What is aquatic therapy?

What is aquatic therapy?

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Aquatic therapy, also known as aquatic physical therapy or water therapy, is a specialized form of physical therapy that takes place in a pool or aquatic environment. It involves performing exercises and rehabilitation activities in water, under the guidance of a trained physical therapist. The unique properties of the aquatic environment provide clinicians with treatment options that may otherwise be difficult or impossible to implement on land. The buoyancy, viscosity, and hydrostatic pressure of water provide unique therapeutic benefits, making aquatic therapy an effective modality for a wide variety of rehabilitation populations including, pediatrics,  cardiopulmonary, musculoskeletal and neurological patients.

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In aquatic therapy, the physical therapist designs an individualized treatment plan based on the patient's specific needs and goals. The therapy sessions take place in a pool heated to a comfortable temperature, typically between 90°F to 94°F (32°C to 34°C). The pool may be equipped with various features, such as adjustable water depth, underwater treadmills, resistance jets, and handrails to support exercises and movements.

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The specific purpose of aquatic therapy is to facilitate functional recovery by providing an environment that augments a patient’s and/or practitioner’s ability to perform various therapeutic interventions.

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Aquatic exercises can be used to achieve the following specific goals:

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• Facilitate range of motion exercises
• Initiate resistance training
• Facilitate weight bearing activities
• Enhance delivery of manual techniques
• Provide three-dimensional access to the patient
• Facilitate cardiovascular exercise
• Initiate functional activity replication
• Minimize risk of injury or reinjury during rehabilitation
• Enhance patient relaxation

Benefits of aquatic therapy

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Key benefits of aquatic therapy include:

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1. Buoyancy: The buoyancy provides the patient with relative weightlessness and joint unloading by reducing the force of gravity on the body. In turn, this allows the patient to perform active motion with increased ease. This can be particularly beneficial for individuals with weight-bearing restrictions or conditions that cause pain during land-based exercises.
2. Resistance: Water provides natural resistance, which can be used to challenge and strengthen muscles during exercises. This resistance can help improve muscle strength, performance and endurance.
3. Improved Balance and Stability: The hydrostatic pressure of water (pressure exerted by the water on immersed objects) provides gentle compression around the body, enhancing proprioceptive input and promoting better balance and stability during exercises.
4. Relaxation and Pain Relief: The warmth of the water and the hydrostatic pressure can induce a relaxing effect, reducing muscle tension and promoting pain relief.
5. Range of Motion: The support from water allows for improved range of motion in joints, making it easier to perform stretching and range-of-motion exercises.
6. Gait Training: Aquatic therapy can be especially helpful for gait training, as the reduced impact and support in water allow individuals to practice walking or stepping with less fear of falling.
7. Aerobic Conditioning: Aquatic therapy is also beneficial in improving cardiovascular and pulmonary conditioning of a patient, as it helps in regulating blood pressure and increasing lung capacity. 

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Aquatic therapy can benefit individuals with various conditions, including musculoskeletal injuries, chronic pain, neurological disorders, balance disorders, post-surgery rehabilitation, and conditions that affect mobility. It is often used in conjunction with other forms of physical therapy or as a transitional therapy between land-based exercises.

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As with any form of physical therapy, aquatic therapy requires the expertise of a licensed physical therapist trained in aquatic rehabilitation. The therapist will carefully assess the individual's condition and design a tailored treatment plan to achieve the best outcomes.

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Who would benefit from aquatic therapy?

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Aquatic therapy can benefit a wide range of individuals with various musculoskeletal, neurological, and medical conditions. It is particularly beneficial for those who may have difficulty with or limitations in traditional land-based exercises. The following groups of people may benefit from aquatic therapy:

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1. Individuals with Joint Pain and Arthritis: The buoyancy of water (upward force) makes aquatic therapy an excellent option for individuals with joint pain, or conditions like osteoarthritis and rheumatoid arthritis.
2. Post-Surgical Patients: Aquatic therapy can be an essential component of post-surgery rehabilitation, helping individuals regain strength, mobility, and function while minimizing stress on healing tissues.
3. People with Chronic Pain: The warmth and hydrostatic pressure of water can provide pain relief and relaxation, making aquatic therapy beneficial for those with chronic pain conditions.
4. Neurological Conditions: Individuals with neurological disorders, such as stroke, multiple sclerosis, and Parkinson's disease, may benefit from aquatic therapy for improving balance, gait, and overall functional mobility.
5. Athletes in Rehabilitation: Athletes recovering from sports-related injuries or orthopedic surgeries can use aquatic therapy to progress safely in their rehabilitation, as water provides a controlled environment for exercising.
6. Balance and Mobility Issues: Individuals with balance disorders, unsteady gait, or conditions affecting mobility can benefit from aquatic therapy to improve balance and stability.
7. Chronic Respiratory Conditions: Aquatic therapy may be helpful for individuals with chronic respiratory conditions like chronic obstructive pulmonary disease (COPD), as it allows for exercise while reducing the demand on the respiratory system.
8. Postpartum Women: Aquatic therapy can be beneficial for women during the postpartum period, providing a low-impact exercise option while promoting relaxation. It helps to improve both physical and mental health of the patient.
9. Children with Developmental Disorders : Aquatic therapy can be used to support children with developmental disorders such as cerebral palsy, autism, and global developmental delay, as the water environment encourages movement and sensory integration.
10. Aging Adults: Aquatic therapy is well-suited for older adults, as it provides a safe and effective means of exercise that reduces the risk of falls and promotes functional independence.
11. Individuals with Weight-Bearing Restrictions: Those with weight-bearing restrictions due to injuries, fractures, or medical conditions can engage in effective exercise in the buoyant water environment.

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Aquatic therapy can be used as a stand-alone treatment or as part of a comprehensive rehabilitation plan. The therapy sessions are tailored to each individual's needs and goals, and the exercises can be modified based on the person's condition and progress. 

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There are a lot of factors to be considered prior to initiating aquatic therapy (e.g. the severity of the condition and other underlying health problems), some may require close monitoring and not all of the patients with the conditions mentioned above can undergo this type of therapy.

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As with any form of therapy, it is essential to work with a qualified healthcare professional, such as a licensed physical therapist, experienced in aquatic rehabilitation. They will perform a thorough evaluation and develop a personalized treatment plan to ensure the best possible outcomes for each individual.

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Common aquatic therapy exercises

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Aquatic therapy exercises can vary depending on the individual's specific needs, goals, and medical condition. The physical therapist will design a customized treatment plan that includes exercises tailored to address the person's unique requirements. Here are some common aquatic therapy exercises:

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1. Water Walking: Walking forward, backward, and sideways in the water is an effective low-impact exercise that promotes mobility, improves cardiovascular fitness and strengthens leg muscles.
2. Water Marching: Marching in place with high knees in the water provides a gentle cardiovascular workout and helps improve balance and coordination.
3. Leg Swings: Holding onto the pool wall for support, swinging one leg forward and backward or side to side can enhance hip flexibility and strengthen hip muscles.
4. Heel Raises: Standing near the pool wall, lifting the heels off the pool floor and then lowering them back down helps strengthen calf muscles.
5. Knee Lifts: Bringing one knee toward the chest while standing in the water helps strengthen hip flexor muscles and improves balance.
6. Hip Abduction/Adduction: Moving the leg away from and toward the midline of the body while standing in the water helps strengthen hip abductor and adductor muscles.
7. Arm Circles: Performing circular motions with the arms underwater and using hand paddles or webbed gloves for added resistance provides shoulder range of motion and strengthens shoulder muscles.
8. Wall Push-Offs: Using the pool wall for support, individuals can push off the wall and walk or swim short distances, working on leg and core strength.
9. Water Jogging: Jogging in place or moving across the pool while maintaining constant movement is an excellent cardiovascular exercise.
10. Balance Exercises: Balancing on one leg or performing single-leg movements in the water challenges balance and proprioception.
11. Core Strengthening: Various exercises, such as water crunches or pelvic tilts in a seated position, help strengthen the core muscles.
12. Trunk Twists: Rotating the torso from side to side in the water can improve spinal mobility and strengthen core muscles.
13. Arm Rowing: Using water resistance to mimic rowing movements with the arms helps strengthen the back and shoulder muscles.
14. Stretching Exercises: Patients may tolerate immersed stretching exercises better than land stretching because of the effects of relaxation, soft tissue warming, and ease of positioning. Stretching exercises helps to improve range of motion of the restricting tissues.
15. Resistance Training: Immersed resistance exercises are more beneficial and may be safely initiated earlier in the rehabilitation program than traditional land resistance exercises, as it helps reduce joint compression, provides three-dimensional resistance, and decreases perceived pain. Equipment such as resistive paddles, hydro-tone bells (aquatic dumbbells) may also be utilized to generate more resistance in the water. 
16. Aquatic Treadmill (Immersed treadmill walking or jogging): Walking or jogging on an immersed  treadmill can be used to improve gait mechanics, cardiovascular endurance and leg strength.
17. Swimming Strokes: For patients able to tolerate positions necessary to perform various swim strokes, swimming may be an excellent tool to train and improve cardiovascular fitness. Swimming may elicit significantly higher elevations of heart rate and blood pressure than other aquatic activities. It also contributes to the added benefit of hip and trunk strengthening. 

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It is important to note that aquatic therapy exercises should be performed under the guidance of a trained physical therapist. The therapist will ensure that exercises are appropriate for the individual's condition and help them progress safely. The water's buoyancy, viscosity, resistance, and hydromechanics offer unique benefits for rehabilitation and exercise, making aquatic therapy a valuable option for individuals with a wide range of medical conditions and fitness levels.

Trust PeteHealth for aquatic therapy

Looking for a physical therapist to help you provide expert, tailored aquatic therapy? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

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Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

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*Please note aquatic therapy is only available for PeteHealth patients with access to a pool

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