Aquatic therapy precautions and contraindications

Aquatic therapists are always looking for ideas on what conditions should be contraindicated for aquatic therapy.

Before you make your final decision, ensure that you never plan to see someone with a given condition in the water before you add that condition to a contraindication list. Otherwise, it should become a precaution -- a "red flag" but not an absolutely forbidden condition.

The following list is ONE example of how clinics might categorize the distinction between precautions and contraindications. Your clinic must make its own decisions.

Sample Precautions List:

• Bowel incontinence with firm stools (pt should be on stool program and wear plastic pants into pool)
• Communicable diseases (cold flu, Hepatitis)
• Autonomic dysreflexia
• Sensitivity to disinfection chemicals
• Sensitivity to heat/ humidity (e.g Multiple Sclerosis)
• Rashes, skin conditions with flaking or open areas (psoriasis)
• Orthostatic hypotension
• Hydrophobia
• Combative or difficult to control population
• Poor cognition
• Dependence in ambulation
• Controlled seizures, exercise-induced angina, controlled diabetes
• Open wounds with bio-occulsive dressing
• Compromised immune system (e.g. low T-cell count)
• On chemotherapy for cancer
• On dialysis for renal/kidney dysfunction

Sample Contraindications List:

• Uncontrolled seizures, unstable angina or uncontrolled diabetes
• Bowel incontinence with diarrhea, and no stool program
• Open wounds or bleeding without bio-occulsive dressing (including menstruation without internal protection)
• Tracheotomies until healed
• Acute flare-up active joint inflammation (rheumatoid arthritis, hemophilia)
• Orders for NPO (nothing by mouth)
• Presence of DVT (deep vein thrombosis) without anticoagulation therapy or filter

Comments

[MARY ELLEN HARRIS]

Hey aquatic gang, I have a patient referred who is undergoing kidney dialysis 3x/wk- can he get into the water?