the aquatic therapist

Low back pain and aquatic therapy: Helpful combination say researchers

 

Waller B, Lambeck J, Daly D. Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil. 2009 Jan;23(1):3-14.

University of Jyväskylä, Finland.

Objective: To examine the effectiveness of therapeutic aquatic exercise in the treatment of low back pain.

Design: A systematic review.Methods: A search was performed of PEDro, CINAHL (ovid), PUBMED, Cochrane Controlled Trials Register and SPORTDiscus databases to identify relevant studies published between 1990 and 2007.

Population: Adults suffering from low back pain. Intervention: All types of therapeutic aquatic exercise. Comparison: All clinical trials using a control group. Outcomes: Oswestry Disability Index, McGill Pain Questionnaire, subjective assessment scale for pain (e.g. visual analogue scale) and number of work days lost as a direct result of low back pain. Methodological quality was assessed using the PEDro scale and the SIGN 50 assessment forms.

Results: Thirty-seven trials were found and seven were accepted into the review. Therapeutic aquatic exercise appeared to have a beneficial effect, however, no better than other interventions. Methodological quality was considered low in all included studies. The heterogeneity among studies, in numbers of subjects, symptoms durations, interventions and reporting of outcomes, precluded any extensive meta-analysis of the results.

Conclusion: There was sufficient evidence to suggest that therapeutic aquatic exercise is potentially beneficial to patients suffering from chronic low back pain and pregnancy-related low back pain. There is further need for high-quality trials to substantiate the use of therapeutic aquatic exercise in a clinical setting.

Open Meme Friday: The Economy and Your Practice

First there was the mortgage bubble. Then there was the credit crunch. Now there are layoffs. While the experts are waiting for "the bottom", the rest of us are keeping a tight reign on our spending. Ordinarily, this should not effect the healthcare industry because consumers of HC services don't normally pay out-of-pocket for their care but we are starting to hear rumblings; rumblings of hospital cutbacks and rumblings of facility closures.

Taking in what the pundits think is one thing but we want to hear it from the aquatic street so we are turning on the comments this weekend to hear from you.  How has your aquatic therapy practice been trending the last few months? How does the economic downturn look in regard to your census? Have your referrals dried up? Have you had to let staff go? Or have your profits tracked even with last year or actually gone up? Contribute to this meme by clicking on the comments link below. The stories you tell may dictate how we all do business in the next 12-18 months.

Another nail in the coffin of the only-weight-bearing-exercises-will-improve-bone-density theory

You've heard the conventional wisdom. Aquatic exercise is nice, but what about bone loss? Only weight-bearing activities can retard (and even reverse) bone loss. Right?

Hmmm. Well someone better tell these guys, soon.

Rotstein A, Harush M, Vaisman N. The effect of a water exercise program on bone density of postmenopausal women. J Sports Med Phys Fitness. 2008 Sep;48(3):352-9.

Department of Life Sciences, Zinman College, Wingate Institute, Netanya, Israel. rotstein@wincol.ac.il

AIM: The aim of the present study was to examine the effect of a seven months program of water exercise, on bone mineral density (BMD) in postmenopausal women.

METHODS: Thirty-five postmenopausal women trained for seven months for three one-hour sessions per week. DEXA test findings for vertebrae L2-L4 showed that although the time factor had a significant effect only on the bone mineral content (BMC), (4.61 P < 0.05), the interaction of time group was found to be significant for each of the variables: BMD (9.25 P < 0.01), BMC (7.99 P < 0.01), z-score (5.35 P < 0.05) and t-score (9.41 P < 0.01).

RESULTS: These interactions indicate a general trend towards maintenance or improvement of bone status in the experimental group and a trend towards declining bone status for the control group. DEXA test findings for femoral neck density indicated no significant differences between the groups pre and post treatment. However a significant interaction was found for BMC (8.08 P < 0.01) in the right leg indicating an increase trend in BMC in the experimental group and a trend towards decrease for the control group.

CONCLUSION: The findings of the present study support the hypothesis that it is possible to plan and execute a water exercise program that has a positive effect on bone status of post-menopausal women.

Add deep water running to your therapy sessions ... To improve balance???

 

For many years, therapists have been advised that aerobic training (like deep water running) may not be billable unless tied to a client's specific cardiopulmonary deficit. We knew the benefits of deep water work for cardiovascular health, mood, pain control and healing rates. But, balance?

This study, just published in the Journal of Aging and Physical Activity helps make the case for spending time in the deep end... to improve the balance and reaction time of our clients.

Kaneda K, Sato D, Wakabayashi H, Hanai A, Nomura T. A comparison of the effects of different water exercise programs on balance ability in elderly people. J Aging Phys Act. 2008 Oct;16(4):381-92.

Graduate School of Comprehensive Human Science, University of Tsukuba, Japan.

This study compared the effects of 2 types of water exercise programs on balance ability in the elderly. Thirty healthy elderly persons (60.7 +/- 4.1 yr) were randomly assigned to a deep-water-running exercise (DWRE, n = 15) group or a normal water exercise (NWE, n = 15) group.

The participants completed a twice-weekly water exercise intervention for 12 wk. Exercise sessions comprised a 10-min warm-up on land, 20 min of water-walking exercise, 30 min of water exercise while separated into NWE and DWRE, a 10-min rest on land, and 10 min of recreation and relaxation in water.

Postural-sway distance and tandem-walking time were decreased significantly in DWRE. Postural-sway area was decreased significantly in NWE. In both groups, simple reaction times were significantly decreased.

The findings of this study show that a water exercise program including deep-water running is much better than normal water exercise for improving dynamic balance ability in the elderly.