Ask ARN: Should the tracheostomy patient be allowed to do aquatic therapy?

The Aquatic Resources Network gets questions from clinicians each day. We think everyone should learn from the answers!

Question: Is it contraindicated for a patient with a tracheostomy to get into the pool for aquatic therapy?

Answer: The answer is: It depends! Many clinics consider a trach a contraindication -- there is too big a risk for any benefit the client may receive. For those who decide to allow patients with an open trach into the water, here is one research article which may assist in that difficult decision. (more to come in future postings...)

Authors: Taylor,S.
Title: The ventilated patient undergoing hydrotherapy: a case study
Periodical, Full: Australian Critical Care
Pub Year: 2003
Pub Date Free Form: Aug
Volume: 16 Issue: 3
Start Page: 111-115
Descriptors: Neurological; Liability; Adverse Effects; Metabolic and Systemic; Tracheotomy; Best

Abstract: The ascending peripheral neuropathy and paralysis that result from Guillain-Barre Syndrome's (GBS) demyelination of peripheral nerves is a challenge to health professionals; the patient requires support during the acute disease process and during the remyelination recovery period, often lasting months to years. The staff of a major metropolitan teaching hospital's critical care unit (CCU) and physiotherapy departments developed a hydrotherapy treatment programme for a ventilated patient with GBS. Through careful planning and appropriate preparation, it was found that hydrotherapy could successfully and safely be incorporated into a patient's treatment regimen. The benefits included improved range of movement due to the supportive nature of water, anecdotal increased strength, size and movement of remyelinating muscles and a psychological improvement. Although this patient has not recovered from GBS to be independent, hydrotherapy was a valuable part of the treatment regimen and it could be suggested the increase muscle strength lead to improved respiratory function and enabled weaning from ventilation, reducing intensive care length of stay and cost.