the aquatic therapist

Watsu® for CVA patients: Water shiatsu comes into its own in the world of aquatic therapy research

(photo: aquatichealing.com)

It wasn't too many years ago when Watsu® was little known in the world of western medicine.

Well, 28 years after its inception, therapists across the globe can now read about using Watsu for their most disabled clientele.

It's validating for those of us who first learned Watsu back in the 80's and 90's to watch it make such a mark on westernized medicine. We always knew the beauty, the power and the effectiveness of Watsu. It's just that now it's been published.

Watsu® is a registered trademark of the Worldwide Aquatic Bodywork Association.

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Well, Chon SC, Oh DW, Shim JH. Watsu approach for improving spasticity and ambulatory function in hemiparetic patients with stroke. Physiother Res Int. 2008 Sep 30.  [Epub ahead of print]

ABSTRACT
Background and Purpose. This study reports the effect of Watsu as rehabilitation method for hemiparetic patients with stroke.

Method. Watsu consisted of 40 treatment sessions for 8 weeks, delivered underwater or at water surface level, it applied in three patients. Outcome measures included tools for assessing spasticity and ambulatory function.

Results. All patients showed decreased scores in the TAS and RVGA after Watsu application. Conclusions. Watsu was helpful in controlling spasticity and improving ambulatory function of the patients with hemiparesis. Copyright (c) 2008 John Wiley & Sons, Ltd.

AUTHOR AFFILIATIONS: Physiotherapy Section, Department of Rehabilitation Medicine, Hanyang University Hospital, Seoul, Korea.

What to do if you are not getting the weekly eSplash (aquatic therapy industry newsletter)

Aquatic therapy gurus,

Many of you who signed up for our Aquatic Resources Network weekly eSplash have told us you are still not getting it. This may be because the email has photos/graphics which can tend to plop it into your spam folder.

To make it even easier, we took all the back issues and put them on the web.

For archived copies, go to:

http://archive.constantcontact.com/fs054/1102184430637/archive/1102261598185.html

Here are a few topics we've covered recently:

• 2 second test to determine if you are suffering from low-grade chronic dehydration
• Why Medicare changed their mind about community pool rental exclusivity
• What to do if your payers don't recognize aquatic therapy
• Sensory integration tips for pediatric therapists... and much more

Andrea Salzman, MS, PT
Aquatic Resources Network
www.aquaticnet.com

The shoulder isn't getting the cold shoulder anymore. Aquatic therapy works for the upper extremity, too

Finally! Some research that looks at aquatic therapy for the shoulder. And the conclusion is a nice verification of what we have always thought to be true... that aquatic therapy is a viable alternative to traditional land-only therapy.

Isn't it sweet to be validated?

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SOURCE: Brady B, Redfern J, MacDougal G, Williams J. The addition of aquatic therapy to rehabilitation following surgical rotator cuff repair: a feasibility study. Physiother Res Int. 2008: Sep;13(3):153-61

ABSTRACT:

BACKGROUND AND PURPOSE: Rotator cuff tears are frequently encountered in medical outpatient settings and often require surgical repair to achieve desirable functional outcomes. However, the optimal form of post-operative rehabilitation of rotator cuff repairs remains unidentified by the research literature. The aim of this study was to determine the feasibility of implementing and investigating the effect of a combined aquatic and land-based rehabilitation programme in the post-operative rehabilitation of rotator cuff tears.

METHODS: A cohort of 18 subjects undergoing rotator cuff repair were examined over a treatment period of 12 weeks. Twelve subjects participated in a combined aquatic and land-based programme, while six subjects received a standard land-based protocol. Passive range of motion and the Western Ontario Rotator Cuff Index outcomes were measured pre-operatively and at three, six and 12 weeks, post-operatively. Subjective responses on patient's assurance and confidence in the value of the exercises (questionnaire using an 11-point Visual Analogue Scale (VAS)) were collected at 12 weeks for both groups.

RESULTS: There was a significant improvement in both range of motion and Western Ontario Rotator Cuff scores in all subjects with treatment (p < 0.001). Furthermore, participation in aquatic therapy significantly improved passive flexion range of motion measures at three weeks (mean 46 degrees , 95% CI 17-75, p = 0.005) and six weeks (30 degrees , 95% CI 8-51, p = 0.01). There was no significant difference in the attendance rates (80% in both groups) or patients perceptions of the programmes (100% confidence and assurance in both groups).

CONCLUSION: The implementation of a combined aquatic and land-based physiotherapy programme following surgical repair of the rotator cuff is feasible and presents a potential viable alternative to conventional land-based exercise with comparable outcomes.

Copyright (c) 2008 John Wiley & Sons, Ltd.

Looking for practical ideas for treating sensory integration in the pool? Sign-up for our webcast

Tired of attending a seminar and going home with no immediately practical ideas for treating your pediatric clientele on Monday morning?

Well, our Aquatic Sensory Integration webinar is chock-full of practical treatment ideas generated from working with OTs, COTAs, PTs, PTAs, SLPs, adapted aquatic instructors and even a few hydrotherapists from Israel!

We have created a budget-conscious method for learning how to transform your therapeutic pool into a sensory integration "room".

To watch our 90 minute webcast, you only need a high-speed internet connection. If you know how to log onto a webpage, you can attend our webinar. And for $199, your entire office can watch along with you.

Shoot. Project it on a wall, order subs, and make our webcast into your in-house inservice!

Our live-streamed seminar will show you how to create 16 sensory stations in your home pool -- so that no matter what area your patient gravitates, you will always have a treatment plan.

With a few inexpensive toys (a flow-through mat, a child's plastic slide, a canvas hammock) your pool will become a joy to work in.

<more info on "Get Dressed Relay" under photo...>

Masterton Recreation Centre. A glimpse of the indoor children's pool. There is also an outside complex with a large pool, plus a diving pool. Also a water slide, children's pools and picnic tables.

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Here's one idea we'll be discussing on Tuesday, December 2, 2008 (1PM Eastern/12 noon Central).

Problem: Difficulty with body awareness.

Scenario: Your 6-year old patient has trouble donning his clothing correctly in the mornings.

Practice the “Get Dressed Relay” in the pool. Put various articles of clothing in two opposing corners of the deck.

Have your patient either swim or gutter crawl (hand-cruise along the edge of the pool) from the first location to the second and then climb up onto the side of the pool. He will pick a clothing item from the pile, put it on, swim (or crawl) to the second location (usually 14-20’ away), climb out of the pool and put on another piece of clothing. He will repeat this until fully dressed.

To make it even more challenging, require your patient to put on the clothes in an appropriate order (for instance, boxer shorts and tshirt first, socks second, pants and shirt third, belt and shoes last). This drill provides extensive amounts of proprioceptive input and problem-solving and kids love it.

[Idea courtesy Karen Reckamp, OTR/L, ATP, Wolfson Children’s Rehabilitation, Jacksonville, FL]

Why balance train in water & how to convert the Berg Balance Assessment into an aquatic challenge

Why balance train in water? Read the 2008 full text research which supports this idea (article is in Portuguese and English).

In the water, patients may be challenged beyond limits of stability without the fear of consequences of falling which are often present with land-based balance training. The environment leads to improvement in balance reactions which are translatable to land.

(Read Andrea Salzman's Converting the Berg Balance Test into an aquatic challenge)

 

Movement through water is affected by turbulence and viscosity. Water is more viscous than air, and resistance to flow through water is greater than resistance to flow through air. Thus, it takes more force to push through water molecules than to push through air molecules.

Additionally, the faster an object is pushed through the water, the more turbulence is created and this creates additional resistance to movement.

A body immersed is surrounded by a viscous fluid which retards the speed of movement. This viscosity prevents rapid falling and elongates the period of time in which a patient can respond to a shift of his center of mass outside his base of support.

Additionally, the natural end result of a loss of balance which is not corrected is a fall into a compliant fluid (water) and not a fall to a noncompliant solid (the ground). Thus, the patient may be challenged to move outside his base of support without fear of traumatic consequences.

This reduction in patient anxiety may encourage the patient to attempt tasks which he would not attempt on land. It becomes possible to elicit balance challenges which the patient has both time and mental confidence to combat. On land, without the assistance of such aquatic properties, the resultant balance responses may be incomplete or absent.

So, it makes sense that aquatic based balance training could lead to an improvement in balance on land.

Link to Andrea Salzman's adaptation of the Berg Balance Assessment into a 30 minute aquatic treatment for your balance patients.

2008 research source: Resende SM, Rassi CM, Viana FP. Effects of hydrotherapy in balance and prevention of falls among elderly women. Rev Bras Fisioter. 2008;12(1):57-63.

Beat the CEU rush with our Last Gasp webinars coming Dec 08

Running out of time to get your 2008 continuing education credits? Don't like to travel?

This year, bypass the nightmare of smokey hotel rooms and embarrassing body searches by registering for our Last Gasp Aquatic Therapy eCourses instead.

Pick the topics (online poll)

Price is $199/webinar and includes:

• handouts,
• bibliographies,
• CEU credits for OTs, ATCs and PTs
• and more!

With a few clicks of a mouse, you can get up to 6 CEUs from the comfort of your own home or office by joining one of our four online webinars.

Water based work conditioning

Here is an interesting article published June 2008 in Rehab Management on using the pool for work conditioning.

Read more...

ATRI (Aquatic Therapy & Rehab Institute) Celebrates Winners in 2008

 

Marty Biondi, PT, CSCS, ATRIC, has been named the recipient of the 2008 Aquatic Therapy Professional Award. The award was presented at the 16th Aquatic Therapy Symposium, July 3rd in Fort Myers, FL by the Aquatic Therapy & Rehab Institute (ATRI).

Tsunami Spirit Awards were presented to Melissa Lewis, MPT, ATRIC, NCCARD, Mick Nelson, BS, MS, and Sue Nelson, BS, ATRIC.

Aquatic Therapy Dolphin Awards were presented to SFC Vincent Fanning, US Army Retired, and Bess Maxwell, PhD, PT.

The Aquatic Therapy Professional Award recognizes outstanding professionalism and contributions to the aquatic therapy industry.

Previous Aquatic Therapy Professional Award winners include:
Gwen Garrett, MA, OTR/L; Lynette Jamison, MOT, OTR/L; Peggy Schoedinger, PT; Igor Burdenko, PhD; Alison Osinski, PhD; Andrea Salzman, MS, PT; Johan Lambeck, PT; Bruce Becker, MD, Paula Briggs, MS, ExPhys, ATRIC; Ann Wieser, MS, PhD, ATRIC; Dori Maxon, PT, PCS, MEd, ATRIC; Mary Essert, BA, ATRIC; Luis Vargas, PhD, PT, ATRIC; and Mary Wykle, PhD, ATRIC

To read more...

Describing what you do in the therapy pool: Aquatic specialty techniques

 

(Illustrations by Nick Orabovic; ©2008, Aquatics International)

Constantly searching for a quick and dirty way to describe exactly what you do in the therapy pool? Payers, doctors and patients may not have heard of terms like "Ai Chi" or "Watsu®" -- so how do you explain them in an easy-to-understand and completely accessible way?

Well, once again, the Aquatic Resources Network has done it for you.

Check-out the 2008 series we published in Aquatics International.

In each monthly column of WaterFitness, Andrea Salzman describes (and Nick Orabovic illustrates) the most popular aquatic specialty techniques.

Click the links to access each short, informative article:

• Aquatic PRE
• Aquatic PNF
• Aquatic spinal stabilization
• Ai Chi
• Bad Ragaz Ring Method
• Cardiorespiratory conditioning
• Watsu

Watsu® for orphans: What better way to celebrate aquatic therapy worldwide?

What better way to celebrate World Watsu® Week (April 20-26, 2009) than to donate water therapy sessions for children living in orphanages and childcare institutions?

Watsu providers from all over the world (Brazil, Haiti, France, Great Britain, USA, Lithuania, Poland, Hungary, Thailand and Africa) are joining in.

Watsu for Orphans was initiated by Basia Szpak Borst, a Watsu practitioner and instructor from the Netherlands, and is supported by an Endowment Fund.

This project is an opportunity for orphanages to learn about this ground-breaking water therapy (Watsu) and to benefit from the installation of mobile pools donated by the Endowment Fund wherever technical possibilities allow their installation.

The long-term objective of the donation is to ensure continuous presence of Watsu practitioners and therefore enable participating institutions to integrate Watsu into their existing therapeutic and pedagogical programs.

But why water for these children?

As just one example, look to Bulgaria where the Ministry of Health is monitoring a 10-year follow-up of babies from an orphanage. They found that these children had a greater chance to be adopted because of a 20-minute a day medical water training.

Quick links for more info:

Watsu for Orphans newsletter update (newsletter is in English)

Website - Watsu for Orphans

Videoclips - Watsu sessions

Watsu for Children book chapter