Hydrotherapy means application of water, either internally or externally, for the treatment of physical or psychological dysfunction.

Properties of water
1. 2. 3. 4.

Specific heat and thermal conductivity Buoyancy Resistance Hydrostatic pressure

Physiological Effects Of Hydrotherapy

1. 2. 3. 4. 5.

Cleansing effects Musculoskeletal effects Cardiovascular effects Respiratory effects Renal effects

Uses of Hydrotherapy
1. 2. 3. 4.

5.

Superficial heating or cooling Wound care Water exercise Pain control Edema control

Application techniques
1.

Whirlpool Equipment required: Hot and cold water mixing valves Thermometer Turbine Seat or stretcher Gravity drain Heated, well ventilated space Towels and blankets

LOW-BOY WHIRLPOOL

EXTREMITY WHIRLPOOL

Advantages: i. Can be used for heat transfer, cleansing, debriding open wounds, exercise. ii. Patient can be positioned securely and comfortably. iii. Weaker muscles can move more freely than on dry land. iv. Allows movement while heat is being applied.

Disadvantages: i. Size of tank limits amount of exercise and size of area that can be treated. ii. Risk of infection iii. Costs associated with cleaning, maintenance.

2. Hubbard tank : Equipment needed : Hot and cold water mixing valves Turbine to agitate and aerate the water Seat or stretcher for the patient to sit Gravity drain Heated, well ventilated space Towels and blankets

Advantages: i. Can be used to treat large or multiple areas of the body ii. Can be used for heat transfer, cleansing or debriding the wounds, or for water exercises.

Disadvantages i. Costly to provide treatment. ii. Costly equipment and space requirement iii. Requires extra caution with regaurd to possible systemic effects of overheating with large amount of body area exposed

3. Contrast Bath : Equipment required : Two water containers Thermometer Towels

Advantages: i. Promotes vigorous circulatory effect than heat or cold alone. ii. Provides good contact with contoured distal extremities compared to other thermal agents. iii. May help to provide pain control without aggravating edema. iv. Allows movement in water for increased circulatory effects.

Disadvantages: i. Limb is in dependent position which may aggravate edema. ii. Some patients do not tolerate cold immersion.

4. Non-immersion Irrigation Device: Examples : Shower cart, hand-held; Showers, syringes, electric; Pulsatile irrigation devices. Equipment needed: Non-immersion irrigation device. Irrigation fluid usually bags of sterile saline. Towels

Advantages: i. Control of fluid pressure. ii. Reduced risk of inflammation. iii. Less time consuming. iv. Saves expenses. v. Reduces risk of hyponatremia. vi. Can be used where whirlpool treatment is not recommended.

Disadvantages: i. Does not provide the therapeutic benefits associated with the buoyancy and hydrostatic pressure of immersion hydrotherapy.

5. Exercise pool : Equipment needed: Appropriate space for pool Non slip area around pool Water supply Safety equipment Infection control equipment, including pump and filter, chemicals and testing kit Towels Thermometer

Advantages : i. Patient can move freely, without the risk of falling. ii. Decreases weight bearing on joints. iii. Buoyancy may assist weak muscles to allow increased performance of active exercise.

Disadvantages: i. Difficulty stabilizing and isolating body parts during exercise.

1.

2.
3. 4. 5. 6.

Decreased tone Stimulate righting reactions Increase range of weak muscles Stimulate correct pattern of movement Stimulate functional movement patterns Encourage and develop efficient breath control

7. Produce psychological effects 8. Treat orthopedic complications 9. Increase cardiovascular fitness

1.

2.
3. 4. 5. 6.

Acute vomiting or diarrhea Recent Heart Attack or Resting Angina Wound Infection Skin Infection Recent Neurological Event Recent chemotherapy or radiotherapy

7. Recent DVT or Pulmonary embolism. 8. Incontinence 9. Sexually transmitted disease 10. Fever 11. Uncontrolled epilepsy 12. Uncontrolled diabetes

Precautions
1. 2.

3.
4. 5. 6.

Controlled Epilepsy Fear of water Hemophilia High or Low blood pressure Poor skin integrity Pregnancy if water exceeds 35 degrees Celsius

Physical Agents in Rehabilitation by Michelle H. Cameron - Saunders Publications.