of WPB Cold: dec HR lengthens diastole enhance cardiac ms tone inc BP Heat: inc BP ? dec BP Mechanical Effects of WPB Whirlpool Agitation Relaxes muscle spasm Relieves joint pain and stiffness Improves mechanical debridement Facilitates exercises

Parts of a Turbine : 

Parts of a Turbine On/off switch located on the top of the turbine turns the motor on or off Drive shaft Amount of water ejected at its base will determine the force of the ejected water Adjusting the THROTTLE near the top of the shaft can control the amount of water ejected Breather tube Amount of air mixing with the ejected water at the base of the tube can be adjusted by turning the BUTTERFLY VALVE near the top of the shaft

Indications for WPB : 

Indications for WPB Wound care (Pseudomonas aeroginosa) Povidone-iodine Saline solution Sodium hypochlorite Chloramine-T Skin graft and tissue flap Delicate 3-5 days post grafting ( 5 mins minimal agitation) Painful open lesions

Classification of Wounds : 

Classification of Wounds Based on time frame of closure Primary – closed in < 5 days Delayed Primary – i.e dog bite Secondary intention – allowed to close by granulation, marginal epithelialization, wound margin contracture (i.e stasis ulcer) Based on their color

Wound Exudate Characteristics : 

Wound Exudate Characteristics

Hubbard Tank : 

Hubbard Tank A large, specially designed tank in which a patient may be immersed for various therapeutic underwater exercises Dimensions: L: 8 ft; Upper width: 6 feet; Middle width: 36 in; lower width: 4 ft; capacity: 425 gallons Dosage: 32.2-38.8°C Adv: allows motion of all extremities px accesible to PT

Hubbard Tank : 

Hubbard Tank INDICATIONS Wound care ROM & therapeutic exe for people who need full body tx For patients who should remain in a lying position CONTRAINDICATIONS Cardiac dysfxn Respiratory dysfxn Decreased thermal sensation Severe PVD Bleeding Acute RA Surface infection Uncontrolled bowel Pregnant woman (1st trimester)

Slide 32: 


Pool Therapy : 

Pool Therapy Combines physical forces of water with therapeutic exercises Aims: Promote relaxation Improve circulation Restore mobility Strengthen muscles Provide gait training w/ less stress on jts Temp: 32-38°C Dimensions: D: 3-4 ft; L: 12 ft; W: 16 ft

Slide 34: 

Advantages Free movement with less risk of injury Dec WB on joints Buoyancy assists weak ms Affects all body systems Allows ease of positioning in PT Disadvantages Slippery w/ risk of falling outside the pool Risk of infection Difficult isolating body parts during exercise Risk of drowning

Pool Therapy : 

Pool Therapy Indications Ms weakness Loss of joint mobility Poor coordination or balance Pain or lack of confidence Pre-gait training Contraindications Open wounds URI Uncontrolled BP Febrile conditions Severe MR Uncontrolled epilepsy Hydrophobic px

Special Forms of Hydrotherapy : 

Special Forms of Hydrotherapy Spa Therapy Pelotherapy Thalassotherapy Sauna-Hot and Steam Baths Carbon Dioxide Baths Kneipp Treatment

Spa Therapy : 

Spa Therapy Areas w/ effervescent sparkling water Therapeutic agents: Mineral-containing water Na; Ca; Mg; Cl; HCO3; SO4 Mud or water from lake or sea Effects: Inc in blood sugar and ascorbic acid Decrease in serum potassium Increase serum calcium Decrease chloride in urine Increase phagocytosis Decrease gastric secretion Decrease weight

Contraindications for Spa Therapy : 

Contraindications for Spa Therapy Significant CV and PVD Contagious and infectious dse Malignant d/o Cachectic states

Related Terms : 

Related Terms Balneotherapy – immersion in mineral water bath Crenotherapy – use of natural mineral water for medicinal purposes Emanotherapy – inhalation of air charged with natural radioactive substances Fangotherapy – application of mud of volcanic origin Hydrokinesiotherapy- underwater gymnastics Psammotherapy – hot sand bath Vapor bath – steam bath

Thalassotherapy : 

Thalassotherapy Belgium; France; Germany; Italy; Soviet Union “thalassa” – Greek word for sea “heliotherapy” – use of sunlight for medical purposes “climatotherapy” – breathing or air saturated with sea spray “anemotherapy” – wind therapy

Sauna Baths : 

Sauna Baths Finland and Northern Russia Finish sauna (dry sauna) : 80-110 C (humidity 20-40%) Turkish/Japanese or steam bath: 45-50 C (humidity: 100%) Contraindications: Cardiac px Elderly px Pregnant women (1st trimester)

Carbon Dioxide Baths : 

Carbon Dioxide Baths Form of hydrotherapy using water which contains sufficient amounts of carbon dioxide to accumulate on skin “effervescent bath” Effects: Skin hyperemia Dec HR Dec BP Inc RR Inc CO

Kneipp Treatment : 

Kneipp Treatment Northern Italy, France and Holland Consists of alternating cold with hot applications given 1-3x for one to several months in combination with dietary regimen and regular walks Not employed for any specific condition